Cell & mobile phones, key to health monitoring in vulnerable areas

 Cell & mobile phones, key to health monitoring in vulnerable areas

The use of cell phones in hard-to-reach areas and in the context of the current pandemic is an efficient alternative to monitor the health of mothers and children under two years of age, suggests a study focused on Guatemala. Image credit: Pikrepo, under public domain.

of mothers and children under the age of two, suggests a study focused on Guatemala. Image credit: Pikrepo, under public domain. Take a look Remote monitoring by cell phone helps fight chronic malnutrition In Guatemala, study found that phone calls are more effective than text messages In Argentina, an NGO used WhatsApp as an additional alternative

By: Pablo Corso

The use of cell phones in hard-to-reach areas and in the context of the current pandemic is an efficient alternative to monitor the health of mothers and children under two years of age, suggests a study with a focus on Guatemala but implications for the entire region. The study specifies that this country has "the highest rate of chronic malnutrition among children aged 0 to 5 years [46.5 percent] and is ranked sixth in the world." In this context, four researchers evaluated the feasibility of monitoring the provision of vaccines and drugs in state health centers during the most critical period of child development. "Monitoring these interventions is highly relevant in an area where food insecurity and chronic malnutrition are serious problems," warns the report published in the journal PLOS ONE. The research was developed in Quiche, a rural region of the Western Highlands of Guatemala, with malnutrition rates greater than 68 percent, rugged geography and intermittent connectivity. During four months during 2019, eight tele-operators asked 1,542 families about the reception of 13 health and nutrition services scheduled according to age, one month after they were scheduled.

The calls "seem to enable a more frank and personalized contact in homes, reducing mistrust regarding, for example, answering an SMS from an unknown number.

For children under two years of age, consultations focused on breastfeeding, micronutrients and vaccines. For pregnant women, in the incorporation of folic acid and ferrous sulfate, in addition to control visits to health centers. As Quiche has a population of mostly Mayan origin, the monitoring was done in different languages. The response rate to telephone calls - made in the language of each home - was 75.8 percent, while that of text messages (SMS) - in Spanish, which tends to be used for reading and writing - fell to 14.4 percent. The calls "seem to enable a more frank and personalized contact in homes, reducing mistrust related to, for example, answering an SMS from an unknown number," says the work. These communications made it possible to resolve doubts and increase trust. Unlike SMS, replying to them was free.

"The results could be replicated in rural contexts in Honduras and El Salvador, as well as in other Latin American countries," Manuel Hernández, one of those responsible for the work and member of the Markets, Commerce and Institutions Division, gave an email to SciDev.Net. from the International Food Policy Research Institute (IFPRI), based in Washington DC, USA. His team presented these conclusions to the Guatemalan government with the aim of promoting a monitoring system that allows to supervise the provision of agricultural, educational and welfare services, "both in the current context and in the future, especially in areas of difficult access." Hernández detailed.

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 HAJANDO Camino, an NGO that seeks to improve the quality of life of vulnerable families in northern Argentina, also appeals to the use of cell phones to monitor children and pregnant women, but with the mobility restrictions imposed by the pandemic, it had to suspend weight controls and face-to-face carving that he did to his beneficiaries. "We went from care within the institution to an approach with home visits and the sending of audiovisual material by cell phone," explained Natalia Fernández by phone, who coordinated the monitoring of more than 400 families in the provinces of Chaco and Santiago del Estero. The monitoring by WhatsApp enabled verbal and audiovisual communication, with exchanges of photos and videos. "It was the only thing that allowed us to be in contact with the families," added Fernández, who acknowledged that not all have a multimedia telephone or permanent signal, because some live in remote places. With similar advantages and difficulties in both Guatemala and Argentina, the most pressing challenges for these initiatives appear to focus on infrastructure issues, with provision of devices and expanding coverage as priority needs.