Devising Scalable Deployment Strategies for mHealth

Over the course of this academic year, I intend to work alongside D-Tree and Dimagi on developing a sustainable deployment and scale-up model for CommCare, a mobile-based scheduling, monitoring, and referral application for community health workers (CHWs). Through its “Safe Pregnancy” module, CommCare aims to routinize antenatal care by providing CHWs and their supervisors the ability to monitor, in a consistent and standardized fashion, the progress of pregnancies within a defined geographic area. Examples of the types of capabilities CommCare can provide include, but are not limited to, real-time data collection, complication readiness checklists, decision support mechanisms, check-up reminders, and scheduling capabilities.

The question that follows, then, is how best can these types of mobile applications be deployed in a scalable manner? Even more importantly, how can a mobile health (mHealth) application like CommCare serve as a vehicle for empowerment, both at the individual and community level, by enabling community health workers to take ownership over the health of their individual communities? There is considerable debate regarding whether technology limits CHW agency by over-standardizing and mechanizing decision-making, or whether it serves to supplement these existing practices by augmenting the capability of CHWs to make more informed, timely decisions. How can we ensure that the latter holds true?

The other question that arises involves the vehicle through which mHealth applications can best be deployed. Ideally, any development initiative should ultimately be sustained by the public sector – the nonprofit sector, in my opinion, should only play the role of developing, piloting, implementing, and eventually transferring effective social service delivery models to the government.

In the case of mHealth, what vehicles, in your experiences, have worked best as the starting point for the launch of a particular mobile application? How have you leveraged community-based organizations’ capacities to deploy the application in a locally relevant, culturally sound manner?

I realize I’ve asked more questions in this post than I’ve answered, but that’s because this is an emerging field where the experience of practitioners is immensely valued. So please, send us your thoughts!