On a recent home visit to check on a mother and her two-week-old son in Ghana, nurse Valerie McCarthy Vroom looked in newborn Aristotle’s ears, squeezed his nipples and tucked a thermometer under his arm. Declaring him healthy, she then turned to the mother to talk about how to keep herself and her baby strong, showing the mom visual aids on the nurse’s cell phone to illustrate points. McCarthy Vroom asked the mother what the drawings were saying:
“She said she should breastfeed all the time and not give the baby any water,” said McCarthy Vroom, translating for the mother, Gifty Apau.
Concern and our partners have won a first place design award for this new smartphone app that frontline nurses like McCarthy Vroom are using for helping pregnant women and newborns.
The CHN on the Go app helps nurses diagnose tough cases in the field and determine next steps.
The nurses themselves helped design the app, which recently won the Design Management Institute’s first place “dmi: 2015 Design Value Award.” We share the award with ThinkPlace, a design consultancy that led the design process with the nurses; Grameen Foundation, which developed the app; and Ghana Health Service, which provided content and supported its roll out.
See CHN on the Go in action:
Nurses on the Go
The app, called CHN on the Go, equips about 300 Community Health Nurses, or CHNs, and their supervisors in southern Ghana. These nurses, who visit pregnant women and newborns in their homes, play a critical role in reducing deaths of mothers and newborns, yet they face enormous challenges. Posted in remote areas far from their homes, CHNs can feel isolated and cut off from peers, family and health information. They travel hours by foot, motorbike and canoes to visit mothers.
“They quickly go into the app and know what they are supposed to do. They just tap it and everything is there.”
CHN on the Go helps these nurses diagnose tough cases in the field and determine next steps. Nurses use it to plan targets such as how many children to immunize, take accredited eLearning courses, and share pictures and questions with supervisors when they need on-the-spot guidance. A separate app allows supervisors to monitor nurses’ progress, and WhatsApp groups designed just for these nurses connect them with peers and supervisors so they feel less isolated. The app aims to boost their motivation and sense of connection.
“After work, I read through my courses,” says Nurse McCarthy Vroom. “It improves my confidence a lot.”
“They quickly go into the app and know what they are supposed to do,” said Ghana Health Service District Director Florence Gyaase-Nketiah. “They just tap it and everything is there. Definitely, it has helped them improve health service delivery.”
Nurse McCarthy Vroom said it makes her job easier. “If there’s something I don’t understand, I go to my app and get nursing information from there. After work, I read through my courses,” she said. “It improves my confidence a lot.”
The mother that she visited in the village of Old Ningo said she likes it, too. “She said it is her hope that all CHNs in Ghana have access to the CHN app and all mothers can learn from it,” said McCarthy Vroom, translating for mom Gifty Apau.
Nurses Designed their Smartphone App
In developing the app, we collaborated closely with nurses and supervisors on the ground, who articulated their problems and needs and then co-designed their own solution. The nurses determined what modules the app should include so they could be well-equipped and well-informed.
“At each point, we went back to the community health nurses to engage them, to let them know this is what we’re developing based on what we heard from you.”
“We spent a lot of time with nurses, getting a better understanding of how they spent their day,” said Jahera Otieno, a senior program officer for Concern.
Once developed, continuous feedback from the nurses led to multiple new and improved versions. “At each point, we went back to the community health nurses to engage them, to let them know this is what we’re developing based on what we heard from you,” said Patricia Porkeuu, Concern’s program manager.
Using the app as a hands-on example, Concern gave a workshop at a major international conference last month, the Global Maternal Newborn Health Conference in Mexico City, on how to engage users in the design process.
The app is part of our Innovations for Maternal, Newborn & Child Health initiative, which pilots programs to improve the health and survival of women, babies and children. Innovations embraces the design philosophy used with the app, called “design thinking,” across its programs. Our research partner, JSI Research & Training Institute Inc., is monitoring how well the app is helping nurses.
Gyaase-Nketiah said she hopes it scales up across the whole country. “It’s an important tool,” said the Ghana Health official, “in the ultimate goal of reducing the deaths of mothers and children in the communities.”
Find out more about the award.