ChildCount.org

We are seeking an experienced software engineer to join our New York based team to play a key role in the development of mHealth systems including our ChildCount+ platform.   In particular, we are looking for someone with an excellent design sense and demonstrated expertise developing web-based user interfaces.   Strong Python skills are also highly preferred.

• This is initially a six-month, full-time consulting position.
• The position is based at Columbia University in New York City with the potential (not guaranteed) of travel to help with the implementation of programs in the field.
• While you are NYC based you will be expected to work closely with our programming team spread out across East and West Africa.
• Software development will be done primarily in Python using RapidSMS which is based on Django.  The position may also require developing integration components for OpenMRS.
• We are looking for someone who is passionate about making a difference with code and we are proud to be an FOSS shop.
• We are looking to hire immediately.

A full job description follows.  If you are interested in applying for this position, please send your CV and cover letter to mberg at ei.columbia.edu.

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In a recent article in the Scientific American entitled, “Expert Systems Fight Poverty“, Jeffrey Sachs, Director of the Earth Institute, wrote about how appropriate information communication technology paired with community involvement can save lives.  In the article, Sachs mentions how mobile phones are being used in Ghana to coordinate teams of ambulance drivers, midwifes and CHWs to refer emergency pregnancies and save lives.   He then goes on to talk about how ChildCount+ along with rapid diagnostic tests (RDTs) are being used in Kenya to improve home based treatment of Malaria by CHWs.

In the Kenyan village of Sauri, also part of the Millennium Village Project, CHWs are pioneering the application of expert systems for malaria control. In the past, suspected malaria patients had to walk or be carried to a clinic, often miles away, have a blood smear read under a microscope by a trained technician and, if positive, receive a prescription. With clinics few and far between and with trained technicians and microscopes even scarcer, untreated, lethal malaria ran rampant.

In the new approach, CHWs visit households on the lookout for fevers that may signify malaria. They carry rapid diagnostic tests that examine a drop of blood for the presence of the malaria pathogen. Then they send an SMS (short service message) text with the patient’s ID and the test results. Seconds later an automated text response informs the health worker of the proper course of treatment, if any. The system can also send reminders about any follow-up treatments or scheduled clinic visits for the patient. The new system of malaria control includes insecticide-treated bed nets made to last for five years and a new generation of combination drugs based on a traditional Chinese herbal treatment, artemisinin.

This full set of tools constitutes a remarkably effective malaria-control system. Already a partial deployment of the system is reducing the malaria burden dramatically in several parts of Africa. Modest international financial support could greatly accelerate the deployment of the full system, and if it were scaled up throughout Africa, hundreds of thousands of lives could be saved annually at around $7 per person a year in the malaria-transmission zones.

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By Jessica Fanzo
Nutrition Director, Earth Institute

Severe acute malnutrition (SAM) affects 20 million children under five years of age each year and contributes to 1 million child deaths per year. Moderate acute malnutrition contributes more to the overall burden of disease, as it affects many more children. As a nutritionist, these statistics are devastating, and largely go unrecognized by many working in global health. Why is this? Often, children who are malnourished suffer from complications of other diseases and nutrition is often an orphan – misunderstood in diagnosis and treatment. Nutrition is often seen as “complicated.” It is not totally untrue – in the past, treating malnutrition has been cumbersome, requiring hospital services and complex medical treatment. However, in the last few years the game has changed.

An innovative community-led public health model to address acute malnutrition in developing countries has been established called Community-Based Management of Acute Malnutrition (CMAM). The community-based approach engages the community to detect signs of SAM early by sensitizing communities and subsequent active case finding, and provides treatment for those without medical complications with ready-to-use therapeutic foods (RUTF) or other nutrient-dense foods at home. If properly combined with clinical care for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children. The CMAM combines three treatment modalities, inpatient therapeutic (IP), outpatient therapeutic (OTP) and supplementary feeding (SFP) according to the clinical and anthropometric characteristics at presentation. CMAM can maximize treatment by improving coverage, access, and cost-effectiveness of treatment.

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Jackline Oluoch, a Regional Community Health Worker Program Coordinator based in Nairobi, recently wrote an article on the workshop held to introduce CHWs to the ChildCount+ system held in Nairobi.  The article, The MVP Introduces Enhanced Mobile Technology to Reduce Child and Maternal Mortality, gives an overview of the objectives of the workshop and the anticipated outcome.  Overall, the workshop was successful and provided much need cross-site interactions.

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I was recently listening to NPR.  Talk of the Nation was on-air and the topic of the hour was how the “Recession Continues to Challenge News Industry” given the recent release of the Project for Excellence in Journalism’s State of the News Media 2010 Report.  A caller phoned in sharing his experience of losing his position to a web position.  He was forced to switch fields—from magazine writer and editor to a job in PR—in order to support his family “and some 25-year old who doesn’t have anywhere near [his] experience is going to be filling those pages, or screens, instead.”  He continued on to make a comment about how democracy suffers due to a “less-informed electorate” who are “incapable of making informed decisions.  And you’re seeing that in the health-care debate now.” (1)

While there has been a shift in authority in print news and other information sources, I believe that the benefits of the web and new media technologies outweigh the risks and may actually lead to more informed populations—especially when it comes to their health.

An article by Biedler on how “Education Improves Health Status” concludes that there needs to be more funding and initiatives towards education (2).  I would like to take this one step further and propose that more resources should be put towards health literacy, in particular.  Health literacy can be defined as the “ability to read, understand, and act on health care information” (3).  In areas with high illiteracy rates, the latter two points are the most important.  Ways that health literacy can be achieved include health education outreach programs taught by healthcare providers, media (audio and visual) outreach and literature outreach [in the language and culture of context].  To add to this, health literacy does not limit itself to those outside of the health field, but also includes health care leaders, educators and policy-makers.

There are numerous ICT initiatives geared towards achieving the MDGs that not only seek to support traditional methods of education but also go beyond that and seek to provide health information to communities.  One example of such an initiative is the mLearning component of ChildCount+.  The content of mLearning is broken down into courses called modules.  Each module corresponds to a section of the Community Health Worker (CHW) Manual used by MVP for CHW trainings.  CHWs are able to download mLearning modules to their mobile phone and access them in the field or elsewhere.  mLearning supports continuous education and refresher knowledge of the CHWs on key areas in family planning, reproductive health, care for newborns, malnutrition, diarrhea and infectious diseases.  The application, as supplementary educational material for CHWs, supports the ChildCount+ system.

With more populations having internet-capable phones, individuals are more readily able to access countless sources of information and, as such, become more informed.  But in order to decrease some of the misinformation-related risks with this access to information, maybe there needs to be an added component of how to filter and assess what one reads online.

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The following is from a posting by Dr. Prabhjot Singh Dhadialla, our CHW team leader, on the ICT4CHW mailing list, an excellent discussion, started by Neal Lesh and others, on using technology to enable CHW programs.

CHW Programs within MVP

I’m currently the Community Health Worker and Health System advisor to the MVP. In this post I’ll give some background about the Millennium Villages Project, the Health component/CHW program and then a bit about our approach to technology usage. It may seem like a long preamble to getting to the ICT, but I’ll say something about why I’ve done this at the end. In addition, I’ll speak about ongoing scale-up work:

The Millennium Villages Project

The MVP was designed to consolidate the world’s current implementation knowledge about achieving the Millennium Development Goals and put them into action throughout challenging terrains in Sub-Saharan Africa. Located in 10 countries at 14 sites, the first wave of Millennium Villages are clusters of about 40 to 80 thousand people — ~450,000 in total. The clusters were identified through a process that requires a national government to request MV presence in the country [1]. This triggers a process of identifying areas of high need and then working with the districts to find candidate communities where there was enthusiasm for the process.

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We’re thrilled to announce our new ChildCount+ logo which reflects the addition of maternal health (hence the plus) to the ChildCount+ system.

The logo was generously designed for us by Arthur Dagard of MonAmour* Studio, an independently owned, cross-design agency in Paris.

Arthur has long been supportive of the work of members of our team including the design of the Kunnafoni Foundation logo in Mali and MoulinWiki, an off-line Wikipedia project, we launched at Geekcorps Mali over 4 years ago.

Arthur a sincere thanks from the entire ChildCount+ team.  Thank you very much for the continued support of our work. Once we get t-shirts made, we’ll be sure to send some your way!

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ChildCount+ Dev Team at work in Uganda

We are looking to hire a skilled programmer (ICT Solutions Expert) to help lead the development and implementation of our ChildCount+ program in Ghana.  While Python experience is preferred, we are looking most for someone with a demonstrated passion for making things with code and who is willing and eager to learn.  The programmer will join a growing team of developers spread across East and West Africa.

While primarily a programming position, the ICT Specialist will be expected to help support the design, development and deployment of other ICT interventions at the Millennium Villages Site in Ghana.

If interested please email me directly at mberg at ei.columbia.edu

Please click continue reading to view full job posting.

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Credit: James Hill for the New York Times

From March 9th, 2010 New York Times article by Jeffrey Gettleman: “Shower of Aid Brings Flood of Progress“.

His (Jeffrey Sachs) intent was to show that tightly focused, technology-based and relatively straightforward programs on a number of fronts simultaneously — health care, education, job training — could rapidly lift people out of poverty.

In Sauri, at least, it seems to be working. Some of the goals were literally low-hanging fruit, like teaching banana farmers to rotate their crops. Other programs were more sophisticated, like the battle against malaria, which employs cutting-edge mobile technology against a disease that kills more than one million children each year.

The other day, a community health team in Sauri stooped through the doorway of a home of several sick children, said hello to Grandma and got to work. Within minutes, a health worker had pricked a child, sent a text message with the blood results by cellphone to a computer server overseen by a man named Dixon in a town about an hour away and gotten back these instructions: “Child 81665 OKOTH Patrick m/16m has MALARIA. Please provide 1 tab of Coartem (Act) twice a day for three days.”

These small miracles are happening every day now in Sauri, population 65,000.

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We just completed a first attempt at an updated movie for ChildCount+.  This movie helps provide an overview of the changes to the new ChildCount+ system.  We have introduced new forms including support for CHW household visits and maternal health.   Another new addition to this system is a web based data entry tool.  This allows us to collect paper forms from the CHW and do data entry (while retaining most of the core system’s functionality) for sites when implementing a mobile phone based solution is not possible.

We would welcome any comments or questions! Please use the comment section below.

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