An electronic register for vital registration in a rural village with no electricity in Malawi

Gadabu, Oliver Jintha; Manjomo, Ronald; Mwakilama, Shawo; Douglas, Gerald P.; Harries, Anthony; Moyo, Chiccoe; Makonokaya, L. D.; Kang'oma, Sophie; Chitedze, P.; Chinsinga, F. B.

doi:10.5588/pha.14.0015

Cited by 12 publications

(13 citation statements)

References 9 publications

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“…This was even identified as an important factor to be considered by the participants in interviews before they started to use the CDSS (3). The problem with reliable electricity supply is well-known and was reported as a basic need in a study from Malawi (18,19) where they maintained successful use of the system by access to a low voltage computer. In addition, a review of ICT studies from Africa, it was stated that functional solar panels for power supply can ensure reliable access to ICTsystems in rural settings (20).…”

Section: Discussionmentioning

confidence: 99%

Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

Zakane

Gustafsson

Sié

et al. 2017

OJPHI

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Objective: Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS.Methods: A workshop, organized as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent. Workshop transcripts were analyzed thematically. Socio-demographic and usage patterns of the CDSS were examined by a questionnaire and analyzed descriptively.Results: The participants reported that the contextual basic conditions for using the CDSS were not fulfilled. These included unreliable power supply, none user-friendly partograph, the CDSS was not integrated with workflow and staff lacked motivational incentives. Despite these limitations, the HCWs reported learning benefits from guidance and alerts in the CDSS. Using the CDSS enabled them to discover problems earlier as they learned to focus on symptoms to prevent harmful situations.Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

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Section: Discussionmentioning

confidence: 99%

Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

Zakane

Gustafsson

Sié

et al. 2017

OJPHI

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“…Albania [75], Liberia [61], Malawi [74], Peru [56], Tanzania [76] Supply Telecommunication and physical infrastructure development in parallel with policy implementation facilitated successful rollout.…”

Section: Supplymentioning

confidence: 99%

“…In total, 25 countries were represented: 10 countries from Africa, 4 from the Americas, 5 from Southeast Asia, 2 from the Western Pacific, and 4 from Europe and the Eastern Mediterranean(Table 1). Nineteen articles from 15 countries reported experience implementing supply policies[44,[47][48][49][50][51][52][53]56,59,61,[66][67][68][74][75][76], one article from Mongolia reported on a demand policy[57], one article from Canada reported on a penalty[65], 5 articles from 5 countries reported experience implementing incentive policies[46,54,63,73,77], and 16 articles from 9 countries reported experience implementing a combination of different policies[12,45,55,58,60,62,64,[69][70][71][72][73] (Table 1).…”

mentioning

confidence: 99%

Evaluation of approaches to strengthen civil registration and vital statistics systems: A systematic review and synthesis of policies in 25 countries

et al. 2019

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Background Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most lowand middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems. Methods and findings The ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although

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“…The Baobab Health Trust, a Malawian non-governmental organization involved in the development and implementation of medical and civil registration informatics interventions, took up the challenge and developed a solar-powered EVR in 2013 for two villages in Traditional Authority Mtema (Chalasa and Mtema) in rural Lilongwe, Malawi, where there is no established electricity supply. The pilot study in these two villages showed the feasibility of training a village headman and assistant to use the EVR to document, transmit and collate village demographics along with new births and deaths ( 12 ). Following the pilot, the EVR was expanded to all 83 villages in the TA to determine whether an electronic birth and death registration system at village level could be functional and interconnected in this area.…”

Section: Background and Rationalementioning

confidence: 99%

“…This has been previously described ( 12 ), but there has been upgrading and modification of the system which briefly works as follows ( 13 ): Power is supplied through solar panels placed close to the village headman's house and these connect to deep-cycle batteries that are enclosed behind a lockable panel that also houses and protects the electronics. All the electronic devices for the EVR are installed on a single modular equipment panel to reduce installation and maintenance efforts in the field, and the system is designed to run 24 h a day.…”

Section: Essential Elements Of the Interventionmentioning

confidence: 99%

Can a Village Headman Use an Electronic Village Register and a Simplified Community-Based Verbal Autopsy Tool to Record Numbers and Causes of Death in Rural Malawi?

Munthali

Kang'oma²,

Nasasara

et al. 2018

Front. Public Health

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Introduction: Most people in Africa die without appearing in official vital statistics records. To improve this situation, Malawi has introduced solar-powered electronic village registers (EVR), managed by village headmen, to record birth and death information for production of vital statistics. The EVR is deployed in 83 villages in Traditional Authority Mtema, Lilongwe, which is an area without electricity. In 17 villages, village headmen were also trained to use a simple verbal autopsy (VA) tool adapted from one developed by the World Health Organization (WHO). Study objectives were to (i) document numbers and causes of death occurring in 17 villages between April 2016 and September 2017, and (ii) assess percentage measures of agreement on causes of death as recorded by village headmen using a simple VA tool and by a team of health surveillance assistant (HSA)/medical doctor using the WHO VA tool.Methods: The study was in two-parts: (i) a cross-sectional study using secondary data from the EVR; (ii) primary data collection study comparing causes of death obtained by village headmen using a simple VA tool and by HSA/medical doctor using the WHO VA tool.Results: Over 18 months, 120 deaths were recorded by EVR in 14,264 residents - crude annual death rate 5.6/1,000 population. Median age at death was 43 years with 69 (58%) deaths being in males. Death occurred at home (75%) and at health facility (25%). Malaria, diarrhoeal disease, pulmonary tuberculosis, acute respiratory infection, and stroke accounted for 56% of deaths recorded by village headmen using the simple VA tool. Causes of death between village headmen and the HSA/medical doctor team were compared for 107 deaths. There was full agreement in causes of death in 33 (31%) deaths, mostly for malaria, severe anemia, intentional self-harm, cancer, and epilepsy. Unknown-sudden death and sepsis recorded by the HSA/medical doctor team were responsible for most disagreements.Conclusion: It is feasible for village headmen in rural Malawi to use an EVR and simple VA tool to document numbers and causes of deaths. More work is needed to improve accuracy of causes of death by village headmen.

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An electronic register for vital registration in a rural village with no electricity in Malawi

Cited by 12 publications

References 9 publications

Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

Evaluation of approaches to strengthen civil registration and vital statistics systems: A systematic review and synthesis of policies in 25 countries

Can a Village Headman Use an Electronic Village Register and a Simplified Community-Based Verbal Autopsy Tool to Record Numbers and Causes of Death in Rural Malawi?

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