Technical Challenges Commonly Faced by Frontline Community Health Workers and Local Implementing Partners During Initial Rollout of the UDS, Ethiopia, 2024
| Technical Issues | Measures Taken |
|---|---|
| Frontline Community Health Workers | |
| Mobile data outage (internet blackout) in areas with security problems | Increased offline data persistence capability of UDS mobile app |
| Mobile app dysfunction for data entry | Installed the latest mobile app version |
| Slow loading of cases in case list (mobile app taking too long to navigate and find clients from the case list) | Divided location hierarchies with >6,000 number of beneficiaries; recommended device specification based on the number of beneficiaries |
| Duplicated and wrong data entry | Introduced validation logics, conducted data cleaning and data verification visits |
| Delayed data entry | Developed real-time data entry tracking metrics to track field-level operations by CHWs |
| Incomplete data entry to CommCare/UDS | Developed data completeness composite score monitoring dashboard |
| Device loss due to damage or theft | Provided device management training and standard operating procedure to CHWs |
| End-users had the expectation that the move from paper-based to a fully digitized system would coincide with the initial rollout | Developers clearly communicated with end-users about the time it would take to transition fully from a paper to digital system to set expectations |
| Other technical issues | UDS partners’ forum was conducted to discuss issues and put solutions in place |
| Local Implementing Partners | |
| Mobile device misspecification | Developers conducted testing of mobile app performance across SDPs with different number of beneficiaries, and they recommended device specifications based on the test results |
| Data discrepancy and mismatch between dashboard and case data/form data available in the database | Conducted data cleaning and validation checks |
| Indicator computation challenges | Joint review of indicator definitions and computational procedures |
| Lack of some functionalities | New features and functionalities were added, such as automated reporting of activity performance |
| Sub-optimal data use | Conducted monthly KPI review meetings to promote data use for reviewing performance and monitoring, reporting, and data-informed decision making |
| Manual data entry burden to DATIM by local implementing partners | Developers implemented DATIM data import for performance reporting electronically |
| UDS complex data export and usage issues | Provided training, developed user manuals and short tutorial videos on data merging and analysis |
| Misunderstanding of some MER indicator definitions among partners | The unified UDS dashboard guarantees consistency and accuracy of indicators across programs |
| Bidirectional referral implementation issues | Upgraded UDS software to track actual referral from designated mobile devices |
| Software Developers | |
| System integration (with the national e-CHIS) | Developers supported the Ministry of Health in developing and pilot testing of the HIV module within e-CHIS |
| CommCare Power BI integration performance issues | Implemented custom software layer to solve this issue |
| Technical glitches and bugs | Provided regular software maintenance |
| Challenge in tracking dashboard usage performance | Developers built a custom web application that displays Power BI dashboard and tracks usage statistics |
| Mobile workers failed to enter client-level follow-up data despite service provision | Developers added visual reminders to the UDS mobile app when client follow-up is due |
Abbreviations: CHW, community health worker; DATIM, data for accountability, transparency, and impact; KPI, key performance indicator; MER, monitoring, evaluation, and reporting; SDP, service delivery point; UDS, Unified Data System.