Using eHealth to Improve Health Delivery in Bangladesh
Bangladesh, one of the world’s most populous countries, has some of the worst maternal health indicators. One of the contributing factors to poor maternal health is the lack of life-saving information on family planning and reproductive health, maternal nutrition, safe delivery, antenatal care, and postnatal care. The government-supported community-based frontline health workers (CHWs) that provide counseling to mothers often lack accurate and up-to-date information around these topics themselves. However there are reasons to be optimistic! The government’s commitment to improving maternal health, and its goal of a Digital Bangladesh, provides a unique opportunity to explore solutions through innovative technology in communities.
The Bangladesh Knowledge Management Initiative (BKMI) is improving access to and use of essential maternal health information in Bangladesh communities through simple and cost-effective eHealth solutions. Working closely with the Ministry of Health and Family Welfare (MOHFW), BKMI has developed an easy to use eToolkit, or digital library, and eight interactive eLearning course videos for a low-literacy audience. The eToolkit contains well-organized and cross-cutting behavior change communication (BCC) health resources vetted by technical experts and CHWs, for use with community clients. The eLearning courses are designed to supplement health worker trainings. They cover these maternal health topics, and also include interpersonal communication and counseling, and integrated messaging.
The eToolkit and eLearning courses are being deployed as an eHealth pilot through 300 netbook computers and up to 300 existing facility and information center-based computers in two of the lowest-performing districts in Bangladesh, Sylhet and Chittagong. This digital resource is intended to support frontline healthcare by lessening the load of the CHWs and improve their client interaction. CHWs often have too many job aids to carry, lack basic BCC tools and training, and are given material with conflicting messages that may not be best practices. Trained CHWs can take the lightweight netbooks to households and reach a greater number of clients with essential maternal health information at their fingertips, without having to carry heavy materials. More than 40 partners submitted material for consideration; resources include digital flipcharts, radio and TV spots, posters, etc. The eToolkit will be loaded to existing computers in health facilities and information centers so that service providers can use the materials in the workplace when counseling patients or for their own reference.
Importantly within the context of Bangladesh, government workers are trained in either “family planning” or “health” – the material they learn and share is distinct and without integration. The BKMI eToolkit, eLearning Courses, and netbook pilot bridge these priority health areas. Coordination efforts within key MOHFW units, and use of innovative technology, are expected to improve the knowledge and skills of health workers, and change the behavioral intentions of these communities.
We are very excited that this pilot will be underway in just a few short weeks! The netbooks have arrived in Dhaka, and work now begins to configure them with appropriate software then image the Toolkit. Simultaneously through our local partners, we are providing orientation and training to the CHWs on how to use the netbooks, and establishing guidelines for monitoring and evaluating established indicators. We have had great support for the initiative and are looking forward to seeing real and measurable change once we launch this spring!