Smartphones for community health in rural Cambodia: A feasibility study

Abstract

Background: Village Malaria Workers (VMWs) are lay people trained to provide a valuable role in frontline testing and treatment of malaria in rural villages in Cambodia. Emergence of artemisinin-resistant malaria highlights the essential role of such VMWs in surveillance and early treatment of malaria. Smartphone technology offers huge potential to support VMWs in isolated and resource-poor settings. Methods: We investigated the feasibility of issuing established VMWs with a smartphone, bespoke Android application and solar charger to support their role. 27 VMWs in Kampong Cham and Kratie provinces participated. Results: 26/27 of the smartphones deployed were working well at study completion twelve months later. Interviews with VMWs using quantitative and qualitative methods revealed pride, ease of use and reports of faster communication with the smartphone. VMWs also expressed a strong wish to help people presenting with non-malarial fever, for which further potential supportive smartphone applications are increasingly available. Conclusions: As a result of this pilot study, two smartphone based reporting systems for malaria have been developed at the Cambodian National Malaria Center, and the programme is now being extended nationwide. The full code for the smartphone application is made available to other researchers and healthcare providers with this article. Smartphones represent a feasible platform for developing the VMW role to include other health conditions, thus maintaining the relevance of these important community health workers.

User experiences and perceptions of health wearables: a cross-sectional study in Cambodia

“…Sustainable program implementation would also require health system integration, public funding, and improvements in the quality of care, which remains a signi cant challenge in Cambodia [23]. In recent years, other mHealth interventions have been piloted in Cambodia including smartphones applications to deliver messages for hypertensive and diabetic patients [24], to improve newborn care awareness in rural areas [25], to remind users about available family planning methods [26], and to support community-based malaria surveillance [27]. While these programmes have generally had a positive impact on health outcomes, sustainability of donor-driven initiatives without domestic funding and full ownership has been a recurrent challenge.…”

Malaria elimination in remote communities requires integration of malaria control activities into general health care: an observational study and interrupted time series analysis in Myanmar

“…From the febrile patient’s perspective, it matters little what the cause of their fever is, as long as it is treated effectively, so the incentive to seek treatment from the “malaria only” CHW declines as malaria incidence declines. Malaria-only community health workers recognise that when malaria declines, febrile patients are less likely to consult them, and wish to be able to provide help to patients with non-malaria fever [ 27 ]. Patients return to untrained informal health care providers, who provide inappropriate medicines and interventions.…”

Perspectives of health and community stakeholders on community-delivered models of malaria elimination in Lao People’s Democratic Republic: A qualitative study

“…Therefore, malaria elimination intervention such as case-based surveillance and response activity, the 1-3-7 model, is still challenging for malaria elimination because the very first step of elimination intervention, reporting of malaria cases, is delayed [ 7 ]. In other GMS countries, DHIS2 with real-time data is reported through mobile phone or tablet applications operated by health care providers, including volunteers [ 45 , 46 ]. However, in some areas of the GMS, mobile phone reporting is impractical because of insufficient mobile internet access in some remote areas of the country [ 47 ].…”