Modernizing Birth Registration with Mobile Technology

As part of our mobiles for outreach and data gathering training last week, we went out to a community about 20 minutes away from the hotel today to hear Silla, the district civil registrar, talk about a project that Plan Kenya is supporting that aims to modernize the birth registration process. Plan Kenya is looking incorporating mobile data gathering and outreach into the project, so it was a good opportunity to test data gathering. We tested the Nokia Data Gathering Software using a form that the team had created earlier in the week based on the paper forms that the District Registrars office uses. It all worked just fine. Photo: Silas from Kwale District, and Petri, Director of the Nokia Research Center in Manaus, Brazil.

Silla is really an expert on birth registration and anything that has to do with it. He can quote you just about any law related to the subject in great detail. Currently, for registering births, people have to go to the sub-registrar/assistant chief’s office which can be quite far. Once there, sometimes there are not enough actual registration forms and they just give the registration information to someone who writes it in a school notebook. Later when they have more forms, the information is transposed to the official form, and sent along for processing. It can take awhile for processing, and people have to return to the sub-registrar’s office personally if they want to find out if it’s ready. The district is quite large, so they may have to travel up to 100 kms sometimes to go into check, and the certificate may not even be ready yet. Photo: Silla schools us on civil registration and explains why the district wants to modernize the process.

I talked to Ali M and Ali K (‘the Ali’s’ as we call them, since they are pretty much inseparable) who both work with Community Based Organizations (CBOs) that are participating in the birth registration project. (They were both at the video training with me last month here also). They explained some of the main reasons that not having a birth certificate makes life difficult:

If children don’t have birth certificates, they cannot get passports obviously, but that is the least of the issues. They cannot attend secondary school without one, nor can they benefit from any type of social service or insurance. Kwale district has a very high incidence of child marriages, yet if there is no birth certificate there is no way to prove in court that a girl is too young to be married. Other kinds of abuse also cannot be proved as child abuse. Without proper registration, the district does not get its fair share of the national budget because it’s not clear how many people are actually there. Photo: Ali K and Ali M - real leaders and innovators in community development.

As the Ali’s explained, if Kwale District is successful in incorporating SMS’s, mobile data gathering, and mobile outreach into the birth registration process, not only will they be the first district in Kenya to do it, but Kwale will be the first to even computerize the birth registration process. A couple ways they want to use mobiles are to provide a phone number that people could SMS their registration number to and find out if their certificates are ready or not, thus avoiding a long trip into the district office for nothing. They are also thinking of shifting the actual data gathering from hand written (carbon paper with several copies) to mobile data gathering and computerized data storage. In any case, a full project is being developed and piloted that will automate much of the current time consuming processes.

I remember when I lived in El Salvador and the municipality changed from hand written logs to computers. You used to have to go really early in the morning and wait in a huge line to get a number. Then you waited again till they called your number, went up and gave someone your information. That person would give your information to someone else who would look up the name/date, etc. and after an hour or 2, they’d call you and give you a little piece of paper with your record number on it. From there you would go wait in the cashier line to pay a fee for the copy of the certificate. Then you would go to another line at another window and give that number to someone else and sit down again for another few hours while that person would go into the archives books (bound books of hundreds of records) and find your certificate for you (birth, death, marriage, etc.). They’d make a copy and then it had to go to an official somewhere to authorize the copy before they’d give it to you. So basically you had to get there around 7 a.m. if you wanted to get it the same day, and it was a whole day affair.

Around 2000, they got a computer system in and modernized the process. I went in to get a copy of a document, and I clearly remember the security guard laughing at me because I looked at the certificate twice in shock when I paid my fee and was handed the actual certificate after about 30 minutes.

If the Ali’s and the Kwale District are able to get the equipment and set the project up, it could mean huge time savings for people and translate into greatly increased numbers of parents getting birth certificates for their children. The Ali’s have already taken the idea to a national level meeting and have other districts interested in their idea. Hopefully Kwale pulls it off and the model can be nationalized once any kinks are worked out! Photo: Mwenda and Ali, Kwale district CBO members.

SMS in Program Outreach

Building on the last post, I wanted to share also some of the discussion at last week's Kenya workshop about incorporating mobiles into our work. People in general were pretty excited. Even those people who were skeptical seemed to see mobiles as tools that could improve work we are already doing if well incorporated and done from ‘the bottom up’ in sustainable ways, based on program information and communication needs. Some great discussions came up and participants shared some potential solutions and good practices.

Issue: Access

We are working with children. How many children have phones? How do we get information from children? We work with communities who are the “poorest of the poor” – so how do we get info from them using FLSMS – do we expect them to have phones? Or people may have phones but no credit? How do you handle such circumstances?

Use a short code if you can get one

Credit is a very important issue. If organizations or institutions want to use SMS, then there is an investment cost unless you can acquire a short code. If you have a short code you deposit money to make this free or much lower cost for people.

Don't assume that children don't have access to mobiles

We should not assume children do not have access to phones. If the information is out there, children will find someone that is willing to help them make a call or text. Many children now call us (at the Child Help Line) even without a fixed line. They have a teacher, an auntie, a big sister who will allow them to borrow the phone. I’ve seen that almost everybody in the community has a SIM card. They do not have a handset, but when they need to make a call they borrow the handset for a few minutes and somehow they do it. We can’t make the argument that children can’t use technology. There are innovative ways of using the technology so let’s put the technology out there and stop assuming that people can’t access it. The issue is how can we make the technology reach as many as possible?

Give out SIM cards with a few minutes on them to protect privacy and confidentiality

We had a similar situation with a reproductive health project that was offering out information that most girls wanted to remain confidential. What we did was gave out 10 bo SIM cards. We passed them out in little boxes. Many of the girls had phones but wanted to send in anonymous questions so they used the SIM cards to send the SMS in, and then removed the card from the phone, put it in their pockets, and replaced their original SIM. It only costs 1 shilling via Orange. We found that normally the SMS conversation lasts for around 6 shillings. They can maintain anonymity this way. It’s cheap and they can just keep these SIMs in their pockets.

Issue: If mobiles begin to replace face-to-face contact and relationships with partner communities.

Using Frontline SMS for community outreach and communications has many advantages, particularly in terms of the information that we constantly need to gather. However, we should be careful though that it doesn’t substitute field visits. If people get used to getting information quickly they are likely to avoid going out and getting in touch with communities to see what is happening. If you just sit and wait for an SMS you will lose this face-to-face contact with the community.

Mobiles can be a tool, but must be integrated with other communication means

This point reminds us that we should not totally substitute it but use it as an additional tool in the toolbox to improve, cut costs, reduce, etc.

Issue: A text does not give enough space for full and clear information in health or other cases

We talked about using Frontline SMS for radio. In our participatory youth media programs, children bring out issues in video, in radio, etc. We are not always able to respond immediately to their concerns and issues. FLSMS could be a way to respond to these issues. Are there examples of how to pass on this type of technical information? If I’m a midwife and am too far from hospital, I need very clear information. How could this be done with SMS via an auto reply and only a short amount of text?

Use SMS to bring face to face help more quickly and to track/record incidents

SMS isn't a solution for everything, but I know of an example of how that can work. There is another program called Ushahidi that is about crisis mapping. It’s a digitized map. Sometimes when a situation becomes extreme people are asked to share their locations using GPS and then you can send local people to these places on bicycles or through other means to help. This allows the professional help to arrive more quickly. Maybe SMS can’t solve it but it can bring help more quickly.

Use SMS as a supplement, not a replacement for human contact and long-term work

In the case of trying to change harmful practices and traditions, we need time and eye contact. If we are working with trying to make cultural changes, such as in the case of infanticide or something, you can’t just send a text that says “this is a bad practice”. You need to come close to people. I believe FLSMS can offer a secondary way or a supplement to a given community meeting, to strengthen a rapport with the community, but it's not a replacement for our long term work and ongoing relationships with people.

In Kenya, Brainstorming on Mobiles

I spent last week in Kwale, Kenya in the company of several colleagues learning about and discussing the use of mobiles in community development, both for outreach and communications and for mobile data gathering. There was a variety of people -- from frontline staff to members of Community Based Organizations (CBO) in Kwale, to monitoring and evaluation (M&E) staff from Plan Kenya’s districts and central offices and Plan’s West Africa Regional office, to IT staff, to youth and those working with youth media, to partner organizations working on child help lines and social media outreach.

Photo: Anthony from Plan along with Mativo, a former Plan colleague, trained us on FLSMS

We looked closely at Frontline SMS (FLSMS) and Nokia’s new Data Gathering Software (NDGS) and brainstormed on ways that this type of tool might support the work that people are already doing. Really an interesting week!

In addition to the more common ideas of using mobiles for health campaigns, disaster/crisis situations and general communications and monitoring, people mentioned:

For youth media programs:

-Organizing weekly radio contests via Frontline SMS and allowing many more youth to participate in the radio program that way. Now for contests, they have to write a letter with their answer and bring it to radio station by foot. Using SMS many more could participate, increasing listeners and engagement.

-Assessing the radio show right after the recording. The youth and children could go in the audience and gather the data they normally do by hand using mobile data gathering software, thus easing the processing time and analysis of the information.

-Monitoring progress and changes made in relation to the show at a broader level -- the participating youth could use mobile data gathering to monitor change related to the issues they are targeting in the radio shows and to see if youth organization and awareness building is impacting on the community over time.

Photo: people got really excited when their first forms appeared on their phones to be filled in!

For Child/Human Rights work and Global Child Rights Campaigns:

-Assessing the knowledge/awareness of the communities about rights issues and/or our global campaigns

-Receiving reports and sharing information about violations of rights (gathering info on whether children are being registered at birth, the incidence of school violence, girl’s or women’s rights violations, cases of child abuse) and offer short information on where to go for help.

-Monitoring child abuse cases, e.g. community members could text in key words such as ABUSE or MARRIAGE to report and track child abuse cases and early marriages happening in the community:

Birth Registration (UBR) implementation

-Tracking birth registration certificates and sharing information on the steps of the registration process. With auto SMS replies we could enhance information accessibility 24/7. We could provide instant feedback to people on the status of their birth registration. It would be a very quick way of sending information to many.

-Using mobile data gathering software, the birth registration process could be made paperless and computerized, thus saving time and effort for the population and increasing the number of children who are registered at birth.

Photo: Jackson and 3 other colleagues from Brazil trained us on the NDGS.

Monitor services

-Running a mobile survey or a rapid assessment to find out whether a service like Childline is reaching people and whether the service is known and being utilized in the field.

Communicating among Plan staff, CBOs, Communities

-Passing along information such as training dates, schedules, meetings, etc., to avoid making a trip out to the community to get information

-Surveying on health, school attendance, and school enrollment through a network of teachers

Communities communicating amongst themselves

-Communities have a lot of information they want to share among themselves, among the Community Health Workers (CHWs), with the other communities and other leaders – they could do this with FLSMS.

Managing Meetings and Decisions

-Inviting participants, confirming attendance, updating on the absentees when you’ve reached a decision they could be contacted this way. You could even involve those who are absent in voting by SMS if you don’t have quorum; eg., text in 1 for this candidate, 2 for this other one, or vote yes/no on something.

Photo: SMS was seen as a great way for communities and CBOs to communicate and organize.

Chickens and Eggs and ICTs

We've been thinking and discussing the best way to follow up on the Social Media for Social Change workshop that we had in December in Kenya. Ideas have been going back and forth about the best way to really find out what the Information and Communication needs are in the countries where we are working, and then how to support the different offices and staff to find the best and most appropriate Technology solutions.

We ended up with a chicken and egg situation in a way.... if ICT4D is not your top priority, and you don't spend your life trying to figure out what is happening with ICT4D, you may not know what all is out there. (Ha, even if you do spend your life doing it, you don't know what all is out there). So it can be hard to imagine tools and solutions if you've not seen them in action, used them yourself, or heard about how others are using them. At the same time, each local situation is different, so one size doesn't fit all, so in order to find a tool or a solution, the situation analysis must come from those who would use that 'solution.' So what do you do first -- learn about different tools and potential solutions so that the lightbulb goes off on ways to incorporate/adapt the existing tools to your needs, or discuss your 'needs' and design something that works -- sometimes re-inventing the wheel. We thought that the best way we could manage the situation was to try to do both at once.

What we want to do is to activate our knowledge and study more about the concrete information and communications needs at the community level as well as in Plan's program work that could be supported by ICTs. So we are hoping that we can produce a document which offers specific recommendations about utilizing ICTs in our work in the participating countries in Africa. And we then hope that we can identify areas to be developed further including successful initiatives currently being implemented by Plan itself and also those areas where we can build on existing synergy with governmental strategies. We are also hoping to better understand the capacity building needs among Plan and its partners.

It should be interesting research/training and hopefully will take us one step further towards incorporating appropriate technology to improve our communications and management of information so that we can have greater impact in our existing programs or even develop new programs that we didn't think were possible before....