e-CARE: An app to fill in the gaps in pediatric care

The app serves as a virtual medical assistant, using an algorithm to aid diagnosis and treatment for children under five in the Central African Republic.

An MSF staff member at the Kidjigra center holds a tablet with the e-CARE application for pediatric consultations in Bambari, Central African Republic.

CAR 2023 © Kristen Poels/MSF

In the under-resourced Central African Republic (CAR), Doctors Without Borders/Médecins Sans Frontières (MSF) teams have developed an app to combat staff shortages and over-prescription of antibiotics among children under age five. The app uses an algorithm to suggest treatments better suited to the health concerns of young children seen in consultations.  

When Nancy enters the small consultation room at the Kidjigra health center, her two-year-old daughter Chancelvie is crying and looks very tired. The little girl has had a fever for several days, with no improvement. Nancy explains her condition to Bénédicte, a health worker at the center, who logs the details electronically on a tablet. 

“Depending on what the parent says, I select the main complaints from the tablet and click on the corresponding options," explains Bénédicte. “The app guides us throughout the consultation, directing us to the most likely diagnosis and the corresponding treatment."

Health care workers sit in a circle outside the Kidjigra center in Bambari, Central African Republic
A morning meeting at the Kidjigra center. CAR 2023 © Kristen Poels/MSF

Filling the gaps where staff shortages hinder care for children under five 

The e-CARE app helps health care providers overcome shortages of qualified personnel. Based on a clinical algorithm, it aims to improve the diagnostic process for children under the age of five so teams can propose the most effective treatment. 

The app was implemented in a health center in the Ouaka prefecture just over a year ago, and now it’s already in the consolidation phase and awaiting wider deployment in other places where MSF works, particularly those struggling with capacity. e-CARE is designed to serve as a virtual medical assistant, enabling caregivers to ask all the questions needed for a proper diagnosis and recommend the appropriate course of treatment.  

A mother in a red dress with her young daughter in a yellow dress, patients at the Kidjigra health center in Bambari, Central African Republic
Esther Pagomendji and her daughter Fabiola Dera, patients at the Kidjigra health center. CAR 2023 © Kristen Poels/MSF

Antibiotic over-prescription decreases since e-CARE’s introduction 

Over the years, over-prescription has exposed people to the risk of developing increased resistance to antibiotics, which poses a real public health problem. 

“Before e-CARE came along, patients were almost automatically given antibiotic,” says Bénédicte. “This is not good because it creates resistance [to antibiotics]. Now, we can find other solutions based on what the app suggests."  

The antibiotic prescription rate dropped from 40 percent to 21 percent in just one month after the introduction of e-CARE at Kidjigra health center.

After the introduction of e-CARE at the Kidjigra health center, the number of antibiotic prescriptions dropped significantly, from 40 percent to 21 percent after just one month. By helping to address over-prescription, e-CARE is helping to rectify one of the major problems health care systems face in under-resourced settings around the world.  

A forgotten health emergency in Central African Republic

Read more