For us, it’s a strong indication that the use of mobile and web technologies is becoming more widely accepted in the public health community as a viable and valuable tool in tackling primary health care issues.

The presentations at the conference where Mobile Researcher was involved include:

• Experiences of using cell phones in data collection in a large scale project (V. Magasana, P. Ijumba, Z. Msimela, S. Ndwandwe, N. Radebe, M. Msweli, S. Mavuso)
• Using a web based information system to manage the implementation of a randomised controlled trial (P. Ijumba, Y. Singh, M. Tomlinson)

Several other organisations present findings on studies where Mobile Researcher was also leveraged as a data collection tool.

The presentation will highlight the methodologies, strategies and technologies utilised in the design of the Good Start Management Console (GSMC). The GSMC is a web-based system which was built to leverage the Mobile Researcher Application Programming Interface (API) to allow the activities involved in a large-scale randomised control trial to be closely managed and monitored. Community Health Workers (CHWs) make use of low end mobile phones and complete simple surveys which are fed back directly to the GSMC.

Mark will be presenting the paper as I will be overseas, so if you’re in Johannesburg during those dates and are interested in health informatics, be sure to register – the conference is sure to have a number of insightful speakers and perspectives.

If you’d like to learn more about the GSMC, the case study is a good place to start.

Leveraging the Mobile Researcher API to integrate, automate and guide the processes involved in a multi-site, longitudinal clinical intervention project. Download the case study.

Organisation Profile

The South African Medical Research Council (MRC) is a statutory council mandated by government to improve the nation’s health and quality of life through promoting and conducting relevant and responsive health research.  As one of the largest research organisations in the country, the MRC is able to embark on large-scale long-term projects which break new ground in a range of areas including HIV/AIDS.

Project Scope

The MRC’s “Good Start” study focuses on interventions for the Prevention of Mother to Child Transmission (PMTCT) of HIV and strategies to improve neonatal survival.  The project involves over 40 members of staff and, over the course of its 3 year term, several thousand participants.

Following the successful completion of two preceding phases, participant recruitment of pregnant mothers residing in Umlazi, a township located outside Durban South Africa by Community-based Health Workers (CHWs) began in 2008. Consenting participants, randomly assigned to a control or intervention group based on their household location, receive antenatal and postnatal CHW visits with the view to assess the effectiveness of the intervention strategy.

Antenatal visit dates are based on the mother’s expected date of delivery.  Postnatal visits must take place at specific intervals dependent on the date on which the mother is discharged from her delivery facility.  Operational information from each visit is required which must be relayed to supervisors to facilitate planning and ensure adherence to the visit schedule.  Birth information must be gathered and disseminated immediately to allow for time-critical postnatal visits to take place on time.

The duration a participant remains active in the study varies between 3 and 12 months depending on when she was identified and enrolled.  Upon the completion of applicable visits, an assessment interview is held at Prince Mshiyeni Hospital in Umlazi with a data collector.

Complexities relating to participant exclusions, additional visits for low birth weight infants, multiple possible delivery locations, and severely limited infrastructure posed significant challenges to the MRC’s team.

Mobile Researcher Implementation

Mobile Researcher, used in phase two of the project, was again leveraged as the data collection and communication platform and formed the base on which the development of a portal to cater for the project’s custom logistical, operational and reporting requirements was built.  CHWs could use their entry level handsets (used previously for the collection of baseline data), to complete surveys about each participant visit.  This feedback, along with information regarding enrolment and birth events from data collectors –also captured via low cost mobile phones– was exposed by the Mobile Researcher Application Programming Interface (API) for incorporation into the purpose-built web portal – the Good Start Management Console (GSMC).

The GSMC leverages information from a variety of sources, including data captured on mobile phones to schedule, track, monitor and coordinate the operational activities necessary to fulfil the project mandate.  Supervisors, administrators and managers may login to see, at a glance, the current status of a participant, their upcoming milestones, notes, observations and previous interactions.  Only specific information based on a user’s role is available ensuring that blinding – a common requirement for most intervention studies – is not compromised.

Lasting Impact

The weekly meetings held with CHWs are informed by the wealth of information managed by the GSMC.  Visit schedules which are automatically generated by the system based on the most recent interactions may be printed for each CHW.  As visits take place and are captured in the field, the web-based portal updates to reflect a near real-time view of the progress on the ground.  Reported births from data collectors trigger scheduling of postnatal visits and notifications to supervisors.

Paper forms have been largely removed and data has become centralised and available to authorised project staff for their specific operational, analysis and reporting needs.  Subsequent enhancements will provide detailed performance reports, dashboards and additional functionality to further guide and assist in the successful implementation of this landmark study.

The MRC selected Mobile Researcher, a locally developed research platform, for a large-scale baseline study conducted in Umlazi, KZN. Equipped with standard cellphones, fieldworkers were able to capture and upload responses from within the mobile application, eliminating the need for paper and subsequent data capture.

The Medical Research Council of South Africa is one of the largest research organisations in the country. It has as its mandate to promote and conduct research for the improvement of health and quality of life of the public.

The intention of the study was to collect baseline data on a large number of households within the Umlazi area, located near Durban, South Africa. The study included questions pertaining to the structure of dwellings and access to basic services. Statistics on female inhabitants and infant mortality were also captured as part of the baseline study to provide reference points for future intervention projects. The surveys conducted were relatively brief with 60 data fields captured per household on average.

A team of approximately 25 fieldworkers was assembled to conduct interviews with Umlazi residents on an ongoing basis. Each fieldworker was issued with a low cost Nokia 2626 handset. The Mobile Researcher application was installed on each phone to allow surveys to be conducted and uploaded using low cost GPRS. SMS was not a viable technology for the study due to survey length, data complexity and intermittent reception. SMS was however used to assist in logistics with all fieldworker communication managed and logged via the Mobile Researcher system.

Key Successes

• Low cost Nokia 2626 handsets were successfully used by fieldworkers to conduct surveys.
• On average, over 400 households were surveyed daily with data available for analysis and reporting before the fieldworkers returned to the field the following day.
• Research staff and management were able to isolate and rectify issues whilst the study was in progress.
• Fieldworker activity could be monitored routinely via the web-based console for training, quality assurance and remuneration purposes.
• More than 25,000 households were surveyed in the first 3 months.
• In total over 85,000 surveys were conducted.

The resounding success of the project illustrates the potential of leveraging web and mobile technologies for the conduction of large-scale field research ? particularly in rural areas. Combining even entry-level mobile phones and the Mobile Researcher system enables high quality, affordable research to be conducted even where no cell phone reception is available.

About Populi.net Mobile Researcher
Powered by the Populi.net platform, Mobile Researcher transforms the ubiquitous mobile phone into a cutting-edge research tool.

Leverage web and mobile technologies to design and deploy surveys to fieldworkers in minutes, monitor, manage and communicate with your team and analyse responses in real-time.

Developed by Digital Solutions company Clyral, Mobile Researcher presents a breakthrough in research technology. Learn more at mobileresearcher.com.