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Exploring the use of mobile phone technology for optimizing, tracking and responding to children's developmental progress in Korogocho, Nairobi, Kenya, Saving Brains

KENYA, 2019
Human Development (HD)
Patricia Kitsao-Wekulo
Last modified March 25, 2025 Page views 6032 Documentation in PDF Metadata DDI/XML JSON

Identification

IDNO
DDI-KEN-APHRC-SAVINGBRAINS-2024-v1.0
Title
Exploring the use of mobile phone technology for optimizing, tracking and responding to children's developmental progress in Korogocho, Nairobi, Kenya, Saving Brains
Subtitle
Saving Brains
Country
Name Country code
KENYA KEN
Abstract
Background:

The massive use of technology can be leveraged to facilitate access to growth and development programs for children with access constraints. Existing programs supporting children's growth and development especially for children younger than three years are inadequate and not accessible to most families. In most cases, primary caregivers are unable to identify delayed milestones in their children's growth and development due to inadequate information on how to assess the key developmental milestones, and they often report the cases when they have become very severe. To promote early identification of possible developmental delays, the African Population and Health Research Center (APHRC) together with Val Partners developed, implemented and evaluated the use of mobile phone technology to help young mothers track their children's development.

Objective:

The objective of the study was to develop and test the feasibility of using mobile phone technology for optimizing, tracking, and responding to children's developmental progress.

Study design:

The study employed a quasi-experimental design and used a mixed-methods approach combining quantitative and qualitative methodologies. It was a two-arm study, where the first arm was trained on the use of a mobile phone application to assess their children's growth and development, while the second group received the standard of care provided by community health volunteers (CHVs). A total of 220 mothers/primary caregivers-child dyads were recruited into this study. The causal effect of the intervention was estmated using mixed linear models and the Difference-in-Differences estimator.

Study duration: 24 months

Budget: CAD 250,000

Version

Version number
v1.0
Version Date
2024-06-05

Coverage

Geographic Coverage
The survey covered sampled young children between 6 to 24 months and their caregivers from urban settlements in Korogocho, Nairobi, Kenya
Unit of Analysis
The survey covered sample of young mothers (including adolescents) of children under the age of three years
Universe
The survey covered sample of young mothers (including adolescents) of children under the age of three years

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
Patricia Kitsao-Wekulo African Population and Health Research Centre
Producers
Name Affiliation Role
Elizabeth Kimani-Murage African Population and Health Research Centre Overseeing the implementation of research activities
Margaret Nampijja African Population and Health Research Centre Overseeing the implementation of research activities
Kenneth Odhiambo Okelo African Population and Health Research Centre Lead research officer in charge of the day to day operation of the study
Silas Onyango African Population and Health Research Centre Assist in coordination of the project activities
Milka Njeri African Population and Health Research Centre Assist in coordination of the project activities
Abhishek Khamrai Val Partners Limited Provision of technical support in designing the mobile technology application
Dominic Muindi Val Partners Limited Provision of technical support in designing the mobile technology application
Brian Odhiambo African Population and Health Research Centre Data Documentation Specialist
Bonface Ingumba African Population and Health Research Centre Data Governance Expert
Funding Agency/Sponsor
Name Role
Grand Challenges Canada Funder

Sampling

Sampling Procedure
The project targeted young mothers (including adolescents) of children under the age of three years and living in informal settlement areas in Nairobi. Community Health Volunteers (CHVs) living within the community were identified and reccruited to assist the study team to recruit mothers/caregivers who are eligible for inclusion. Effort was made to ensure equal representation of genders in the intervention as both fathers and mothers were included during communications and activities related to the project.
Deviations from the Sample Design
N/A
Response Rate
The response rate was 115.45 percent because the original sample size was 220 in total but the baseline round had 254 participants recruited and interviewed
Weighting
The sample size was calculated using G* Power program (18) where the program was set to a two-sided t-test involving the difference between the independent means (18). Using a piori power analysis, we input the values of 0.05 and 0.84 for significance levels and power, repectively. Additionally, equal sample groups were assumed meaning the allocation ration of N1 (Intervention group) to N(Control group) is 1. The calculation produced a sample size of 110 for each group, which allowed for 10% attrition rate gave a result of 110. It was therefore hypothesised that with 100 caregiver-infant dyads in the intervention group and 100 in the control group, the sample size achieves 80% power to detect a difference among two groups, with an effect size of 0.4 at the 5% significance level (two-tailed test). A sample comprising a total of 220 households (caregiver-child dyads) were therefore recruited.

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2019-04-17 2019-05-16
Mode of data collection
Face-to-face [f2f]
Supervision
Data collection was supervised by carefully trained team leaders and the research team. During fieldwork, data quality was enhanced by APHRC team leads through regular spot checks and sit-ins to approximately 5-10% of each field worker's daily work to verify authenyicity of the data collected. The field supervisor certified the quality of the data through editing of the data before they were transfered to the database.
Type of Research Instrument
Two Questionnaires were used during the study
The first one was (1) PARENTAL ASSESSEMENT QUESTIONNAIRE which constituted 4 themes including: Knowledge, Attitudes and Perceptions (KAP) questions, Ages and stages questions (ASQ-3), Parental report questions and stress-efficacy questions.
The second questionnaire (2) CHILD ASSESSMENT QUESTIONNAIRE

Data Processing

Cleaning Operations
Data collection was done electronically using tablets/phones, with spot checks for quality control. Once all the data collection were completed, all the inconsistencies were resolved prior to data analysis. An automated routine to check on the data completeness, correctness and consistency was also run on 100% of the collected data.
Other Processing
Differences in caregiver KAP and wellbeing at baseline and end-line for the intervention and control groups were determined by summing the scores on the items and running a t-test for comparison.

For child developmental outcomes, raw scores were constructed by adding all the items passed for each domain on the PCM-IT. Composite scores were computed by summing the scores across all the domains. As we expected scores on each test to increase with age, the scores were standardized for age to allow for direct comparisons across tests. After the data were cleaned, quantitative data analysis was performed using Stata. A first set of analyses consisted of descriptive statistics. This will allowed us to detect similarities and/or differences between subjects' characteristics across the different groups. We compared some baseline measurements between the control group and intervention group using the t-test adjusted for continuous variables, and cluster-adjusted chi-square for binary variables. The second set of analysis consisted of assessing the causal effect of the ECD intervention in Korogocho via the DID estimator, and mixed linear model. Individual items on the PCM-IT were reviewed for missing data, as well as for floor and ceiling effects. In the case where more than 10% of the responses on the items were missing, the data was excluded from further analysis. The time taken to complete the assessment was calculated. We also calculated the totals by summing the scores of the items included in the tool to establish children's performance levels at baseline and at end-line. This enabled us to identify child development domains that have acceptable variability.

Data Appraisal

Estimates of Sampling Error
The calculation produced a sample size of 100 for each group, which allowed for a 10% attrition rate gaving a result of 110. We therefore hypothesized that with 100 caregiver-infant dyads in the intervention group and 100 in the control group, the sample size achieved 80% power to detect a difference among the two groups, with an effect size of 0.4, at the 5% significance level (two-tailed test). A sample comprising a total of 220 households (caregiver-child dyads) were therefore recruited.

Data access

Contact
Name Email URI
African Population and Health Research Center datarequest@aphrc.org www.aphrcmicrodataprtal.org
Conditions
APHRC data access condition

All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research.
This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained and to abide by the conditions outlined below:

1.Data Ownership:
The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2.Purpose:
The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3.Respondent Identifiers:
The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4.Confidentiality pledge:
The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5.Reporting of errors or inconsistencies:
The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6.Publications resulting from APHRC data:
The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7.Security:
The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8.Loss of privilege to use data:
In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9.Acknowledgement:
Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:
"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10.Deposit of Reports/Papers:
The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11.Change of contact details:
Citation requirement
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download

Metadata production

Document ID
DDI-KEN-APHRC-SAVINGBRAINS-2024-v1.0
Producers
Name Abbreviation Role
African Population Health Research Center APHRC Documentation of the DDI
Date of Production
2024-06-04
Document version
Version 1.0 (June 2024)