Piloting PDAs to Improve Data Collection and Monitoring of Health Projects in Nepal

Imagine the near instant collection and analysis of essential health data, at the fingertips of policy and decision makers! This is no longer a dream. Through the use of information and communications technologies (ICTs), data collection and analysis can be cost effective and efficient - if used appropriately.

USAID/Nepal and USAID/Asia and Near East Bureau (ANE) are funding the dot-ORG Nepal Health Monitoring Pilot Project to explore the use of ICTs for health monitoring. With SATELLIFE and other dot-ORG partners, the project is testing hand-held computers or personal digital assistants (PDAs) and global positioning systems (GPS) to be used by community health workers to quickly and accurately collect important survey data on vitamin A distribution.

Screen shot of survey in Nepali on a PDA - allowing public health workers to interview mothers.Answering Critical Questions about PDAs for Data Collection
A mix of computer and communication technologies can enable Ministry officials and health NGOs to quickly collect data on a disease outbreak, analyze collected routine data, and efficiently produce reports for decision makers so they can respond before the outbreak spreads to new areas or change the intervention to target critical regions.

These scenarios sound ideal, and before these digital technologies are used on a large scale several critical questions need to be answered.

How can and should these technologies actually be used in developing country situations? What are the costs involved? What are the benefits of using these technologies over conventional approaches? What are the opportunities and the limitations of both the technology and the human resources needed for technology enhanced data collection?

These are some of the questions that the ANE Bureau and USAID/Nepal have set out to answer through the Nepal Health Monitoring Pilot Project. This activity is based in part on the experience of SATELLIFE and Uganda Chartered HealthNet in using hand-held computers and cellular telephone-enabled transmission devices to build the multi-district Uganda Health Information Network.

Building on this experience, SATELLIFE, HealthNet Nepal (HNN), AED/dot-ORG, USAID/Nepal, and local implementing partners are working together to test the use PDAs combined with GPS devices to collect data. This data will help create geographic information systems (GIS) to enhance ongoing monitoring and evaluation efforts for a USAID/Nepal-supported vitamin A distribution program.

Funded through the dot-ORG Access associate award, AED is providing the monitoring and evaluation component of the project and a write up of the lessons learned from the experience. It is anticipated that a successful model would be promoted for replication across USAID.

Monitoring the Health Situation in Nepal
The Health Monitoring Pilot Project is supporting the Mission's efforts to monitor and evaluate the health situation in Nepal. Different health surveys are routinely conducted at various times and frequencies, including:
  • Monthly supervision of female community health volunteers;
  • Biannual surveys of the vitamin A distribution program to children under 5;
  • Yearly studies on behavior change for HIV prevention; and
  • Demographic health surveys every five years.
In a country such as Nepal, where the mountainous landscape creates isolated communities and telecommunication infrastructure challenges, these sorts of surveys are very resource intensive - requiring high levels of funding, a great deal of time, large numbers of personnel, and extensive post-survey data entry and analysis.

Delays in delivering results for decision makers and numerous errors in data often decrease the usefulness of field data. Lack of reliable data undermines the ability of public health officials to respond appropriately to emerging trends or problems with interventions. Accurate and timely health data could significantly improve public health programming in Nepal and, in turn, the health of people in remote communities.

The USAID/Nepal technology team recognized the potential role that new technologies could play in increasing the speed, accuracy and quality of the monitoring and evaluation of USAID projects. In response, USAID/Nepal staff teamed with the ANE Technology Advisor to design this pilot project to address several key questions including:
  • Given the difficulties of connectivity, language, geography, and access to electrical power in Nepal, how effective would these technologies be in helping USAID/Nepal and their local partners improve health survey activities?
  • Would the benefits from the use of these technologies exceed the operating costs of the system, including cellular air time, field operations, training and equipment maintenance?
  • How much user support and training is needed to use these technologies for health monitoring in Nepal?
  • What are optimum operating procedures and protocols for the system?
The project builds on an earlier pilot within Nepal where USAID, through the dot-GOV project, partnered with UNDP, World Bank, WorldSpace, Equal Access, International NGOs and a variety of Nepalese NGOs in a Digital Broadcast Initiative (DBI). In this activity, public health and civil society information is shared with isolated populations through an "edu-tainment" soap opera, and distributed using a network of satellite digital radio and traditional radio stations.

dot-ORG was awarded Nepal Health Monitoring Pilot Project on December 1, 2003 for a period of 12 months (Subagreement under the Access Associate Award No. GDG-A-00-02-0016-00 under the dot-ORG Leader Award No.GDG-A-00-01-00014-00).

For More Information, Contact:
Eric Rusten
Project Director, Programa para o futuro
Academy for Educational Development
Tel: (202) 884-8714

Holly Ladd
Executive Director, SatelLife
Tel: 617-926-9400

Related Resource Partners
Related DOT-COM Activity
Applying a New Generation of Information Technology at Community Internet Centers (Access)

Nepal Health Monitoring Pilot Project
Related DOT-COMments Newsletter Articles
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Core funding for the DOT-COM Alliance is provided by the United States Agency for International Development (USAID), Bureau for Economic Growth, Agriculture & Trade, Office of Infrastructure and Engineering (EGAT/OI&E), Office of Education (EGAT/ED), and Office of Women in Development (EGAT/WID), under the terms of Award numbers: GDG-A-00-01-00009-00, dot-GOV; GDG-A-00-01-00014-00, dot-ORG; GDG-A-00-01-00011-00, dot-EDU.
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