India

Two and a half years ago, I realized I had a large challenge in front of me. In order to complete the first step of our program, a baseline survey in 500 villages to determine the exact malnutrition situation we were dealing with, I was going to have to get creative. Sitting in front of me at the New Delhi train station, in heat of well over 100 degrees, were 500 survey books, over 1 ton of paper. I had a train ticket, 50 new workers at a training over 600 miles from where I stood, and 12 hours to get there.

Photo: Dimagi Master Trainer Mohini Bhavsar working with RMF CNEs/

Six months into our Eradicate Malnutrition program, we were facing daunting numbers, incredible heat, and a huge geographic distance to cover. We had just completed our baseline survey, one of the most comprehensive door to door assessments of the children in the area. We had covered over 80,000 children in our baseline surveys, collecting valuable information on their family’s diet, income, and health. Again, I was staring at over 1 ton of paper, which somehow had to get to Rajasthan (380 miles) to a bank of data entry operators for entry and analysis.

Every day, RMF India’s CNEs face the same challenges when going out into our 600 villages to work with families of malnourished children. They meticulously record everything into diaries. At the end of every week, this information is recorded into weekly reports, which are then compiled into monthly reports. Every month, our program creates more tons of paper, all of which needs to be carefully verified and entered into computers to understand the impact our program is having.

Photo: RMF India's current data reporting relies on daily dairies and weekly reports. Although accurate, the time from data collection to analysis is often long, inhibiting the adaptiveness of our program.

For two years, we have been trying to think of a better way.

This past weekend, May 17-20, 2012, our team took one big step away from the tons of paper I have brought on trains. With a generous donation of 70 phones from Dimagi, Inc (www.dimagi.com), RMF India now has a comprehensive mobile phone data collection system in use by all of our field staff.

Following our successful pilot in July-October, 2011:http://www.realmedicineblog.com/2011/08/09/india-malnutrition-program-monitoring-evaluation-part-2/ I have been looking for a way to integrate mobile technology into our program. The results of our pilot were encouraging, the data we collected was incredibly versatile and accurate, and all of the ten CNEs who first used Commcare were very happy with its performance, usability, and interface. On the backend, we were ecstatic about the ways we could analyze this new data, and the new real time access we had.

With the help of Dimagi's master trainers we conducted a 3 day training program with our staff on the usage of the Commcare application on mobile phones.  As always, our amazing team surprised me with their aptitude for new technology. Even though some of our CNEs had never owned mobile phones before, all of them quickly and eagerly mastered the new technology in a little under a day and a half, leaving us another 2 days to review other critical program material ahead of the upcoming busy season. When all of the migrants return to our target villages in mid-July, RMF India will have a new database, a new tool, and a new sense of purpose in our villages.

Photo: (left) MF India Program Manager Pratik training, (right) Dimagi Master Trainer Mohini Bhavsar.

In just over three days of operation, RMF’s CNEs have already uploaded information on 570 children with SAM or MAM into their mobile phones and our servers on Commcare HQ. These cases are automatically saved onto each CNE’s phone for easy recall and updates, as well as stored digitally in our new databases. Anytime I like, from New Delhi, Jhabua, Bhopal, or anywhere in the world, I can log onto Commcare HQ for a quick snapshot of the CNE’s activities, from children they have identified, through referrals to NRCs, to counseling sessions held with families and villages. If I have a question about a particular child, that data is instantly available on Commcare HQ as well.

Necessity is the mother of all invention, and sometimes inconvenience is the mother of all innovation. As I sat back and watched the growing RMF India family (may of our CNEs now have children of their own, who attend our trainings) master a new technology, I couldn’t help but think of how far we’ve come, together, since that train station two and a half years ago, or wonder where we will go next.