The Golden Generation: Thriving Community Health through Client-centered Precision Care with Coordinated Teams of Frontline Health Workers and Next-generation mHealth

Summit Institute of Development
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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, each of which has different responsibilities and expertise. Clients typically visit each FHW, who may work in isolation without coordination, 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 smart phones and tablets. This will be enabled by: 1) pervasive real-time sharing of health data and schedules by FHWs; 2) facial recognition for client tracking; 3) chat-bot technology for smart reminders and health promotion; and 4) artificial intelligence and network science to optimize care delivery and identify high-risk clients. In Lombok, Indonesia, Summit has adapted Open Smart Register Platform as a frontline mHealth tool with GEN2025 features, and seen improvements of 25 percent in indicators of care of maternal services in 112 villages. This foundation will enable scale-up of the approach, which will be assessed by a cluster randomized step-wedge trial deploying mobile devices to ~750 FLWs providing services to ~1,200,000 persons and 22,000 pregnant women annually.

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