[liberationtech] eHealth Project of the Bangladesh Knowledge Management Initiative

[Yosem Companys]

From: Vanessa Mitchell <pa2worries at gmail.com>

My name is Vanessa Mitchell and I’m a Senior Program Officer at the Johns 
Hopkins Center for Communication Programs (JHU.CCP) in Baltimore, Maryland. 
I’m thrilled to be able to discuss with you an eHealth pilot which was a 
large component of a USAID-funded project that our team worked on in 
Bangladesh called the Bangladesh Knowledge Management Initiative (BKMI), 
under the global Knowledge for Health project (K4Health).

Government field workers in Bangladesh, known as Health Assistants and 
Family Welfare Assistants, have a lack of accurate and up-to-date 
information, tools and trainings to do their jobs, which contribute to the 
country’s low health indicators, especially for family planning, maternal 
and child health and nutrition. Field workers also have weak interpersonal 
communication and counseling skills (IPCC) and have trouble integrating 
messages within counseling sessions in order to address multiple health 
issues in one session.

The eHealth Pilot offered an opportunity for the Government of Bangladesh 
to explore solutions through innovative technology. BKMI developed an easy 
to use Health Population and Nutrition (HPN) eToolkit, or HPN digital 
library, and video-based eLearning courses for low literacy field workers. 
Three-hundred netbooks equipped with the eToolkit and video eLearning 
courses were distributed to field workers who worked in two of the lowest 
performing districts in Bangladesh, Sylhet and Chittagong. Following 
training by BKMI, the field workers used the digital resources on the 
netbooks for 4 months to improve their own knowledge, and facilitate their 
usual counseling activities with mothers in households and clinics.

The results of the eHealth pilot are compelling and are summarized in the 
BKMI eHealth Pilot Results Summary (
https://www.jhuccp.org/resource_center/media/bangladesh-knowledge-management-initiative-ehealth-pilot-results-summary). 
Some results, such as increased field worker knowledge, were expected; 
others, such as the field workers’ improved ability to integrate key 
messages during counseling, and an overall increase in demand for HPN 
information in communities, were more surprising.

 

BKMI has developed a short film to illustrate the eHealth Pilot results. 
The documentary, available in a full version 
https://www.jhuccp.org/resource_center/media/bkmi-ehealth-pilot-documentary-full-version 
(12 minutes) and a short version 
https://www.k4health.org/resources/bkmi-ehealth-pilot-documentary-short-version 
(5 minutes), explains the process, successes and challenges of the eHealth 
pilot. In the documentary, Rafiq and Kawsar, two field workers from 
Chittagong and Sylhet who participated in the eHealth pilot, discuss how 
they improved their knowledge and skills around family planning, maternal, 
newborn and child health and nutrition and began to change health behaviors 
in their communities.

After a successful pilot, what’s next? Well we hope that we’ll be able to 
cost-effectively scale the eToolkit and the eLearning courses nationally, 
so that all government field workers and health care provider in Bangladesh 
can have access to them. The Ministry of Health and Family Welfare (MoHFW) 
is ready for this as well, and our team is developing a proposal for how 
this can be done. However we expect challenges with how to load these 
digital resources in an offline format on about 24,000 tablets (located in 
clinics and with Health Assistants) which are Android based, and another 
15,000 computers which are Windows based. We know we need installers for 
each and also need a solution for how to keep the information current on 
the computers (but maintain offline accessibility).  In addition to the 
scale-up plan, BKMI 2 plans to conduct additional research, under the name 
of Alo meaning Light (to bring light to the community), in order to further 
study the impact of digital resources including our eToolkit, Interpersonal 
Communication and Counseling (IPCC) and Integrated Messaging (IM) trainings 
for field workers, on behavior change in communities.

I would love to hear from others in this group what considerations we need 
to take into account when scaling, and if there are any IT people in the 
group, how can we scale up nationally on Android and Windows and remain 
offline? How would you staff a scale-up team in a country if this was your 
project? From a research perspective, what else would be interesting to 
study with field workers use of information and behavior change in 
communities? Any suggestions are welcome! Thanks!

Vanessa
________________________________

Vanessa L. Mitchell, MPH | Senior Program Officer | Knowledge for Health 
(K4Health)
Johns Hopkins Bloomberg School of Public Health Center for Communication 
Programs (JHU∙CCP)
vanessa.mitchell at jhu.edu | www.k4health.org| 410-659-2657 | Skype: 
vanessamitchell | @K4Health
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