The 130th Annual Meeting of APHA

Abstract #50517

Emmanuel d'Harcourt, MD¹, Emily Sonneveldt, MPH², Eugene Twahirwa, MS², and Placide Musafiri, RN³. (1) Health Unit, International Rescue Committee, 17 Dwight Street, Boston, MA 02118, 617-482-2298, harcourt@aya.yale.edu, (2) Rwanda Child Survival Program, International Rescue Committee, BP 2961, Kigali, Rwanda, (3) Rwinkwavu Health District, Ministry of Health, Government of Rwanda, Region Sanitaire, Kibungo, Rwanda

In July 2000, IRC and the Rwandese Ministry of Health implemented an information system for community health workers (CHWs) in Kibungo region, in southeastern Rwanda. The purpose of the system is to monitor health outcomes and to improve supervision of CHWs. CHWs give monthly reports to health center managers, who transmit them in compiled form to health districts. There are 248 trained CHWs in the system’s pilot zone. From July 2000 to December 2001, an average of 73% of CHWs have returned reports. In that period, CHWs reported 1321 deaths, compared with 182 deaths reported by health centers through the official reporting system. Of the reported deaths, 53% were in children under 5, 17% were in adult women, and 17% were in adult men. The leading causes of death were febrile illnesses (74%), non-febrile illnesses (22%), accidents (3%), and maternal deaths (1%). The system cost $4,300 to implement. Recurring costs are very low and are absorbed by health districts. The system is popular with CHWs, who have said that they now feel their work is “visible”. Health center managers report that the system has greatly increased their contact with CHWs and with the community. We conclude that such an information system is a low-cost, effective way to gather otherwise unavailable information, as well as to supervise and motivate CHWs. However, further work is needed to improve the accuracy of the reports, and to ensure the information is used by health planners and by communities to improve health outcomes.

Learning Objectives: At the end of this session, the participant will be able to

• Describe 5 key features of an information system for community health workers in Kibungo region.
• List 8 key indicators collected by the information system.
• Evaluate the information system's success based on impact and process measurements.
• Discuss 6 key features of information factors favoring or limiting success.

Keywords: Information Systems, Developing Countries

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.