IFGH 2012: D-Tree Decision Support to Community Health Workers

January 31, 2012

 

Posted by Irish Forum for Global Health | Conference Abstracts

Authors:Mitchell, M

Author Affiliations:D-tree International, Lecturer, Harvard School of Public Health, USA

Option 2– Lessons from the field; project and programme evaluations; and syntheses or analyses Presented as – Oral Presentation

Issues:


Task shifting implies that health workers with limited training are able to assume responsibility for more complex care. In order for this to be successful, the training must be linked to an integrated support system that includes detailed specification of tasks required, real time monitoring and supervision, job aids to support point-of service (POS) care, and functioning referral networks. This talk presents both a conceptual model of this end to end support system and specific examples of how it works in practice.

Description:

D-tree International has developed mobile phone based decision support tools for use by Community Health Workers (CHW) that provide support for the diagnosis, treatment, and referral of patients in a wide variety of clinical areas including antenatal care, labour and delivery, neonatal care, child health (IMCI), nutrition, family planning and HIV supportive care. At the core of these systems are clinical algorithms that take the CHW step-by- step from client assessment (what is wrong) to a presumptive diagnosis based on the assessment to a specific treatment (with drug and dosage specified) and counselling or referral. Integral to the system is the patient record that provides real time data to supervisors and program managers about what is being done by the CHW when he or she is seeing a client.

Lessons learned:

We have learned that this end to end system is both feasible and leads to improved quality of care by clinic based and CHWs in low income environments.

Next steps:


Development of a classroom and remote training program that is tightly coupled to decision support, information and supervisory systems. This will require detailed task analysis for CHW in a variety of programs and innovative approaches to training.

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