Description of Session
As in many resource constrained settings, the ratio of client populations to community health workers is large. Further inflating this ratio are issues of chronic absenteeism and inadequate staffing. A direct result of this overburdened health workforce is the limited time then available for quality service provision by the health worker that is on staff. The limited time available results in the most vulnerable populations being habitually “missed”, as they often live the furthest away from urban centers and due to affordability of land, in the most difficult-to-reach parts of communities. As part of the mCARE-II trial being implemented in rural Bangladesh, investigators sought to quantify the true gaps in coverage and service provision that exist for these populations. This session will demonstrate the use of digital health strategies to answer critical questions, such as, how many clients actual live in each government worker’s catchment area? What happens to clients living in areas where there is confusion of catchment area boundaries? How can geofencing and vector-overlap (concave hull) tools be used to identify missed clients or overlapping areas ? Are clients who are visited by their community health workers different than those who are missed, and if they are, how so? Data to answer these questions is available from the independent JiVitA Project research workforce, tasked with prospectively establishing a true denominator of all eligible women, pregnancies, and birth outcomes that occur within a 450 sq km area, as well as assessing the care that these individuals receive. This analysis will help define the workforce gap using digital tools -- a major barrier to achieving high coverage of essential public health interventions.
