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. 2021 Dec 21;9(4):990-999.
doi: 10.9745/GHSP-D-20-00486. Print 2021 Dec 31.

Development of an Innovative Digital Data Collection System for Routine Mental Health Care Delivery in Rural Haiti

Alexandra L Rose  1   2 , Darius L Fenelon  3 , J Reginald Fils-Aimé  3 , Wilder Dubuisson  3 , Sarah F C Singer  2 , Stephanie L Smith  2   4   5 , Gregory Jerome  3 , Eddy Eustache  3 , Giuseppe Raviola  2   4
Affiliations

Development of an Innovative Digital Data Collection System for Routine Mental Health Care Delivery in Rural Haiti

Alexandra L Rose et al. Glob Health Sci Pract. .

Abstract

Introduction: Effective digital health management information systems (HMIS) support health data validity, which enables health care teams to make programmatic decisions and country-level decision making in support of international development targets. In 2015, mental health was included within the Sustainable Development Goals, yet there are few applications of HMIS of any type in the practice of mental health care in resource-limited settings. Zanmi Lasante (ZL), one of the largest providers of mental health care in Haiti, developed a digital data collection system for mental health across 11 public rural health facilities.

Program intervention: We describe the development, implementation, and evaluation of the digital system for mental health data collection at ZL. To evaluate system reliability, we assessed the number of missing monthly reports. To evaluate data validity, we calculated concordance between the digital system and paper charts at 2 facilities. To evaluate the system's ability to inform decision making, we specified and then calculated 4 priority indicators.

Results: The digital system was missing 5 of 143 monthly reports across all facilities and had 74.3% (55/74) and 98% (49/50) concordance with paper charts. It was possible to calculate all 4 indicators, which led to programmatic changes in 2 cases. In response to implementation challenges, it was necessary to use strategies to increase provider buy-in and ultimately to introduce dedicated data clerks to keep pace with data collection and protect time for clinical work.

Lessons learned: While demonstrating the potential of collecting mental health data digitally in a low-resource rural setting, we found that it was necessary to consider the ongoing roles of paper records alongside digital data collection. We also identified the challenge of balancing clinical and data collection responsibilities among a limited staff. Ongoing work is needed to develop truly sustainable and scalable models for mental health data collection in resource-limited settings.

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Figures

FIGURE 1
FIGURE 1
Zanmi Lasante Depression Care Pathway Used at Health Facilities in Rural Haiti Abbreviations: CHW, community health worker; IPT, interpersonal psychotherapy; SW, social worker; ZLDSI, Zanmi Lasante Depression Symptom Inventory. aAdminister the Zanmi Lasante Depression Symptom Inventory every 2 weeks. Illustration prepared by Partners in Health.
FIGURE 2
FIGURE 2
Diagnoses and Psychological Interventions Sections of English Version of Digital Data Collection Form With Comorbid Depression and Anxiety Example Used in Rural Haiti
See this image and copyright information in PMC

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