Goducate’s health program in Sabah is implemented by our local health educator. Since most of the community served by Goducate there do not have access to state health services, our health educator is often consulted about health problems. We have been exploring how to support her through a telehealth system that enables her to consult our registered nurse based in Singapore.
We initially tried live teleconsultation, but because of unreliable 3G connectivity in the field, it was not possible; however asynchronous teleconsultation was.
When our health educator is approached by a villager about a health problem, she will take measurements of some basic vital signs as well as record the villager’s medical concerns on a form that she will submit online to our nurse in Singapore. The clinical advice is then given in a form of skype chat/call to the relevant patient.
This online consultation does not cater for emergency situations, but rather for cases with chronic conditions. In the first two weeks of the trial, advice was given to 12 patients through this method.
Another area in which we are trying to use free technological applications to help our health educator is in growth monitoring. Traditionally, health workers use the Age-BMI growth chart to plot measurements and detect a child who is malnourished or severely underweight.
Since this process is manual and can be very time consuming, and considering the vast number of students whose growth we are monitoring, a free application tool is used instead to obtain z scores (a measure of the degree of deviation from the mean) more quickly and accurately.
With this free application, known as Anthro Plus, our health educator needs only to input the student’s age, height and weight, and the software automatically calculates the z-score of the student.
So far, these two technology tools have proven to be reliable and effective to keep the team in Singapore in touch with the team in Sabah.