The following is a guest post by Marc Mitchell, Founder and President of D-tree International. It’s an excerpt that appeared on Health Works Collective, as part of theMobile Health Around the Globe series. Read it in its entirety here.
Zanzibar, an island nation off the coast of Tanzania, evokes images of cloves and cinnamon, white sandy beaches and fishermen in their Dhows, a boat that brought traders from the Arabian Peninsula to the East Coast of Africa. But it is also known for its high rates of childhood malnutrition. It is estimated that 12% of children on Zanzibar have acute malnutrition, among the highest in Tanzania.
Malnutrition is a disease that threatens the lives of children worldwide. It is estimated that 53% of all child deaths in low income countries can be attributed to being underweight . In Tanzania, it is responsible for more than 130 child deaths every day, making it the single greatest contributor to under-five deaths in the country. Malnutrition impacts health, education and work productivity, and is a major impediment to economic growth and development. Malnourished children start school later in life and are more likely to drop out. As adults, their work productivity is limited by poor educational achievement and stunting, often combined with poor diet and anaemia that continue to make them tired and weak.
Yet malnutrition is an entirely treatable disease. D-tree International, working closely with the government of Zanzibar, UNICEF, and the Innovation Working Group, has developed an ambitious program to eliminate acute malnutrition as a public health problem in Zanzibar. The program uses a mobile phone-based application that supports health workers to follow the Zanzibar guidelines for severe acute malnutrition. It was implemented in two sites in 2010-2011 and is now being scaled up to cover about 50 facilities throughout Zanzibar.
How it works
The software is an interactive application taking the health worker step by step through the severe acute malnutrition guidelines using data from past and current visits to determine the child’s progress and treatment. The software captures the data as it is entered into the application so has a secondary benefit of making program data available to health service administrators on a daily basis. It runs on the Android operating system and protects data via a login procedure requiring a password. The program partitions Zanzibar’s national guidelines into several electronic protocols which all contribute to, and have access to, the patient record:
Screening and Registration of each child with malnutrition
Then, for each visit of the enrolled child:
Screening for status (weighing, etc.)
Appetite Test, as prescribed by the guidelines
Physical Examination (e.g. to check for complications)
Treatment (e.g. provision of correct amounts of RUTF)
Counselling of the caregiver
Setting next appointment date
The business model brings together the private sector, public sector and donor community to develop an integrated approach to the delivery of high quality child health interventions in Zanzibar.
D-tree International is a non-profit organization committed to changing the way health care is delivered in developing countries, dedicated to improving the quality of healthcare available to the world’s poor by using innovative technology to provide accurate and effective point-of-care diagnosis and treatment. You can read more about their approaches and projects here.
Photo: Courtesy of D-tree International
  Robert E Black, Saul S Morris, Jennifer Bryce, Where and why are 10 million children dying every year? The Lancet, Volume 361, Issue 9376, Pages 2226 – 2234, 28 June 2003
After service in the British SAS Regiment the author became a physician and then an orthopaedic surgeon.
He has held professorial positions in Canada, Vietnam and the United States, practiced and taught orthopaedic surgery in three continents and in several wars.
He has extensive experience as an expert witness in court. Somewhere along the way, time was found to operate a four hundred acre mixed farm, a one hundred seat restaurant and to obtain a licence as a flying instructor.
The author's books are available from bookstores, the publishers, or from on-line bookstores such as Amazon, Barnes and Noble, and Indigo/Chapters.