How Dimagi Helps Deliver Impact Remotely

September 9, 2020

COVID-19 has caused many of us to change the way that we live and work. Due to the pandemic, Dimagi has shifted to a fully remote project execution approach to ensure we continue to deliver maximum impact while keeping our team and partners safe.

To help facilitate this shift, we have developed a set of remote tools based on proven project examples for our team to use with partners. These remote tools will help our partners deliver high-impact digital health solutions and, wherever possible, empower our partners to carry out a modified “design under the mango tree” methodology by leveraging tools like WhatsApp, Skype, and Zoom. From kick-off and requirements gathering to user acceptance testing and end-user training, Dimagi is ready to collaborate with partners at every stage of their project enablement – without ever coming on site.

Scoping

When the Malaria Consortium approached Dimagi to develop updates to their existing upSCALE application in Mozambique, Dimagi conducted the scoping process entirely remotely.

Since early 2016, Malaria Consortium has worked in close collaboration with UNICEF and Dimagi to develop the upSCALE mHealth system. 

The mobile application is a phone-based job aid tool that guides CHWs through the iCCM consultation steps to assess, diagnose, treat, and refer patients for diarrhea, pneumonia, malaria, and malnutrition. Further modules for antenatal care, postnatal care, family planning, and child care have been added to the platform, supporting the work that the CHWs are performing in the field.

To date, the program has provided health care services to 96,626 children under five years and to 10,194 pregnant women across the country using UpScale. In total, upSCALE has facilitated 503,398 consultations with these target populations in Mozambique. 

To launch the scoping process for new additions to the application’s workflows, Dimagi prepared interview guides based on a collection of Malaria Consortium’s paper forms. Dimagi and MC team members then interviewed the different user groups remotely using skype. Dimagi also spoke with other stakeholders, such as Malaria Consortium, UNICEF, and MISAU (the ministry of health), via Zoom to gain a full picture of required changes. The results of these scoping interviews were compiled to inform a design document for the necessary updates to the application.

User Acceptance Testing (UAT)

Early in 2020, Dimagi conducted a remote user acceptable testing (UAT) for an updated version of the Mobile Village Toolkit in Malawi that sought to increase the mobile application’s usage. 

Dimagi initially developed the Mobile Village Toolkit (MVTK) application with the ONSE Health consortium. Its objective was to support improved healthcare service delivery and efficient collection and transmission of community health data in remote hard-to-reach areas in Malawi. The application’s decision support functionality Health Surveillance Assistants’ (HSAs) client assessment, diagnostic, and referral processes.

With the restrictions in place due to COVID-19, including no travel into Malawi, the traditional in-person training and mentoring model was not an option. In addition, mass gatherings were not possible due to mandatory social distancing requirements. Accordingly, the team selected 12 users to receive the updated version of the application, and piloting a new remote support model, Dimagi reached out to these users over Skype and WhatsApp to introduce the changes. 

These users then used the updated app to support their work for several weeks. This process also included online help with migrating to the latest version of the app, as well as audio and video step-by-step recorded guides where calls could not work.

All users were added to the same WhatsApp group, and users were encouraged to provide first line of support to their peers. This promoted the natural emergence of the “go-to” champions within the group who would mentor and support their peers. Besides creating a sense of ownership and responsibility, creating a WhatsApp group helped keep track of the different types of questions users had with regard to the update. To obtain user feedback on the new version of the application, Dimagi reached out to users both individually and through the WhatsApp group. Following the feedback and support process, these end users expressed appreciation for the extra support that they received.

Dimagi project manager Wouter Vink commented that, “Conducting a remote UAT has proven to be a valuable alternative to in-person UAT. Although it is still preferable to be able to directly observe the context and environment that a community health worker is operating in, one big advantage of a remote UAT though is that it’s easier to test the application with a larger group of users. It also allows support to be deployed effectively and interactively, despite the travel ban and meeting restrictions from COVID-19.”

Training 

As part of the Baylor College of Medicine’s ETHICS project in Lesotho, Dimagi provides implementation support and CommCare capacity building to the local team as part of the effort to scale nationally. Their CommCare application supports maternal & child health, tuberculosis, and HIV departments by tracking appointments, sending SMS reminders to patients, transferring patients within and between hospitals, and reporting on a select set of outcomes.

In March 2020, our team planned to travel to Lesotho to lead a training of trainers, but due to COVID-19, they were required to modify their plans.  By leveraging video-conferencing software for the trainers located in the capital of Maseru and by making some modifications to the training schedule and resources, Dimagi was able to adhere to the full training of trainers curriculum. 

Off the heels of the successful remote training, the trainers led the end-user training in May 2020 entirely independently – without any on-site support from Dimagi. This was followed by a two-day remote capacity-building training to enable the Baylor team to take full ownership of the app and to highlight the essential components of post-deployment support as they continue to scale up this application to additional facilities.

Work With Us

Dimagi is here during this unprecedented time to deliver impactful digital health projects – even if we’re all working a little differently. From scoping to training, we will continue to take advantage of tools like Zoom, Skype, and WhatsApp to support the development of your programs.

Even after COVID-19 has been contained, partners can opt into Dimagi’s remote offerings. Dimagi’s remote offerings will be particularly useful for partners who are located in areas where travel continues to be difficult or who want support in upskilling their own team in managing activities like scoping and user acceptance testing. 

To learn more about how to work with us to ensure your program’s impact despite the pandemic, email [email protected]

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Dimagi

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