Foundation Projects

Interactive, structured, multi-modal clinical guidelines to improve quality of care by Rural Healthcare providers

Garhwal Community Development and Welfare Society (GCDWS)

Non-physician rural health providers (RHPs) deliver health care in large parts of rural India, but most have not been trained formally; thus the quality of health care they deliver may not be standardized. This project was designed with the objective of enhancing and standardizing RHPs’ quality of care through use of disease management guidelines/protocols available on a user-friendly mobile phone platform.

It used a system called GuideView to develop the multi-modal ‘how-to’ advice for performing simple procedures in a step-by-step way. The project adapted the WHO’s existing protocols to local conditions. It then field-tested the Guidevues (GVs) developed through this system on 16 RHPs from two different parts of rural Tamil Nadu in southern India.

Half the RHPs were assigned to an experimental group and the other half to a control group.

Overall mean protocol compliance of the experimental group (57.21%) was higher than that of the control group (52.70%). An overwhelming majority of the RHPs found the system useful and usable. The overall mean workload index (TLX) was 5.18 implying that they faced only a moderate level of difficulty. There was a high level of patient acceptance for the system and the majority did not think that it interfered with the treatment process. We conclude that mobile phone based GVs have significant potential for scaling up in underserved rural areas with different types of frontline health workers.