Just attended session B6 “Not the Usual Suspects: Community Based Low Tech Interventions that Improve Child Health Outcomes”. Copying the description and presenter info from the conference website here:

Presenters Discuss: the value of pictorial representation of integrated management of childhood illness (IMCI) algorithms and child care best practices for the quality of care of illiterate community health workers (CHWs) (Afghanistan); steps to engage religious leaders in health promotion, capitalizing on traditional vehicles to provide funds to increase health-seeking behaviors, and building an effective rotating drug program (Ethiopia); the role of computer based tools for microplanning in routine immunization and the planning process using the tool (Jharkhand and Madhya Pradesh, India); and how introducing new medicines in Tanzania and the Democratic Republic of Congo (DRC) catalyzed policy changes and drove interventions to strengthen pharmaceutical management systems (Democratic Republic of Congo, Tanzania). 

First a quick recap of the presenters and what they talked about – and then what was most interesting.

One theme that weaved through the first three talks – and one of the most important – was that the success of “low-tech” technology in improving child health depended on an improved understanding of the people that use the technology.

From the first talk (Aitken, Afghanistan): The approach relied on a different type of literacy – a specific symbolic literacy making use of fingers and moons for time, and drawn images of children and mothers. During the formative research, the CHWs asked, in reference to a diagram showing a child being held by her mother, “Where’s the rest of the mother?” The next revision of the C-IMCI materials showed the entire mother, not just a cropping suggesting a mother. There’s a very strong analog to the Pull-Ups diaper case from the consumer packaged goods industry in the United States. First-hand design research with Huggies in the late 1980s showed the difference in perspectives between those producing diapers – exemplified by physical model of a baby without head, arms, or legs – and parents – who were concerned not with sanitation, but childhood development. [on short time now because of the conference - can provide reference later] 

From the second talk (Roy, Ethiopia): Working together with the Ethiopian Orthodox Church, CARE has been engaged in a comprehensive community-based program to improve child health in Ethiopia. The EOC priest delivers health messages after Sunday sermon, on significant holidays, and to 20-40 families that he routinely visits as a “confessor”. Within this framework there are a number of innovations that they have developed tailored to this specific program. The booklet that contains health information is a pamphlet in the same form factor as bibles that the priests carry with them (building trust). Yellow “referral tokens” allow the priest on his household visits to refer a sick child to a local clinic (utilizing non-health professionals for services). They also have a “data board” which publicly displays mortality and morbidity statistics (community information sharing) – it’s a chalkboard much like the community board from Ghana that was making the rounds recently. [can't remember where I saw this, but will add the link if I remember, or if someone reminds me] Finally, the program is extending the traditional economic practice of idir (a traditional membership-based funeral insurance scheme with democratically-elected leadership) to childhood health emergencies.

From the third talk (Sagar, India): The Microsoft Excel-based computer microplanning tool had unexpected positive consequences for those using it at district and sub-district levels. Where no microplanning had been present before, these small health organizations in Jharkand, Uttar Pradesh, and Madhya Pradesh have started to incorporate microplanning into routine activities. Technology for positive organizational change. And the innovation is diffusing organically – the speaker said he received word today that Bihar is starting to use a similar tool in planning routine immunizations.