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mHealth tool to improve community health agent performance for child development: study protocol for a cluster-randomised controlled trial in Peru
  1. Christopher Michael Westgard1,2,
  2. Natalia Rivadeneyra2,
  3. Patricia Mechael3
  1. 1Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  2. 2Elementos, Lima, Peru
  3. 3HealthEnabled, Cape Town, South Africa
  1. Correspondence to Christopher Michael Westgard; cmwestgard{at}


Introduction Cultivating child health and development creates long-term impact on the well-being of the individual and society. The Amazon of Peru has high levels of many risk factors that are associated with poor child development. The use of ‘community health agents’ (CHAs) has been shown to be a potential solution to improve child development outcomes. Additionally, mobile information and communication technology (ICT) can potentially increase the performance and impact of CHAs. However, there is a knowledge gap in how mobile ICT can be deployed to improve child development in low resource settings.

Methods and analysis The current study will evaluate the implementation and impact of a tablet-based application that intends to improve the performance of CHAs, thus improving the child-rearing practices of caregivers and ultimately child health and development indicators. The CHAs will use the app during their home visits to record child health indicators and present information, images and videos to teach key health messages. The impact will be evaluated through an experimental cluster randomised controlled trial. The clusters will be assigned to the intervention or control group based on a covariate-constrained randomisation method. The impact on child development scores, anaemia and chronic malnutrition will be assessed with an analysis of covariance. The secondary outcomes include knowledge of healthy child-rearing practices by caregivers, performance of CHAs and use of health services. The process evaluation will report on implementation outcomes. The study will be implemented in the Amazon region of Peru with children under 4. The results of the study will provide evidence on the potential of a mHealth tool to improve child health and development indicators in the region.

Ethics and dissemination The study received approval from National Hospital ‘San Bartolome’ Institutional Ethics Committee on 8 November 2018 (IRB Approval #15463–18) and will be disseminated via peer-reviewed publications.

Trial registration number ISRCTN43591826.

  • mHealth
  • ICT
  • implementation science
  • impact evaluation
  • maternal and child health
  • early childhood development
  • anemia
  • malnutrition
  • community health workers
  • Peru
  • Amazon

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  • Contributors CW conceived of the study. CW and NR contributed to the writing and revision of the protocol. PM provided advisory on study design. All authors contributed to refinement of the study protocol and approved the final manuscript.

  • Funding The study is funded by the grant, Saving Brains, by Grand Challenges, Canada.

  • Disclaimer The funding source had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit results.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The investigation was approved by the Institutional Ethics Committee of the National Hospital ‘San Bartolomé' in Peru on November 8, 2018 (Exp. Number 15 463–18, Oficio N. 0744–2018-OADI-HONADOMANI-SB).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work. All data relevant to the study are included in the article or uploaded as supplementary information.