From the Mahatma Gandhi Memorial Clinic in Kabwe, Zambia

In June 2006, the United Nations Foundation and the Vodafone Group Foundation formed a partnership to help fund the development of digital health data systems in Africa so local health care workers can access national health databases. This includes an initiative, admimnistered through the NGO DataDyne, to fund mobile computing devices for health care workers and data officers in Burkina Faso, Kenya, and Zambia.

In the post below, Dr. Joel Selanikio writes in from a clinic in Zambia to explain why cell phones and PDAs have become a critical tool in the development of national health data systems in the developing world.

Kabwe, Zambia – May 16, 2007

In twenty years of international health work, I have become used to seeing examples of what needs to change. Here in Kabwe, at the Mahatma Gandhi Memorial Clinic facility, it was a pleasure to see examples of things done right. I was in Kabwe providing technical support to provincial officer Elizabeth Mwale, who has been helping us field-test our EpiSurveyor software for mobile data collection (in this case collection of facility supervision information on Palm handhelds). Over breakfast of toast and tea served on Barbi placemats in our hotel (the Kabwe Executive Lounge), we decided to stop at a facility to watch Elizabeth use the supervisory checklist, co- developed with CDC, on her Palm PDA — and off we headed to the Mahatma Gandhi Memorial Clinic. The Gandhi clinic was within 30 minutes drive, and Elizabeth had not visited it in several months.

We were greeted after entering the clinic by Bridget Banda, a nurse- midwife and second-in-charge of the clinic. Nurse Banda took us through the spotless registration area, brightly-lit patient care rooms, a busy and perfectly-equipped laboratory equipped with microscopes and centrifuges for diagnosis of malaria, among other tropical diseases, and the counseling rooms where HIV-positive patients can receive both counseling and life-extending anti- retroviral treatment. Staff everywhere were neatly dressed and smiling, and happy to explain their function, and the whole clinic just had this feeling of order and harmony. What a tonic for a world- weary public health doc, accustomed to much less well-equipped centers.

Another thing I noticed, though, was the enormous amount of paperwork, in the form of logs, registries, drug records, patient histories, and more, in this small clinic. Dutifully collected on paper, that information was unlikely to make its way to any analyzable form — meaning that the wealth of information collected by this exemplary facility was never going to reach the rest of the country’s health system! What a tremendous benefit if we could replace all those paper records with easy-to-administer electronic records, accessible from the cell phones carried by each and every caregiver (and patient). Once again, I realize that in developing countries the cell phone is the computer, the internet access point, and the communicator, all rolled into one. For other clinics to learn from the experience of this one, we’ve got to build critical health data systems onto the cell system.