Mobile Learning for Primary Health Workers

http://digital-campus.org© 2013

Improving Health Extension Workers' training and effectiveness through continuous skills improvement, knowledge assessment and patient management processes

GPAF Innovation Project July 2013 - October 2016

Mobile Learning for Primary Health Workers

http://digital-campus.org/


AsiaBangladeshIndiaIndonesiaMongoliaMyanmarNepalPakistanQatar

GPAF project

Technical & Content development

Worldwide project partners

R&D



Inadequate training and very text-heavy.

Little follow up on how the skills and knowledge learned are applied.

Low skilled birth attendance and PNC rate

Need for a professional career development program

BMC Human Resources for Health http://www.ncbi.nlm.nih.gov/pubmed/23171076

Primary health care system challenges in Ethiopia


http://www.ncbi.nlm.nih.gov/pubmed/23171076


Digital-Campus theory of change

Strategies Outputs Outcomes Impact

Increase ANC/PNC knowledgeretention

Bridge the digital gap

among women

Improve quality of

ANC/PNC care

Achieve MDG goals

Quality education

Gender Equality

Develop a M-learningPlatform

Mobile-adapt official training

content

Good health &Well-being

Resources toscale innovativelocal solutions

Invest in innovation

Mhealth Open sourcetechnologies

Creative Commons

content support



• A cohort of 157 HEWs at Mekelle TVET (promotion 2015-16.

• Supplementing 1-year face-to-face training with additional multimedia and quiz activities.

• HEWs Level IV training content – 13 modules – all mobile adapted to run offline – but focus on ANC & PNC.

• We supported HEWs whilst in training centre.

• We followed up ongoing usage and knowledge retention once in health post for up to 11 months.



Mean Age (29 yo) Married (> 80%) Children (1.6 avg)



Phase I: m-learning platform development and content

adaptation

First 12 months. Development and testing

the OppiaMobile platform. Adapting the HEWs level IV

official training content to be used in mobiles.



What is OppiaMobile?

OppiaMobile is the first rich-content open source mobile learning platform specifically designed for users in low bandwidth/connectivity environments.



OppiaMobile learning platform

Supports video, quizzes and other activities.

Works when completely offline – all activities stored on device.

Specially designed for slow broadband networks (2G).



OppiaMobile learning platform

Currently designed for Android, but can be extended to other mobile operating systems.

Designed to support existing or new training and teaching programmes in all professional areas.

Supports multilingual content. Text to Speech – the client app

can “read aloud” text pages.



How it works

No need for programmers to maintain and update learning content.

Course content can be collaboratively edited and produced in Moodle.



How it works

Activity tracking, quiz results, video views all submitted to server – trainers and supervisors can track student progress.

Students gain points and “badges” based on their usage and quiz scores (gamification).



Customised OppiaMobile versions

All open source - can install your own server and create your own client app

Use your own themes/logos for the client application



Official training content for Level IV HEWs



HEWs level IV training content

13 Modules to upgrade the theoretical knowledge of the country’s 40,000 Health Extension Workers.

These Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia.



OppiaMobile adapted HEWs level IV courses



OppiaMobile adapted HEWs level IV courses



Student and teachers dashboard: automatic activity tracking



We developed a glossary english- tigrinya for medical terms



ANC & PNC Checklist app



Phase II: testing the application with HEWs at Dr. Tewelde training

centre From April 2015 until

August 2015. Training workshops:

Android phones ANC/PNC checklists OppiaMobile



Mobile Phone baseline survey

Mobile phone use by HEWs. Findings: 99.5% of the HEWs do have mobile

phone (Mostly feature Nokia and Techno phones)

91% did not know how to use Internet. > 90% did not have an e-mail or social

media account. >90% were not confident using a

computer. >37% of HEWs did not have electricity at

home to charge their phones.



Mobile Apps pre-installed



Training workshops



Understanding HEWs challenges



How to use smartphones





HEWs level IV graduation



Phase III: testing the application with HEWs at their health posts

From December 2015 to October 2016.

Remote follow-up (OppiaMobile Dashboard, phone calls, SMS)

Regular field visits Monthly top-up (50

Birr)



Electricity HP

Network HP

No

Yes



Good network but no electricity in HP



Electricity Home

Network Home

No

Yes



No

Yes



OppiaMobile automatic activity tracking



Health Posts visits





Health Post visits and monitoring

(video)



Group Monitoring



Phase II: testing the OppiaMobile platform with HEWs at the

training centre

RESULTS



COC

May 2105 Aug 2105 Nov 2105



Usage stats for the training period:

1 million activity hits. 80,000 quiz attempts, with responses to 600,000

questions. 16,000 video views.

• Very few technical issues, students and college dean/tutors very happy with app and content (from satisfaction survey).

OppiaMobile main usage statistics (May 15 - July 15)



HEWs looked at all Modules



>13 wks

8-11 wks

4-8 wks

Students activity (May – July 15)



P= 0.001 (Mann-Whitney test)

Antenatal Care module test results

P= 0.29 (Kruskal-Wallis test) P= 0.001 (Kruskal-Wallis test)

Pre-quiz (May 2015) Post-quiz (July 2015)



Pre-quiz (May 2015)

Post-quiz (July 2015)

Pre-quiz ANC Post-quiz ANC



P= 0.014 (Mann-Whitney test)

Postnatal Care module test results

P= 0.63 (Kruskal-Wallis test) P= 0.001 (Kruskal-Wallis test)

Pre-quiz (May 2015) Post-quiz (July 2015)



Pre-quiz (May 2015)

Post-quiz (July 2015)

Pre-quiz PNC Post-quiz PNC



Certificate of Competence national exam results

(Nov 2015)

1st time

2nd time



Phase III: testing the OppiaMobile platform with HEWs at their

health posts

RESULTS



Less than 6% of phones had any hardware issues in 16 months

(lost/stolen, broken or malfunction)

Normal

Lost/stolen

Malfunction

Broken



Phones were not locked



HEWs also installed other apps…

Medical Dictionary

First Aid English-Amharic

Dictionary



2615

15935

58165

7414

23080

11551

18972

35850

4142

7753

8085

19335

40272

22120

21058

8673

13325

14525

18883

16502

12092

84134

23761

46173

25988

12472

18640

8863

10910

28672

35542

6032

47112

14711

12455

15237

480

13452

37564

5015

42767

30930

17498

27657

51126

32647

55287

22895

23421

22428

7774

7950

9250

16466

27304

2054

13850

13250

51036

10998

8679

6565

26916

10898

20490

26540

22717

6090

15589

27370

14816

44549

4481

54774

46479

13167

29996

16872

15894

11367

7035

43855

195

33885

33972

63055

34559

31275

7742

28407

41650

12567

54893

44063

29200

8436

2530

17427

27607

8250

5780

56676

28143

36243

29056

43567

30892

36535

24360

19791

12320

27199

13861

8915

28155

5647

18954

14740

20701

11285

19583

3845

14962

2357

8764

9717

38049

14371

6015

11622

25380

9394

22667

11840

15610

16641

59273

44637

4430

10270

7380

45808

9253

22560

31658

23487

29025

7730

30780

4045

33272

19056

25535

8382

22331

9978

33965

Bizu Tadele: 217.109 !

OppiaMobile activity



Post-training evaluation: antenatal careJune 2016 Test (June 2016)

Excellent

Good

Passed

Not passed



Antenatal careevaluation

Test (June 2016) Test (May 2015)

Excellent

Good

Passed

Not passed



Post-training evaluation: postnatal careJune 2016 Test (June 2016)

Excellent

Good

Passed

Not passed



Postnatal care evaluation

Test (June 2016) Test (May 2015)

Excellent

Good

Passed

Not passed



Postnatal care visits 0-48h (Dec 15 - July 16)

Source: eHMIS



Antenatal care - at least 4 visits (Dec 15 - July 16)

Source: eHMIS data



• This project is innovative and relevant.

• There are clear results and overall the project scores A+.

• The project represents very good value for money.

GPAF QAV Visit Report (January 2016)



Further info/links

• Get the app on Google Play • Documentation: http://oppia-mobile.org


https://play.google.com/store/apps/details?id=org.digitalcampus.mobile.learning

http://oppia-mobile.org/


Thanks!

Contact us at:[email protected]


mailto:[email protected]

Date post:	22-Jan-2018
Category:	Education
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Mobile Learning for Primary Health Workers

Education