December 17th, 2015

Kawok 2015 update

By Ray Brunsting

Related to Kawok, the community mobile health (mHealth) platform developed by TulaSalud, 2015 was a successful and busy year!

  • Kawok was included in the primary health care strategy adopted by the Guatemalan Ministry of Health (MOH)
  • Kawok was included in a $7.6 million project announced by Global Affairs Canada (formerly Canada’s Department of Foreign Affairs, Trade and Development)
  • Kawok was deployed in all health districts in Alta Verapaz, and used by nurses, community health workers and supervisors (covering over 1 million people)
  • The Kawok Android application was redesigned, including new learning and counselling modules in Spanish, and two Mayan languages
  • The Kawok reporting system was expanded to include mobile dashboards, enabling improved supervision of community health workers and training for CHWs and community members

Towards Sustainability

Since 2007, the Tula Foundation has been the primary funding source for the development and deployment of Kawok and related technologies in Alta Verapaz. Significant progress was made in 2015 towards ensuring long term sustainability, through key public-private-partnerships.

First, through partnership with the Guatemalan MOH, Alliance for Nutrition and the Tigo Foundation, TulaSalud supported a national rollout of Kawok as part of Guatemala’s primary health care strategy. By December 2015, Kawok was installed on 2,000 phones, and actively used by frontline health workers across all of Alta Verapaz, including nurses, community health workers and their supervisors (see map below).

[caption id="attachment_808" align="aligncenter" width="642"]All health areas in Alta Verapaz covered Kawok used in all health areas in Alta Verapaz[/caption]

Second, we worked with the MOH to transfer direct responsibility for the overall management and administration of key parts of the community mHealth platform. The MOH undertook to negotiate directly with telecom suppliers to provide the hardware on which the Kawok platform operates (Huawei Android phones). The procurement and distribution processes of these devices by the MOH has been challenging, but the MOH is committed to finding effective solutions to overcome procurement and distribution hiccups.

Thirdly, the Tula Foundation was delighted to partner with Global Affairs Canada (formerly the Canadian government’s Department of Foreign Affairs, Trade, and Development). To the already robust global public private partnership, the Government of Canada will add both its voice and financial support to the tune of Cdn. $7.6 million over the next five years. The government of Canada’s announcement can be found here. Within the GAC program, we will continue to support the MOH as they work to improve decision-making for the primary health care system, and integrate data collected by Kawok to provide real-time reliable data and reports that are easy to understand and acted upon at local, regional and national levels.

Continuing Technological Innovation

The TulaSalud technical innovation team, supported by the Tula Foundation in Canada, have become experts in the development and deployment of mHealth technologies. In 2015, the Kawok mobile application and the reporting system were both significantly improved and expanded.

The Kawok mobile application, based on CommCare by Dimagi, was fully redesigned to take advantage of the capabilities of Android, including the phone camera and GPS. We continued to collect and expand the coverage of critical epidemiological data to reduce maternal and infant mortality and identify high risk women and children in rural communities.  We also developed new learning/counselling modules which include over 20 short videos spanning a range clinical and technical training and counselling topics. Videos related to pregnancy risks factors and emergency planning were among the most frequently viewed, and were often shared with expectant mothers and their families.

The Kawok mapping and reporting system was expanded to include personalized dashboards, used by supervising nurses and technical staff to access up-to-date key performance indicators for all workers under their supervision. The dashboards were designed for easy access on mobile devices, and have demonstrated their value in leading to increased quality and quantity of data being submitted. The graph below illustrates the growth in active users and total number of events registered each day.

[caption id="attachment_806" align="aligncenter" width="700"] Scaling up. Training and supervision are key[/caption]

With everything that was accomplished in 2015, we look forward to what lies ahead in 2016. Stay tuned!