The culmination of our many many meetings was our presentations to the Ministry of Health and the Member of Parliament (MP) for Nakaseke district. (Although admittedly the MP meeting was a bit of a surprise, so a bit extemporaneous.) We had been spending our evenings in Luwero (the town near Nakaseke where we were staying) processing everything we learned, and our days visiting the health centers. We interviewed the in-charges, nursing assistants, and records officers/assistants at 3-4 health centers a day, and asked about stock management, health information reporting, and the general challenges they each faced in their daily work. Almost none of the lower health centers (HCIIs and HCIIIs) had power (“We use lamps”), but even in the HCs with power the staff had mobile phones. In those cases, they charge the phone by sending it off overnight with a matatu (the public mini-bus system) driver for the price of 500 shillings. Most people have nokia candybars that stay charged for about 4 days.
I’m impressed overall with the staff we’ve talked to, and with how well all of the health centers comply with the Ministry of Health’s health information reporting policies. They each submit weekly reports on highly infectious diseases (sometimes by SMS) as well as more comprehensive (4 page) monthly reports on stock levels, outpatient population, and diagnoses. In Rakai (another district) they submit these reports via PDA and gprs – here, they submit on paper in person to the district hospital in Nakaseke.
You can check out our findings in the presentation we made to the MoH, along with some ideas for integrating smartphones into their existing system. The presentations (ours and that of the ICT team) were well received, and we are all looking forward to further collaboration on a project proposal, and hopefully a pilot once we receive funding to move forward. There’s a lot of questions left to be answered (how do we balance paper and digital records? What about power?) and a lot of work to be done, but I have high hopes that handheld computing and communication devices like smartphones can make a positive impact on healthcare in Africa!
