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Evaluation database

Evaluation report

2016 South Africa: Conducting a Rapid Assessment of MomConnect Project from September 2011 to date in eThekwini and Umgungundlovu districts, KwaZulu-Natal



Author: Report completed by the partner - Maternal, Adolescent and Child Health Systems (MatCH) with inputs from the provincial Department of Health and UNICEF

Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report, and the executive feedback summary labelled as ‘Part 3’.

Background:

This report summarises key findings from a rapid evaluation of the KwaZulu-Natal Department of Health’s pilot mHealth project, MomConnect, implemented in eThekwini and Umgungundlovu districts in the period 2011 to 2014. The project was developed in collaboration with the KwaZulu-Natal Department of Health and UNICEF by Virtual Purple Health Systems (VP) and the Praekelt Foundation.
The project MomConnect aimed to use mobile technology to improve the uptake of prevention of mother-to-child transmission (PMTCT) services and improve the health outcomes of mothers and infants on the project.

Purpose/Objective:

MatCH was contracted by UNICEF to conduct a rapid evaluation of the MomConnect project, including a desk review, process evaluation and quantitative and qualitative analysis of the project.

Methodology:

The quantitative analysis explored the project achievements and the messages delivered, based on available data from the project.
Qualitative data collection from clients aged 18 years and older was conducted by MatCH in eThekwini and Umgungundlovu districts at ten facilities where the MomConnect project had been fully implemented.
The study population for the qualitative data collection was 574 women enrolled on MomConnect. A second study population of healthcare workers at both active enrolment sites and inactive sites was also interviewed.
The evaluation used a mixed method study design. A total of 60 semi-structured interviews were conducted with women who received SMSs during the course of the project. In addition, 37 healthcare workers from 37 facilities participating in the project were interviewed in the two districts.

Findings and Conclusions:

The MomConnect KZN project achieved enrolment of approximately 6000 clients in two districts in KZN by 2015, thus reaching the proposed target. The number of scheduled text messages for all categories of clients increased over time confirming successful scale-up of the project at all sites. The data reviewed in this evaluation confirms that the text messaging service was successfully implemented for scheduled visit reminders and health information.
No data was available for this evaluation to ascertain if integration of text messaging and patient medical record system was successful overall, and whether this integration had any effect on the cascade of care.
There is no data relating to the establishment of a communication channel with community care givers. The aim of creating a communication feedback mechanism between clients and the health system was technically achieved as a register of these feedback messages is available. However, it is not clear whether this system is responsive and improves adherence to follow-up visits.
Clients overwhelmingly liked the SMSs and it is apparent that a system that provides timeous and reliable appointment reminders would be well-received. Healthcare workers need to be capacitated in terms of training and reliable technology. A data quality plan is essential to improve data validity, reliability and completeness.
The MomConnect project demonstrates that a scheduled text messaging system can be implemented in the public health system environment in KwaZulu-Natal.

Recommendations:

In order to support real-time data entry and a two-way feedback system – essential components for the success of the project – it will require investment in infrastructure and significant modification of the data collection system. Connectivity at health facilities needs to be improved and maintained.
Ongoing training and support from management is essential for healthcare workers.
Access to a call centre for clients to provide detailed explanations or referrals would be beneficial, as would a facility for keeping contact details up-to-date. Publicity would aid community buy-in and improve enrolment.
Thorough piloting of new systems is needed to fine-tune systems prior to wider rollout.

Lessons Learned:

Qualitative component to be done early on in the process. The current evaluation was done after the project ended and with challenges of recall.



Full report in PDF

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Report information

Year:
2016

Country:
South Africa

Region:
ESAR

Type:
Evaluation

Theme:
Participation (Cross-cutting)

Partners:
KZN Department of Health, UNICEF

Language:
English

Sequence #:
2016/001

 

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