First Stop – Bangladesh

I will begin packing all of the technical and personal items tomorrow to prepare for departure to the Save the Children offices in Bangladesh and Myanmar (formally, and still recognized by many nations, as Burma). These are both return visits for myself, the fourth for Bangladesh, and the second for Myanmar.

My first air flight across either ocean was to Bangladesh in October 2005. It also became my first of what would eventually become my three round-the-globe trips. Upon departure from Bangladesh on that trip, I visited Istanbul, Turkey for a Monitoring and Evaluation (M&E) conference to present mobile data collection using small hand-held computers called Personal Digital Assistants (PDA’s) to the Save the Children USA Middle East and Asia M&E representatives.

Save the Children USA mother-child health and food distribution poster in Barisal, Bangladesh

I went to Bangladesh to provide an assessment for this office on behalf of Save the Children USA Wesport IT to see if PDA’s could help in their combined USAID funded maternal-child health and nutrition (MCHN) and Food Security programs. The office had been deploying a USAID-funded program that provided health care for pregnant mothers and subsequent care for mothers and their children under two years of age. In the Barisal area that I visited Save the Children had identified that child mortality was significant for that age group of children. It, of course, all starts with caring for the child AND the mother before the child’s birth.

The Jibon O Jibaka (meaning Life and Livelihood in the Bangla language) program involved a two-pronged approach. A mother could become registered for pre and ante natal health care by walking into one of over 1,000 community health clinics funded by save the Children and largely staffed by Save-trained community health volunteers (CHV). There, she and/or her baby, would be evaluated and provided appropriate care and guidance.  Save the Children and other governmental and non-governmental organizations  (NGO) are aware if you can give both the pregnant mother and the child medical and nutritional support during the first two years of life for the child, then they have an increased chance of survival to age five and beyond.

Once a mother is registered at a health clinic, she is also qualified to receive a monthly food ration for herself and her child consisting (as of my last trip in June 2007) of vitamin A-fortified cooking oil, whole wheat, and dried lentils. This latter part of the program would be where I would focus my PDA technology towards.

A challenge that the Jibon O Jibaka was encountering, was with the food ration distribution effort at the over 300 locations. It was seen that a technological barrier was emerging that was limiting the effectiveness of the program. Jibon O Jibaka distributed food to several hundred thousand mothers and their babies each month. Each mother would walk or ride to the nearest food distribution center to receive her ration. In order to validate each mother as a registered participant, each had been given a bar-coded registration card to present in order to receive her food distribution. Save the Children had developed a database of registrants which was placed on laptops at each of the distribution locations.

PDA bar code scanner being used for food ration registrant validation in Barisal, Bangladesh

The issues appeared to be two-fold. First, often these food distribution locations had no electricity to run these computers or it was not dependable. So, paper records of each registrant accompanied the food commodities. These paper records significantly slowed the validation of the registrant with the effect of slowing down the distribution activities at that location. I recommended that PDA’s be used in conjunction with waist-mounted lithium-ion batter packs which extended the computerized validation and collection of records from a couple of hours (the average battery life of a laptop in tropical climate) to two to three days. We  also explored use of a small modular bar code scanner inserted into the PDA to scan the mothers registration card to replace the larger hand held bar code scanner attached to the laptop.

Manual hand typing of food distribution records into Jibon OJibaka database at Barisal district office

Manual hand typing of food distribution records into Jibon OJibaka database at Barisal district office

The second hindrance to the program was that after the food distribution activity, all non-laptop gathered paper records had to be hand-typed into the database manually back at the district headquarters. The hand-typing of thousands of ration distribution records each month contributed to a large non-value added monthly interval of process time, further hindering expansion and effectiveness of the program.

Based on my recommendations after my initial assessment of October 2005, a pilot project with 15 PDA’s in March of 2006 followed with a small scale implementation in June 2007. The result was use of 150 PDA’s for the overall program. Additionally. a supply chain encompassing sytem called McAid(Mother and Child Aid) was developed cover all process and data aspects from commodity arrival at the loading dock to ration distribution.

Each PDA contained a pre-loaded instance (replicant) of the McAid database for each specific areas’ registrants. Instead of having to hand type in the paper records of the registrant food distribution activity, they are simply uploaded from each PDA to the main network-connected database in the district office after the distribution activity. We are looking to utilize the widespread cell phone network available in the region in order to reduce physical transportation of the PDA’s for data upload and download.

I am returning to Bangladesh to gather documentation of the process in order to possibly extend it to other Save the Child Food Security programs. Afterwards, I will travel to the Myanmar country office to followup on my work accomplished there last April.

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