Diagnosing children through phone

Recently, government passed the National ICT Policy as a tool for development. Mai Mwana’s novel use of phone in Mchinji testifies to how technological innovations can help address age-old problems. JAMES CHAVULA writes.

What have mobile phones got to do with unrecorded death causes in the country?

Clearly, the most widespread and user-friendly information communication technology (ICT), handheld phones have literally become a handy tool for retrieving public health information that often gets lost and buried when deaths occur outside hospitals.

Residents of Mzangawa Village in Mchinji, Lazaro and Magdalene Cypriano, are witnesses to how the revolution stands to change the picture of public health at a time World Health Organisation (WHO) estimates that a third of deaths worldwide go completely unrecorded.

The couple lost their second son last year, following repeated hospital visits. Now, they are convinced that understanding what killed him will help them provide appropriate care for the last born.

And the husband recalls how a phone made a difference.

“One day, a fieldworker visited our household and afforded me the first opportunity to narrate what happened to my son and have that information recorded. He kept entering the information in the phone, making us able to know what killed him,” he says.

In the rural area, Mai Mwana runs projects targeting under-five children using phones: Local fieldworkers, like those who identified the Cyprianos, record recent deaths. They pass on the information to trained fieldworkers, who later visit the villages to ask relatives a standardised set of questions on the circumstances surrounding family death. Who has died lately? Any signs? What really happened?

For nearly two decades, medics have been using such probes, called verbal autopsy, to get noteworthy observations that can help figure out who died and what they died of. However, this largely involves recording the answers on lengthy scripts that may get lost and can be taxing because overwhelmed health workers have to analyse stacks of questionnaires one by one.

But with the new technology being piloted in Mchinji, the trained outreach workers compute and analyse the information on phone with special software, called Miva.

Just like that, the result is stored in the phone and can be sent to a central database either by text message or Internet.

Dr Carina King, a fellow at University College London, is the overseer of the implementation of the mobile phone autopsies in the district where, like in many parts of the country, deaths that happen outside the hospital usually go unreported.

Last month, he told the British Broadcasting Corporation (BBC): “The mobile phone has been very good and means we don’t have lots of paper forms. We have very quick access to the data and we can analyse it quickly to get the causes of death.”

With Malawi Communications Regulatory Authority (Macra) estimating that 90 percent of the country has access to mobile phone network, it is not surprising that the majority of locals interviewed think the phone use is useful.

Miva programme’s co-creator, Dr Jon Bird of London’s City University, says mobile phones provide a convenient way of collecting information because they are widespread, cheap and robust.

“The everyday nature of mobile phones also makes them really valuable because the people that are being interviewed don’t find them intrusive,” he told BBC.

Principal secretary for the Ministry of Health Dr Charles Mwansambo says the results of the project will not only help government know what is killing Malawians but also to plan ahead and put in place appropriate responses and to carry out health education messages.

“We need comprehensive data from the hospitals and the community to plan well. We find ourselves planning for the small community that comes to hospital, not realising there is a bigger community out there that we need to budget for,” he said.

Kankwamba Phiri, an elder at Mzangawa Village, is already talking to his community to drop the harmful practice.

He confessed: “We have been doing this for a long time but it is wrong. What needs to be done is not to bury the documents and that’s what we’re encouraging people to do.”

The technology is being implemented on a small scale, but the researchers hope to extend it to more equally hit areas.

For the Cyprianos, knowing what killed their child is priceless. Magdalena says what she learnt from this interview will help her take care of their third baby.