Field trials in Nkhata Bay and Rumphi districts

In winter 2016/2017, around 100 HSAs tested the latest release of the Supporting LIFE App in a field trial. They used the app when treating children aged between 2 months and 5 years.

Members of the Supporting LIFE consortium assessed the potential impact of the app by measuring three indicators of better health system outcomes:

  • Referral rates: One of the main advantages of CCM is that it helps HSAs to decide which children need treatment in a higher-level health facility. Failure to refer children when necessary can result in avoidable complications, travel and potentially increased treatment costs. In Malawi, referral rates are extremely low compared to other countries: In Gambia and Kenya, 14% of children are classified as needing urgent referral, 2.5% in Niger, and less than 1% in Malawi. Therefore in the upcoming trial, the first indicator of health system improvement will be any changes in the number of children correctly referred to a health facility as a result of using the app.
  • Attendance rates of caregivers given urgent referral recommendations: Correct referrals can reduce mortality and increase health outcomes only if caregivers actually heed the recommendations and present at higher-level health facilities. Increased attendance rates, therefore, are taken as a second indicator for improved health system outcomes.
  • Re-consultation rates: False diagnoses can result in re-consultations for the same illness episode and higher risk of complications. Decreased re-consultation rates are, therefore, taken as the third indicator for improved health system outcomes.

The results of this trial will serve to improve the Supporting LIFE App and to provide valuable data to Malawi policy-makers to improve the health system. In addition to publishing results in peer-reviewed journals, at conferences and on the Supporting LIFE website, a summary of results was made available to the Malawi Ministry of Health and other stakeholders in several meetings in April 2017.