Assessing the Suitability of a Mobile Phone-Based Case Management System for Children in Adversity in Battambang, Cambodia

Abstract

There are over 250 million children in adversity (CIA) globally; however, insufficient information on prevalence of CIA and their daily needs limits case management of this group by social welfare systems. Recently, mobile technology-based (mHealth) systems have been used successfully to extend health services and information to clients in hard-to-reach, under resourced areas. This study aimed to determine the suitability of mHealth systems for improving case management of CIA in Battambang Province, Cambodia.

Methods used included focus group discussions (FGDs), in depth interview and direct observation with government and NGO social workers, their supervisors and street-based CIA (10-17 years). Data on daily workflows, roles, responsibilities and case management activities of social workers were documented. Mobile phone ownership, use and attitudes among social workers were used to assess suitability of an mHealth tool in the Cambodian context. Daily life experiences and case management needs of CIA were documented.

Our data suggests that routine case management of CIA is limited by low capacity of social workers, logistical constraints, a burdensome paper-based data collection system, scanty resources and poor supportive supervision. All social workers participating in the study owned and used mobile phones, and enthusiasm for further incorporation of these devices into daily work activities was high. Street children came from different situations of adversity, were under-served and had diverse case management needs such as referral to vocational programs, early intervention to prevent violence in the home and continuous follow-up.

An mHealth system could be developed to overcome constraints in case management of CIA by streamlining social worker workflows, facilitating timely data collection, and enabling continuous training of social workers. Such a system, implemented in conjunction with other initiatives to strengthen the social welfare system, could promote better case management for CIA in Cambodia, and globally.