SUMMARY: India’s health workforce improves millions of lives but is limited by persistent challenges of training, supervising, and monitoring. We seek to overcome these challenges and unlock the tremendous potential of India’s health program with CommCare, an innovative, cost-effective, scalable mobile health platform for use by community health workers (CHWs).

PROBLEM SPACE: Dimagi’s mHealth solution, CommCare, addresses the challenges of running successful community health programs in developing nations, namely organizing and tracking CHWs, providing job-aid tools as a supplement to training, data collection and monitoring, and providing reminder messages and feedback to CHWs.

SOLUTION: Large groups of CHWs are geographically dispersed making it difficult to direct their efforts from “HQ”. Trainings and meetings are expensive, especially when considering the opportunity cost of removing the resident health advocate from his or her village. When applying mobile phones to these and other challenges in community health programs one must consider the users of such technology carefully.

Our efforts in developing the CommCare platform are constantly kept in check and directed by the needs of our users, the CHWs. Our user interface is highly customizable, allowing questions and informative prompts of all kinds. For multimedia we can display images, play audio messages, and present videos. For data collection text can be entered in any language, numerical values can be checked for validity, and branching logic defines which questions to show or hide. For feedback we display pop-up messages on screen and send SMS reminders. The interface is designed to be as intuitive as possible while maintaining comprehensive functionality.

New development is spurred by our team of international field engineers, working full-time with CHWs in rural India, Afghanistan, Tanzania, Mozambique, and other countries. Their focus is often to make technology work for the low-literate and the uneducated, which is impossible to do without many days of trial, iteration, and refinement in the field. Our field engineers share experience and lessons-learned with each other, but cultural diversity requires technology to be equally diverse and flexible to fit.

We have defined general processes for creating culturally appropriate content and implementing CommCare, but we must further develop these processes and online tools to allow others across the world with limited experience to make use of CommCare for supporting community health programs. CommCare is open-source and our online services are offered free of charge for small organizations supporting community health programs.