The RapidSMS Child Malnutrition Surveillance project is an effort by a team of six students at Columbia University’s School of International and Public Affairs (SIPA) to use mobile technology solutions to improve the speed and quality of nutrition surveillance data for children in Malawi. The work will involve a pilot study to replace the paper/mail data collection process currently in use at Malawi’s child growth monitoring clinics with instantaneous data transmission via mobile devices.

The project will enable the Government of Malawi, UNICEF Malawi, and their partners to geographically map and track child malnutrition trends accurately and in real time. This tool will provide a critical means of intervention into rapidly unfolding food and nutrition crises. If successful, the pilot will serve as a model to scale up the use of mobile devices in other nutrition and food security surveillance systems worldwide.

The Problem

The country’s current Integrated Nutritional and Food Security Surveillance System is designed to serve as an early warning system for impending food and nutrition security crises. 70 child participants within each district are randomly selected to be measured at growth monitoring clinics by health workers on a monthly basis. Currently, the data is collected on paper forms and then sent through district health managers to a central office in Lilongwe, where they are entered into separate Excel-based datasets for nutrition and food security. Yet the system faces several challenges:

• Delays in transmission of data: there is currently a two month delay between data collection at health clinics and analysis at the government and NGO level, since data is recorded on paper and sent via mail to a centralized location.
• Poor data quality: since the paper data collection forms are frequently lost or contain illegible handwriting, datasets are often incomplete or contain many nonsensical outliers.
• Participant defaulting: there is little incentive for caregivers to travel long distances with their children to the health clinics to participate in the survey.

Since chronic and widespread child malnutrition remains a serious problem in Malawi, the shortcomings of the system are a serious threat to the country’s ability to anticipate and plan for current and future nutrition and food security crises.

 
The Solution

Our project will adapt a mobile-based monitoring system based on UNICEF's RapidSMS platform for growth monitoring clinic workers. Nutritional data will be continuously transmitted from the field via SMS to government and UNICEF databases and indicators commuted automatically. Based on these indicators, instant feedback will be SMSed to health clinic workers, who can immediately share with mothers critical information and advice related to their children’s nutritional status. User friendly 'dashboards' will provide UNICEF and government agencies with spatial mapping of the data collection points and basic tools for data analyses. This platform will be piloted in three sites in Malawi between January and April 2009. The pilot will assess the utility fo the new platform and scaled up if appropriate.

 
The Impact

Mobile technology use at local level growth monitoring clinics will enable:

• Rapid response to child malnutrition trends from government, development, and humanitarian partners
• Improved data quality for better national food and nutrition policy
• A model for other development efforts seeking to use mobile technology solutions