Masaiti District, Zambia, July 2007 — The vaccination assessment team from the capital city of Lusaka listens intently as a village official describes local participation in the recent measles vaccination campaign. He believes that all eligible children in the village were taken to the vaccination posts, but urges the team to verify this for themselves.
In a nation where many households have no phone and no address, collecting health data is a daunting task. It means getting out into some of the most remote districts, like the Masaiti District, and going from house to house, asking “Did your children get vaccinated? May I see the vaccination card?” This kind of fieldwork can generate hundreds of pages of paperwork: multiple sheets of information for each household multiplied by the hundreds or even thousands of households that are visited.
But through a year-old pilot program, Zambia is replacing paper-based health surveys with those used on PDAs (personal digital assistants). This means no data entry, no cumbersome clipboards, and most importantly no waiting weeks or months for data entry clerks to enter stacks of paper into a computer for analysis.
Zambia today is helping to lead a public health revolution that has the potential to improve the lives of millions of people in the developing world. By switching from paper-based to mobile-enabled digital health systems, Zambian health workers are empowered with new ‘eyes and ears’ in the field-devices that increase the speed and accuracy with which vital health information can be collected and recorded. These PDAs, sometimes more powerful than laptops of the recent past, quickly are becoming a vital public health management tool.
DataDyne.org, the non-profit organization I co-founded, is helping to forge this promising new path. Through the course of my work as a Wall Street IT consultant, a pediatrician, and a medical officer at the U.S. Centers for Disease Control and Prevention, I developed an interest in applying computer science to the public health domain. The result is EpiSurveyor–a free, easy to use, open source software solution.
Prior to the use of EpiSurveyor, handheld data collection was gathered using commercial software that required expensive consultant programmers every time a new form was needed, or an old form needed to be modified. Now, with support from the United Nations Foundation and Vodafone Group Foundation, and in partnership with the UN World Health Organization and national governments, EpiSurveyor is putting effective health data-gathering tools in the hands of country health officials.
EpiSurveyor operates using a Java-based engine and a Windows-based Designer application that allows fast and easy creation of forms and data systems. It allows anyone with average computer skills–the ability to use a word processor or email, for example–to create and share mobile data collection systems in minutes, and without the need for consultant programmers.
In keeping with its mission to break down the barriers that block access to health data in developing countries, EpiSurveyor is free–anyone with internet access can download the program. EpiSurveyor is also open source, enabling those with higher-level programming skills to manipulate the program to respond to health needs as they arise. Finally, EpiSurveyor is built to run on mobile devices, providing maximum mobility and ease-of-use for health workers who spend most of their time in the field. Pilot project training is conducted using the Palm Zire.
So far, year-old pilot projects in Zambia and Kenya are showing that data received from the field has streamlined the inoculation of children against measles, collected information on HIV, and has even helped to contain a polio outbreak. For some, PDAs are mostly a convenient way to check email and keep up with schedules. In the developing world, these devices perform many of the same tasks–but when equipped with EpiSurveyor can help save lives.