hopebuilding

Using mobile phones to monitor child malnutrition in Malawi wins award for UNICEF

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Mobile phones, adapted to monitor child health, net UNICEF top development prize

The United Nations Children’s Fund (UNICEF) will share first prize in the United States Development Agency’s innovation competition, known as the “Development 2.0 Challenge,” for adapting basic cell phones to monitor the health of children in danger of malnutrition.

The “RapidSMS” text-messaging system, to be finalized by graduate students from Columbia University, which shared in the prize, was first developed in Ethiopia to monitor food supplies and will now be used to map and track child malnutrition trends in Malawi more accurately and in real time, enabling quick responses to unfolding food and nutritional crises, according to UNICEF.

“This is a perfect example of UNICEF’s vision of bringing together experts from around the world and from diverse fields such as academia, private sector and civil society,” Sharad Sapra, Director of UNICEF’s Division of Communication, said.

The initial phases of the Malawi project are expected to run from January to May of 2009. However, the collaborative and open-source philosophy it is based on means that anyone can take, use and adapt RapidSMS for their purposes, UNICEF stressed.

“The aim is to leverage this global knowledge and create solutions which help achieve lasting benefits for children,” Dr. Sapra said.

This press release, issued by UNICEF 9 January 2009, was distributed by the UN News Centre. The photo accompanied the press release.

MALAWI: SMS to fight malnutrition

JOHANNESBURG, 13 January 2009 (IRIN) - For the first time in years, John Phiri (not his real name), a health extension worker in Malawi's central Salima district, does not have to fill in a stack of forms during his monthly round of collecting data to monitor nutrition levels in the community. Now he whips out his mobile phone and texts the data, including the height and weight of the children in the area, while covering his beat. The information is immediately captured by a computer that stores the national nutritional and food-security statistics in Lilongwe, the capital.

In previous years the data might have taken two months to be registered in the country's Integrated Nutritional and Food Security Surveillance System. The quick collection and availability of data can help government and other aid agencies intervene if the statistics show a crisis is unfolding. Malawi has one of the world's worst under-five mortality rates: up to 120 infants in every 1,000 may die before they turn five, and 46 percent of children younger than five years are stunted - an indicator of the malnutrition level.

The RapidSMS system, as it is called, is on a four-month trial run that began in January 2009 in three districts of Malawi's Central Province. The SMS (short message service) text message and web-based tool was developed by the Innovations and Development team of UNICEF, the UN children's agency, and allows text messages to be captured via the internet. The quick collection and availability of data can help government and other aid agencies intervene if the statistics show a crisis is unfolding. Besides the obvious advantage of speed and quality of data, the system also creates spreadsheets and graphs, allowing for easy interpretation of the data.

Yet doing away with the old system of completing questionnaires and sending them to the capital using the postal system has its drawbacks. The new system is expensive. In Malawi it costs about 10 US cents to send a text message, "But we are in talks with the mobile phone service provider to make the service toll-free," said Stanley Chitekwe, UNICEF's nutrition manager.

Christopher Fabian, who co-heads UNICEF's Innovations and Development team, maintains that the service is still cheaper than the manual collection of data. "The first week of the trial run only cost about $40."

Replacing the questionnaire with only the numbers also means anecdotal information on household security, obtained via the questionnaire, is also lost. "We are aware of that – we are trying to develop a system which will help us get a sense of household food security levels and coping strategies, and we hope to get the system running after four months," Chitekwe said.

Even before it kicked off, the Malawi project, designed by UNICEF and Columbia University's School of International and Public Affairs, in the US, won first prize in the Development 2.0 Challenge, run by the US Agency for International Development (USAID), for its innovative design for adapting a commonly accessible technology to monitor the health and nutritional status of children.

The Malawian programme was developed after UNICEF's success with the RapidSMS system in monitoring and delivering the protein-rich read-to-use therapeutic food, Plumpy’nut, in drought-hit Ethiopia in October 2008. "It used to take the agency three to four months to respond depending on when the information reached the head office to shortages of Plumpy'nut in the 1,800 feeding centres in Ethiopia – now the alerts get through within seconds," said Fabian.

Before implementing the RapidSMS system in Ethiopia, initial field testing was done in northern Uganda by Sean Blaschke, a student at Columbia University who worked as a UNICEF intern during May 2008 in Uganda's Kitgum district. The area is prone to Hepatitis E outbreaks, a disease caused mainly by drinking contaminated water or eating contaminated food.

UNICEF is also considering developing the system to monitor school attendance rates. "It can have any number of uses," said Fabian. "We hope to make the system available, free of cost, to organisations and other implementing partners soon."

This story was prepared and distributed by IRIN News, the humanitarian news agency.

For another story about how mobile phones are being used in health care in Africa, see:

Recycled phones and free software revolutionize health care for Malawi hospital

For a story about Plumpy'nut, see:

New therapeutic food is miracle for starving children

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