November 2023 CHT Round-up recording and notes

Thank you all for your time, participation and engagement at the November 2023 CHT Round-up call. Here is the link to access the Round-up call recording and below are summarized notes from the call.

Agenda 1- Use of geospatial data for microplanning
For the past two years, Partners in Health Malawi, Openstreetmap and Medic have partnered to implement a geolocation initiative. The initiative aimed to explore how geospatial data can be used to improve the efficiency of community health workers (CHWs) in provision of care . The initial phase of this initiative involved the teams exploring the available geolocation data and how different CHT deployments capture geospatial data. After assessing the quality of data, the OpenStreetMap team supported the team to source for additional geolocation data from other multiple sources that helped to validate the accuracy of the geolocation data. The validation process showed that there was variance between the geospatial data that was captured on CHT in the background and the geospatial data that was collected through CHW involvement.

With the improved geolocation data, the team layered on road network, CHW household locations to generate household clusters. Using the household clusters, the teams identified the best ways to assign CHWs households based on clusters. The teams also created design mockups/ideas on different ways the GPS data can be integrated within CHT, different deployments might need to refine these ideas before they are deployed. Some of the ideas that the team suggested included: sorting contacts by distance from where the CHW stays, sorting tasks by distance to help CHWs identify nearby tasks and visualizing all households which need urgent attention. While implementing this initiative the project team faced the following challenges: not all CHWs were able to collect geolocation data, poor mobile network coverage, CHWs disabled GPS because it tends to drain battery more and some devices used AGPS which required mobile network to improve on the accuracy.

Agenda 2 - Care teams updates

2a) CHT target UI updates.
The Care team has been working on aligning the CHT user interface with the android material design patterns. The updated UI gives CHWs a more familiar experience with CHT and it ensures that CHT looks and behaves as other android apps. The team recently updated the target UI to align with the android material pattern of the card component. More details about the updated target UI is available here.

2b) Performance telemetry data for certain user actions.
CHT collects performance and interaction data for certain user actions and this data (telemetry data) gets aggregated each day and is replicated to the server. The telemetry data can be used to evaluate the performance of code and configuration, the Care team has fixed a bug which was making the telemetry data not to be recorded every day. In addition to this fix; the telemetry system has been improved by including performance telemetry data for contact forms, previously only the performance telemetry data for app forms was being recorded. The team is planning on hosting a webinar to do a deeper dive on telemetry and how one can access it and share pointers on how users can engage with queries, more information on the webinar will be shared soon.

2c) Barcode feature improvements.
Currently, health care providers working at Martin Preuss and Lighthouse clinics (in Malawi) are using the CHT barcode to identify patients using the barcode feature which is available in a form. The current barcode feature does not have the ability to search for patients. To help health care providers be able to search patients using the barcode feature, a new QR code icon has been added to the CHT contact tab, CHT users are now able to tab on the new QR code icon and take a barcode picture using the phone camera, CHT interprets the barcode and automatically displays the patient information in the search and also takes the user directly to the patient.

2d) Q3 User research activities.
In Q3 2023, the Care team conducted 5 generative interviews with CHWs. Some of the insights that the CHWs reported during the interviews included: CHT updates taking long to load, UI being difficult to navigate especially the phone number field does not allow CHWs to enter shared phone numbers, challenges in replacing the household head and the configuration does not support some of the delivery areas. From the generative interviews, the Care team also heard new emerging themes such as CHW supervision, client accessibility, hardware and CHW performance goal. In Q3, the Product Allies team also conducted generative activities with CHT App Developers, the Developers shared feedback that it is difficult to find and make sense of errors when setting up CHT and Developers had difficulties in understanding key concepts in the CHT due to insufficient documentation and current CHT local set up guide is designed for App Developers who use Linux.

2e) Care Trip Team updates
The Care team recently took a trip to Kenya and Uganda and spoke to 80 CHWs supporting various CHT implementations. During the trip, the team conducted various activities which included user interviews, household visits with CHWs and usability tests for the new UI changes. From user interviews, the Care team learned that beyond the app task lists, some of the CHWs plan their work based on which tasks they deem to be more urgent and CHWs use external tools like notebooks to manage their work with the app. A customer effort score (CES) survey was conducted with CHWs across different deployments, the survey aimed to find out how easy or difficult it is for CHWs to complete various tasks on the application. Most CHWs responded that it is quite easy for them to perform most tasks like registering new households, searching for households and finding the tasks they would like to do next.

Some of the low scored tasks included not being able to correct mistakes and learning about the new application updates. The other activity that the team conducted was usability tests, the team presented the screens of the new CHT UI navigation and prompted the CHWs to interact with the app. There was a high percentage of CHW’s (78%) who were able to navigate the app on the first try and when the rest of the CHWs were shown how they can navigate the new CHT UI, 96% of the CHWs were able to navigate the app on the second try. Similarly, 92% of the CHWs were able to know which page they were on on the first try and this reached 100% after showing the rest of the CHWs on the second try. They CHWs were also asked which UI they prefer, 75 % indicated that they found the experience to be the same across the current and the new UI, some CHWs stated that the new UI looked more modern and the new UI looked like other apps the CHWs had on their phones. 12.5 % of the CHWs stated that they prefer the current version and will be willing to learn the new UI.

Agenda 3- CHT sync updates.
The Ecosystem team is currently finalizing deploying CHT sync and also carrying out the data audit. To set up CHT sync locally, one needs to install and run npm locally, running the npm command will start logstash, postgres, superset, data generator, couchdb and dbt containers. If you are interested in testing CHT sync you can access all the resources here.

Agenda 4 - CHT v4.4.0 release
CHT v4.4.0 was released on September 14, 2023. The following new features and improvements are available on CHT v4.4.0:

  • CouchDB has been upgraded to v3.3.2 which will ensure that there is a better shard performance.
  • The replication performance has improved, on average synchronization is much faster and improved through the persistent caching of purged doc ids.
  • The CHT dialogs have been updated to align with android material patterns.

The version has loads of other improvements and fixes for a number of bugs. Please read the release notes for more details.

We hope to see you again at the next CHT Round-up call on December 14, 2023.