a tall, dark-skinned woman with short hair and a white coat holds up an iPad for a shorter, dark-skinned woman holding a dark-skinned baby to see. the iPad screen shows some images and a growth chart. they are in a clinic with yellow walls and an empty bulletin board behind them.
Empowering nurses in remote areas with high-quality data
with TIP Global Health
Client

Since 2008, TIP Global Health has been working at a local level to develop highly-effective and self-sustaining community-driven solutions that transform primary health care delivery and health systems. 

Geography

Rwanda

Topic Area

Health

Project Type

Capacity Building
Digital & Physical Tools

The first 1,000 days of development are crucial for every child. Collecting high-quality data is one of the most effective tools to improve health outcomes for mothers and children. But in rural Rwanda, current data collection processes are time consuming and often inaccurate.

TIP Global Health envisioned an app that would put data collection and use into nurses’ hands. But they knew that any new tool would only be successful if nurses and mothers embraced it. We facilitated a collaborative process to design E-Heza, Rwanda’s first point-of-care digital health record, working alongside nurses, mothers, healthcare administrators, and TIP staff to ensure the tool meets each stakeholder’s specific needs.

Project Outputs

Tools We created E-Heza, a tablet-optimized, responsive web app, designed to support the specific needs of nurses and mothers. E-Heza works both on and off-line, as internet access is not always reliable in the remote health centers. Photos and measurements from each session display in a child’s progress report, offering mothers a visual record of their child’s growth and providing nurses a tangible tool for individualized health education.

Key calculations such as z-scores are computed automatically and display as soon as a measurement is entered.
Nurses can see at a glance which tasks they’ve already completed and which are still left to do.
Nurses have the flexibility to move through the tasks in the order they prefer, and switch between group and individual mode based on their context.
The app is complemented by a tablet carrying case, offering hands-free use (especially helpful when holding babies!)
headshot of a light-skinned woman with curly, short blond hair, smiling, wearing a black shirt and necklace with one turquoise bead, against a bright blue wall.

We are so grateful for the GGS team! This has been such a wonderful partnership. They have been incredibly dedicated to helping us bring our vision to life and ensuring the design of E-Heza will truly support nurses and mothers.

Wendy Leonard The Ihangane Project

Client & Community Outcomes

Mindsets

The process of creating E-Heza gave TIP a concrete way to engage their users and stakeholders in the design process, leading to stronger features and an initial group of users eager to adopt the tool. One of the goals of E-Heza is to demonstrate the value of an inclusive process – leveraging the grass-roots knowledge of community members as a driver of the design of new tools. This process stands in contrast with more traditional top-down design or development processes, seeking to shift mindsets toward valuing the expertise and capacity of communities.

Behaviors

E-Heza’s design offers seamless support to nurses as they gather and record critical health data. A goal of this tool is to increase the accuracy and completeness of data collected from mothers and children. Digital, point-of-care documentation also allows for more rapid data analysis, which can support education and behavior change in mothers as well as reflection and improvement at the health centers.

Conditions

As of February 2021, there are over 43,500 mothers and children registered in E-Heza, and healthcare providers across Rwanda have logged over 106,000 encounters. Best of all, children who have had 3 or more visits on E-Heza have a 27% decrease in cases of severe malnutrition.

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