Grant Amount: US$ 22,642

Keywords: TELEHEALTH, PRIMARY HEALTH CARE, INTERNET, SMS, PHILIPPINES

Geographic coverage: Philippines

Objective

The objective of this project is to improve injury prevention programmes through an injury registry.

Research context

In this study free and open source tools from the Linux community combined with participatory people-centric strategies were employed to enable implementation of an injury surveillance system by health workers. The project has three main components: a Short Messaging Service (SMS) for reporting injuries, training of health workers on injury surveillance and a web-based system for the graphic presentation of injury data used by decision makers. The pilot project was implemented in a poor urban village of the Philippines. SMS was selected because of its widespread penetration in the Philippines and its wireless capabilities.

Target beneficiaries

The beneficiaries of this project are community health workers in Pasay City, Metro Manila, Philippines. Other beneficiaries are local government officials who can use the health reports generated by the system for community and local level decision-making.

Outputs

• Rapid prototyping of injury codes, SMS and landline phone submission formats and protocols, community health worker surveillance kits;
• Data modelling for the surveillance system;
• Development of applications to receive data and generate reports, including bug fixes and enhancements;
• Training on the system including preparing related content such as manuals, exams and certificates;
• Pilot testing and evaluation of the system; and
• Deployment of the system with actual submissions of data.

Research results and outcomes

The project’s initial aim was to create a data collection system using SMS over mobile phones, called the Community-Based Child Injury Surveillance System. After preliminary investigations, however, the researchers discovered several constraints associated with the original strategy. These related to the cost of sending messages and public health policies that only allowed official government health centres to submit health data.

The project responded to these factors by shifting strategies and creating a computer-based information system that served, primarily, the needs of the health centre facility and, secondarily, of the national public health system. The project was renamed CHITS (Community Health Information Tracking System).

By employing a combination of methods, including community immersion, systems analysis, joint rapid application development, onsite technical assistance and grassroots-oriented training, CHITS was piloted in two of thirteen health centres in Pasay City. The pilots had two major components: first, an extensible and customizable software engine for health facilities and second, a training programme for health data collectors, such as health centre staff and community health workers.

The researchers note that developing a community-based health information system is a challenging task, closely approximating the level of difficulty found in the development of hospital and clinical information systems. By paying close attention to health centre events and culture, and by employing purposeful immersion in the end-user's way of life, the researchers were able to gain immense insight into their needs and requirements and apply these insights into software code, a process called “evolutionary software development.” The researchers were originally leaning towards a technology-centric implementation of an information system. With deeper analysis and understanding of the needs and requirements of end-users, the researchers were able to put technology in its place to serve the genuine needs of community health workers.

The CHITS project has seen a number of opportunities for further development and replication. A blood bank and a national surgical registry are already using the CHITS generic software engine. CHITS also attracted the attention of the Department of Health and the CHITS Tuberculosis (TB) module has been presented to TB control programme managers in the private health sector who are considering the system for adoption. There are also plans for citywide implementation of CHITS in the cities of Pasay and Marikina. Inquiries from three other municipalities have also been made.

Awards

CHITS was selected as a finalist in the 2006 Stockholm Challenge under the health category. To learn more see: http://event.stockholmchallenge.se/finalists.php

Project Duration

Start Date: January 2004
End Date: December 2004
Total Duration: 12 Months

Contact information

Herman D. Tolentino, Alvin B. Marcelo
Medical Informatics Unit, UP College of Medicine, University of the Philippines
547 Pedro Gil Street, Ermita, Manila 1000, Philippines
Telephone/Fax: +63 2 522 9231
Email: alvin.marcelo@miu.ph

Website

http://www.chits.info
http://www.upm.edu.ph

Reference Website: http://event.stockholmchallenge.se/finalists.php