Target Audience

This documentation is meant for programmers and project managers who are interested in deploying ChildCount+. Project managers and health professionals might focus on the Human Aspects section. Programmers and medical records specialists can focus on the Technology section.

What is ChildCount+?

ChildCount+ [1] is a health data management system designed for day-to-day use by community health workers. To be specific, ChildCount+:

  1. Collects health information from community health workers (by text message or paper forms),
  2. Sends text message alerts to health workers and health managers,
  3. Calculates the values of key health and CHW performance indicators using data collected from the CHWs, and
  4. Produces concise printed performance reports for CHWs and their managers.


ChildCount+’s original design revolved around mobile phones: community health workers would submit information to the ChildCount+ server by text message (SMS). Based on the submitted data, the server would then periodically send information and alerts to the community health workers. The ChildCount+ deployment in Sauri, Kenya, where Millennium Villages Project first piloted ChildCount+, uses the mobile-phone-based workflow depicted in the accompanying figure.

ChildCount+ mobile data flow diagram.

A representation of the mobile-phone-based ChildCount+ workflow.

It is possible to deploy ChildCount+ without mobile phones. In fact, most Millennium Village sites use a paper-based workflow for ChildCount+, since managing airtime credit and fleet of mobile phones is sometimes not possible.

ChildCount+ paper-based data flow diagram.

A representation of the paper-based ChildCount+ workflow.

What’s in the Box

The two major open-source components of ChildCount+ are:

  • Paper Forms: See Forms to check out our paper data collection forms.
  • Software: See the Technology section for details on our software and what you need to get it up and running.

For everything else (community health workers, data entry clerks, programmers, servers, mobile phones, airtime, ...) you are on your own!

Should You Use ChildCount+?

Here are some questions to consider before embarking on a ChildCount+ deployment:

  • Do you have a community health worker program?

    If not, ChildCount+ might not be the best platform for your project. You can customize ChildCount+ to suit your application (tracking levels of drug stocks, for example) but that would require extensive programming and customization. See Human Prerequisites for more information.

  • Do you have the means (i.e., transport) to meet regularly with your CHWs?

    Many of the Millennium Village Project sites aim to have feedback meetings with the community health workers every month. If you have scores of CHWs distributed over a large geographical area, these meetings can take a non-trivial amount of time. Don’t bother deploying the system if you don’t have time to use the data it produces. See Human Prerequisites for more information.

  • Do you have health managers with enough time to maintain the system?

    One major purpose of ChildCount+ is to collect and display public health data. If there’s no one who has time to look at the data, and act based on what they are seeing, then maybe you should skip ChildCount+ and focus on that problem instead.

  • Do you have a technical team (or at least a technical person)?

    ChildCount+ is not a “plug-and-play” solution. In fact, it is more like a “download-and-hack” solution. You will need, at least, one on-call Python programmer with some Linux systems administration experience to install the software and to maintain the server. See Human Prerequisites for more information.

  • Do you have money to pay for paper and SMS fees?

    As an example: in Uganda (May 2011), an on-network SMS costs US$0.02. If you have 100 CHWs each sending or receiving 20 SMS messages per day, that is:

    100 CHWs * 20 SMS/day * $0.02/SMS * 30 days/month = $1200.00/month

    Do you have $1200/month for SMS fees? [2] Paper-only deployments are cheaper, but then you miss out on all of good things that come with SMS.

  • Do you have enough cell phones and phone chargers for your CHWs?

    ChildCount+ makes the assumption that there is one phone per community health worker. With a bit of engineering you could modify the system to allow CHWs to share phones, but you might lose some of the benefits of real-time CHW-to-server communication.

  • Do you have a system in place to manage a fleet of phones and chargers for your CHWs?

    Cell phones break, get lost, and are stolen. If CHWs are using their phones all day every day to send SMS messages to the ChildCount+ server, then you should expect a lot of wear and tear. Make sure you have a policy and a means to replace broken and stolen phones so that CHWs can continue to submit forms even after their phone breaks.

  • Do you have a system in place to manage airtime for CHWs?

    If community health workers are spending US$12/month on SMS messages, you will need a reliable way to get money or airtime to them. Millennium Villages Project has tried to negotiate with the local mobile operator for “toll-free SMS” lines, but it’s not a quick process.

Deployment Background

Millennium Villages Project has deployed ChildCount+ at its sites across sub-Saharan Africa. As of May 2011, these deployments are the only ChildCount+ deployments. For more information on the history of ChildCount+, please see History / Credits.


[1]Why the +? We call our system ChildCount+ (read: “Child count plus”) because it has expanded from a system for collecting data about children to a system for collecting data about people – including adults. The “+” represents the fact that we count children and adults too.
[2]We are considering a GPRS/EDGE-based alternative to our SMS-based transport. In Uganda, that would bring the monthly data cost down to less than US$10.