Case Study: Good Start Management Console

Leveraging the Mobile Researcher API to integrate, automate and guide the processes involved in a multi-site, longitudinal clinical intervention project.

This case study is available for download in PDF.

Organisation Profile

The South African Medical Research Council (MRC) is a statutory council mandated by government to improve the nation's health and quality of life through promoting and conducting relevant and responsive health research. As one of the largest research organisations in the country, the MRC is able to embark on large-scale long-term projects which break new ground in a range of areas including HIV/AIDS.

Project Scope

The MRC's "Good Start" study focuses on interventions for the Prevention of Mother to Child Transmission (PMTCT) of HIV and strategies to improve neonatal survival. The project involves over 40 members of staff and, over the course of its 3 year term, several thousand participants.

Following the successful completion of two preceding phases, participant recruitment of pregnant mothers residing in Umlazi, a township located outside Durban South Africa by Community-based Health Workers (CHWs) began in 2008. Consenting participants, randomly assigned to a control or intervention group based on their household location, receive antenatal and postnatal CHW visits with the view to assess the effectiveness of the intervention strategy.

Antenatal visit dates are based on the mother's expected date of delivery. Postnatal visits must take place at specific intervals dependent on the date on which the mother is discharged from her delivery facility. Operational information from each visit is required which must be relayed to supervisors to facilitate planning and ensure adherence to the visit schedule. Birth information must be gathered and disseminated immediately to allow for time-critical postnatal visits to take place on time.

The duration a participant remains active in the study varies between 3 and 12 months depending on when she was identified and enrolled. Upon the completion of applicable visits, an assessment interview is held at Prince Mshiyeni Hospital in Umlazi with a data collector.

Complexities relating to participant exclusions, additional visits for low birth weight infants, multiple possible delivery locations, and severely limited infrastructure posed significant challenges to the MRC's team.

Mobile Researcher Implementation

Mobile Researcher, used in phase two of the project, was again leveraged as the data collection and communication platform and formed the base on which the development of a portal to cater for the project's custom logistical, operational and reporting requirements was built. CHWs could use their entry level handsets (used previously for the collection of baseline data), to complete surveys about each participant visit. This feedback, along with information regarding enrolment and birth events from data collectors –also captured via low cost mobile phones– was exposed by the Mobile Researcher Application Programming Interface (API) for incorporation into the purpose-built web portal – the Good Start Management Console (GSMC).

The GSMC leverages information from a variety of sources, including data captured on mobile phones to schedule, track, monitor and coordinate the operational activities necessary to fulfil the project mandate. Supervisors, administrators and managers may login to see, at a glance, the current status of a participant, their upcoming milestones, notes, observations and previous interactions. Only specific information based on a user's role is available ensuring that blinding – a common requirement for most intervention studies – is not compromised.

Lasting Impact

The weekly meetings held with CHWs are informed by the wealth of information managed by the GSMC. Visit schedules which are automatically generated by the system based on the most recent interactions may be printed for each CHW. As visits take place and are captured in the field, the web-based portal updates to reflect a near real-time view of the progress on the ground. Reported births from data collectors trigger scheduling of postnatal visits and notifications to supervisors.

Paper forms have been largely removed and data has become centralised and available to authorised project staff for their specific operational, analysis and reporting needs. Subsequent enhancements will provide detailed performance reports, dashboards and additional functionality to further guide and assist in the successful implementation of this landmark study.