The Golden Generation: Thriving Community Health Through Client-Centered Precision Care With Coordinated Teams of Frontline Health Workers and Next-Generation mHealth

Organization: 
Summit Institute of Development
Organization Location: 
Mataram, Indonesia

Reproductive, maternal, newborn and child health (RMNCH) services are provided by multiple community-based frontline health workers (FHW), including midwives, vaccinators, nutritionists, and health volunteers, all with different responsibility and expertise. They may work in isolation without coordination, and clients typically visit each FHW to receive RMNCH services. This leads to fragmented care, low coverage and quality, and increased mortality. The Golden Generation Project (GEN2025) will transition from this provider-centered model to client-centered precision care by transforming FHWs into coordinated teams through use of 4th and 5th generation mHealth tools on smartphones and tablets. This will be enabled by: (a) pervasive real time sharing of health data and schedules by FHWs; (b) facial recognition for client tracking, (c) chat bot technology for smart reminders and health promotion; and (d) artificial intelligence and network science to optimize care delivery and identify high-risk clients. In Lombok, Indonesia, the Summit Institute of Development has adapted Open Smart Register Platform (OpenSRP) as a front line mHealth tool with GEN2025 features, and has seen improvements of 9-34% in indicators of care of maternal services in 17 communities. This foundation will enable scale-up of the approach, and impact will be assessed by a large scale cluster randomized step wedge trial deploying mobile devices to ~1,500 FHWs providing services to ~2,500,000 persons and 57,000 pregnancies annually.