Smartphones for community health in rural Cambodia: A feasibility study

Abstract

Background: Village Malaria Workers (VMWs) are lay people trained to provide a valuable role in frontline testing and treatment of malaria in rural villages in Cambodia. Emergence of artemisinin-resistant malaria highlights the essential role of such VMWs in surveillance and early treatment of malaria. Smartphone technology offers huge potential to support VMWs in isolated and resource-poor settings. Methods: We investigated the feasibility of issuing established VMWs with a smartphone, bespoke Android application and solar charger to support their role. 27 VMWs in Kampong Cham and Kratie provinces participated. Results: 26/27 of the smartphones deployed were working well at study completion twelve months later. Interviews with VMWs using quantitative and qualitative methods revealed pride, ease of use and reports of faster communication with the smartphone. VMWs also expressed a strong wish to help people presenting with non-malarial fever, for which further potential supportive smartphone applications are increasingly available. Conclusions: As a result of this pilot study, two smartphone based reporting systems for malaria have been developed at the Cambodian National Malaria Center, and the programme is now being extended nationwide. The full code for the smartphone application is made available to other researchers and healthcare providers with this article. Smartphones represent a feasible platform for developing the VMW role to include other health conditions, thus maintaining the relevance of these important community health workers.

Keywords: community; m-health; malaria; smartphone; technology.

Figure 1.. Screenshots of bespoke app for data collection allowing data entry.

Screenshots show gender ( a), age ( b), malaria rapid test result ( c), residency status (permanent villager or mobile migrant) ( d), and exit screen to send data including GPS signal ( e).

Figure 2.. Map of Cambodia showing location of research.

Kampong Cham and Kratie provinces are shaded yellow (source: Cambodia National Malaria Center, adapted from http://www.un.org/Depts/Cartographic/map/profile/cambodia.pdf. The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the Ministry of Health of Cambodia concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries).

Figure 3.. Village Malaria Workers (VMW) receive training.

A group of VMWs in Kratie Province receiving training in the use of smartphones for the project at Sambo Health. All individuals gave their consent for the publication of this image.