Registering births and deaths using mobile phones in Kenya
A mini interview with Doris Ma Fat, Statistician, Health Statistics and Informatics Department, World Health Organization (WHO)
20 October 2011
A Health Metrics Network Monitoring of Vital Events (MOVE-IT) project is underway in Kenya to introduce mobile phone technology to speed up and improve the registration of births and deaths in three districts. Doris Ma Fat travelled to the region recently to help set this up and the Health Metrics Network asked her a few questions about the project.
Mobile phone text messages will be used to record vital events at community level. What sort of platform is being set up to be able to do this and how does it work ?
Doris Ma Fat: We will be using RapidSMS, a free and open-source framework for dynamic data collection. This implies that a community health worker would be using a structured short message service (SMS) to notify a registration agent (local authority) about when a birth or death takes place in an area.
This SMS is sent via a server to the registration agent. Here is an example of an SMS reporting a death: Dth John Kamau M 22/12/2010 H 07964344. This means: Death of John Kamau; Male; on 22 December 2010 at home; family contact mobile phone number is 07964344.
We will also be using OpenXdata, another free open-source software for designing web-based forms for mobile phones. The registration agent, once notified of an event, will register the details of the event using the relevant forms on his or her mobile phone.
What practical difficulties need to be overcome?
Doris Ma Fat: The presence of community health workers is essential in order to collect vital registration information at district level. We have found that they are not present everywhere, so there is a need to set up community units with community health workers for the project to succeed.
According to the latest statistics, the number of mobile cellular subscriptions in Kenya increased from 0.41 per 100 inhabitants in 2000 to 62 per 100 inhabitants in 2010. However, some community health workers do not have mobile phones and they need to be sourced. We also need to negotiate the price of sending an SMS with the mobile network provider.
Coordination among different ministries is crucial. The Department of Civil Registration is responsible for the registration of births and deaths, but the community health workers fall under the aegis of the Ministry of Health.
What are the next steps?
Doris Ma Fat: A prototype of the mobile phone platform is under development. The next step will be to test it in a district to adjust and correct for any unforeseen problems. Training of community health workers and registration agents will also be conducted. Then the project would be piloted in a few areas before rolling it out further to the entire country.
Overall, we hope to demonstrate that infrastructural barriers that currently impede the registration of births and deaths can be overcome using mhealth [mobile technology for health]. More robust registration of vital events will ultimately allow decision-makers at various levels to have real time epidemiological data on which to base health policies and targeted health programmes.
For more information about this project in Kenya and other Health Metrics Network vital registration projects in countries, as well as the WHO Department of Health Statistics and Informatics, please see links at top right.