Using Personal Digital Assistants in post-conflict health surveys: Potential and constraints

Compared to their counterparts in wealthier nations, managers and front-line health care workers in non-industrialised countries make more limited use of information technology to assist their decision-making. This is particularly true in conflict-affected countries, which tend to be even poorer, and have a greater scarcity of infrastructure and qualified personnel, than other developing countries. At the same time, more stakeholders are recognising the potential of electronic information management in resource-poor settings, as well as the value of investing in conflict-affected countries more generally. We present here the experience of the International Rescue Committee (IRC) with the use of handheld personal digital assistants (PDAs) for health surveys in conflict-affected sub-Saharan African countries, and discuss lessons learned and potential for further development of this tool. The use of PDAs for surveys has lowered costs, made data available for analysis much faster, and reduced errors. Conflict-specific obstacles, such as insecurity, have not proven to be a significant barrier to PDA use in practice. There have also been limitations. Using PDAs requires survey managers to have some technical proficiency, and PDAs are less helpful for qualitative surveys. Overall, the experience has been positive, and we have found PDAs to be equally appropriate in conflict-affected countries as in other settings. We recommend taking several steps to prevent problems and extend benefits, including using checklists and memory cards to simplify the process, and taking advantage of the same PDAs for other purposes beyond surveys, including supervision, quality assurance, and routine data entry. Finally, it is important to note that PDA use does not dispense survey organisers from the usual principles of good survey implementation.