Experiences Using Mobile Phone Surveys to Monitor and Evaluate the Distribution of Health Services in Sierra Leone

Abstract

Objectives: Evidence-based programs to reduce child mortality and morbidity such as twice-yearly vitamin A supplementation (VAS) and mass drug administration (MDA) for neglected tropical diseases require real-time coverage data to ensure that all populations are reached with equitable coverage. Methods: The EpiSurveyor platform was introduced in 2011 for 'in' and 'end' process monitoring of VAS distribution and MDA for lymphatic filariasis (LF), and was later used in 2012 for a LQAS of the supplementary measles immunization program.  In 2013, the Magpi platform was piloted for VAS distribution and MDA-LF, and the CommCare platform was piloted for routine reporting of MDA. Results: Twelve nation-wide surveys were conducted with a total of 266 enumerators and 59,465 respondents. Data compilation was available to the account administrator within 48 hours of field-work completion with all three applications.  The CommCare platform had several benefits over EpiSurveyor/Magpi: (1) faster programming of skip logic with a friendlier interface (2) ability of the administrator to respond to an enumerator via SMS from the server (3) a prompt for photo evidence and/or Global Positioning System (4) automatic server-input synchronization during network availability (5) ability to program an 'other' category for questions allowing multiple responses. Conclusions: Monitoring and evaluation was enhanced in timeliness and data quality by all three applications. CommCare was found to be more comprehensive and user-friendly compared with EpiSurveyor and Magpi.