Health – Integra LLC

Asia, Asia, Health, Health, Open Project Positions

Technical Office For Fostering USG – MOH Bilateral Cooperation (USAID BANTU II)

Position: Technical Office For Fostering USG – MOH Bilateral Cooperation

Location: Jakarta, Indonesia

Integra is managing the USAID Health Technical Assistance Project (USAID BANTU II), a five-
year project. As a follow-up to BANTU I, BANTU II is the next-generation health sector support
mechanism designed to enable USAID to continue engaging in effective and adaptive technical
assistance while accelerating local ownership and Indonesian self-reliance goals.
Integra is currently seeking a Technical Officer for Fostering Bilateral Cooperation to enhance
bilateral cooperation within the Ministry of Health (MOH), particularly those that are under the
USAID and broader U.S. Government support, by facilitating communication, collaboration, and
knowledge exchange with international partners. The Technical Officer will play a key role in
coordinating activities, managing partnerships, and supporting the implementation of bilateral
cooperation initiatives to advance the MOH’s strategic goals and priorities.

SCOPE OF WORK

The Technical Officer will carry-out the following tasks:

Drafting and reviewing MoU, agreements and other arrangement with foreign
government and international entities
Contributing to the development of policies, strategies, and guidelines related to bilateral cooperation within the MOH, based on lessons learned and best practices from international partnerships
Serving as the focal point for bilateral cooperation initiatives within MOH, liaising with relevant departments, units, and international partners, particularly under the USAID and broader U.S. Government support to identify opportunities for collaboration
Facilitating communication and information sharing between the MOH and international partners, including organizing meetings, workshops, and conferences to promote dialogue and exchange of best practices
Coordinating the development and implementation of bilateral cooperation projects and activities, including drafting project proposals, work plans, and budgets in collaboration with stakeholders, particularly those that are under the USAID and broader U.S. Government support.
Providing technical support and guidance to MOH staff involved in bilateral cooperation initiatives, including monitoring progress, addressing challenges, and ensuring compliance with project objectives and timelines
Supporting the evaluation and reporting of bilateral cooperation projects and activities, including gathering data, preparing reports, and documenting lessons learned and best practices for future initiatives
Building and maintaining relationships with key stakeholders, including diplomatic missions, international organizations, non-governmental organizations, and other relevant partners, to promote collaboration and resource mobilization for health-related projects and programs.
Coordinating workflow with USAID-MOH KGTK staff for USAID Health Programs, in particular BANTU II project, including providing support to relevant reporting systems. This will be done in close coordination and collaboration with the USAID supported Administration and Liaison Assistant.

REQUIREMENTS:

Key experience and competencies:

Master’s degree in international law or international relations or notarial degree, or Bachelor ‘s Degree in international law, international relations or other related field with at least 8 years related work experience
Minimum 6 years proven work experience in legal drafting, legislative work and/or facilitating bilateral cooperation initiatives, preferably in the healthcare or public health sector.
Excellent legal drafting skills, includes the ability to write clear, precise and unambiguous legal language that accurately reflects the agreement objectives and is consistent with the existing laws
Comprehensive understanding of and stay up-to-date with changes in GoI and MOH’s health legal framework, regulations and legal principles to ensure that the drafting of new agreements or MoU or cooperation with foreign governments and international entities aligns with and complements the existing laws
Sound knowledge of international health policies, frameworks, and funding mechanisms related to bilateral cooperation, as well as experience working with diplomatic missions, international organizations, and non-governmental organizations
Proven experience of working closely with government legal experts, and relevant key stakeholders
Attention to detail to produce accurate legal documents
Fluent in written, verbal and presenting communication in English and Bahasa Indonesia
Able to work independently and under minimum supervision, as well as to work together in teams and take initiatives in dealing with problems

This is a long-term consultancy (local hire) up to 12 (twelve) months period and will be based in
Jakarta, Indonesia.

Remuneration Package: A competitive package would be offered based on salary history and
work experience.

HOW TO APPLY: To respond to this opportunity, please send your resume (no longer than 5
pages) with three references. Application should be sent to jobsBANTU2@integrallc.com with
the title of the position in the subject line of your email.

Closing date: October 15, 2024, COB Jakarta Time
Only shortlisted candidates will be contacted.

Integra provides equal employment to all participants and employees without regard to race, color, religion, gender, age, disability, sexual orientation, veteran or marital status.

October 2, 2024/by jschur

Asia, Asia, Health, Health, Open Project Positions

Senior MEL Specialist – USAID Indonesia

Position: Senior MEL Specialist

Location: Jakarta, Indonesia

Integra and partners are pursuing the anticipated five-year USAID/Indonesia PRO – Monitoring, Evaluation, Collaborating, Learning, and Adapting – MECLA Platform (RFP No. TBD). This contract will support the implementation of the U.S. Government’s and USAID’s current priorities such as the Indo-Pacific Vision as well as future priorities that may arise during the life of the activity. This support encompasses activities related to the design, M&E, CLA, KM, and dissemination of results and learning throughout the program cycle.

The project will provide monitoring support services; designing and implementing performance, developmental, and impact evaluations and other studies, research, data analyses, and assessments; developing collaborating, learning and adapting initiatives; and providing short-, medium- and long-term consulting and advisory services and logistical support services to strengthen the implementation of USAID/Indonesia’s CDCS and enhance USAID’s organizational effectiveness.

The activities will be underpinned by cross-cutting support for localization, inclusive development, and partnerships with local stakeholders including the Government of Indonesia, private sector, civil society, and other development partners. USAID Indonesia programming focuses on issues such as democratic resilience and governance, economic growth, education, health, environment, and local institutional strengthening (see https://www.usaid.gov/indonesia/our-work for details).

Position Description: Integra is seeking a Senior MEL Specialist for the anticipated USAID/Indonesia MECLA activity. This will be a full-time position, pending award. The MEL Specialist will require experience in ensuring the MEL principles and priorities are coordinated and consistently applied in compliance with USAID and Integra principles, policies, and procedures.

Primary Responsibilities:

Support the design and implementation of MEL activities across Indonesia, through data collection, monitoring, evaluation, and learning activities.
Responsible for monitoring and tracking of performance indicators to ensure project activities/interventions are impactful and sustainable.
Responsible for data collection, cleaning, compilation, and reporting, in line with USAID protocols, standards, and policies.
Lead the development of MEL Plan, MEL Guide and Toolkit, and Work Plan. Develop Results Chains and Frameworks. Develop data collection instruments (tools and templates), trainings, etc.
Lead or contribute to MEL Communities of Practice and working groups.
Lead or contribute to MEL capacity strengthening efforts for USAID, local organizations and implementing partners.
Support project reports development. Reporting and coordinating MEL information for contract reports and deliverables.
Coordinate with Integra staff, Chief of Party and CLA teams to enable successful delivery of Mission task orders.
Analyze and use project data to assess and improve project quality and performance.
Contribute to collaborating, learning, and adapting (CLA) activities, events, and exercises.
Contribute to data reporting and visualization for success stories, case studies, social media materials, etc.
Manage multi-disciplinary and dynamic teams.

Qualifications:

Advanced degree in economics, public policy, public administration, international relations, economics, business administration, law or a related discipline.
Background in project cycle approach to planning and designing data collection strategies.
10 years of experience in data-collection and analysis, management systems, data interpretation, and integrating outputs into decision-making processes.
Experience using project/program performance tracking indicators and developing theories of change.
Experience identifying and setting and tracking monitoring indicators, data collection techniques and data analysis.
Experience developing Results Frameworks and MEL Plans (i.e., AMELPs).
Strong analytic and critical thinking skills in evaluation and visualization.
Experience planning and designing MEL management systems.
Familiar with USAID MEL work plans and data flow diagrams for M&E data collection, reporting, learning meetings, and data quality assessments.
Can adapt and update log frames, indicator plans, and indicator tracking tables based on the activity situation.
Familiar with quantitative and qualitative tools in adaptive management.
Desire and ability to improve MEL initiatives by identifying best practices, field-tested lessons learned, and creative recommendations.
Demonstrate excellent skills in technical writing experience in relevant areas, including queries, reports, and presentations.
Proficiency with Microsoft, Adobe, R, Stata, SPSS, Power Bi, Nvivo preferred.
Exceptional proficiency in written and spoken English, with fluency in Bahasa Indonesia a plus. Indonesian nationals strongly encouraged to apply.
Strong familiarity with USAID MEL policies and procedures required.
Strong management, communication, writing and interpersonal skills, including a proven ability in quality assurance for technical, reporting and other deliverables.

How to Apply: To respond to this position, please send your resume to jobs@integrallc.com with the title of the position in the subject line of your email.

Closing Date: October 31, 2024

Only shortlisted candidates will be contacted.

Integra provides equal employment to all participants and employees without regard to race, color, religion, gender, age, disability, sexual orientation, veteran or marital status.

September 13, 2024/by jschur

Asia, Asia, Health, Health, Open Project Positions

Senior CLA Specialist – USAID Indonesia

Position: Senior CLA Specialist

Location: Jakarta, Indonesia

Integra and partners are pursuing the anticipated five-year USAID/Indonesia PRO – Monitoring, Evaluation, Collaborating, Learning, and Adapting – MECLA Platform (RFP No. TBD). The project will provide monitoring support services; designing and implementing performance, developmental, and impact evaluations, as well as other studies, research, data analyses, and assessments; developing collaborating, learning and adapting (CLA) initiatives; and providing short-, medium- and long-term consulting and advisory services and logistical support services to strengthen the implementation of USAID/Indonesia’s CDCS and enhance USAID’s organizational effectiveness.

Position Description: Integra is seeking a Senior CLA Specialist to manage the learning, adaptive management, and communication activities under this contract. This position is expected to be based in Jakarta, Indonesia and is contingent upon award.

Duties and Responsibilities:

Facilitate strong CLA management practices in USAID/Indonesia business processes and throughout the program cycle.
Foster strong, collaborative relationships with key Mission stakeholders; drive dialogue and learning around emerging issues; identify and respond to key learning issues.
Coordinate CLA efforts amongst implementing partners (IPs) working on common Development Objectives (DOs).
Develop and implement a learning plan for the Mission and IPs outlining key learning questions, learning objectives, stakeholder roles and engagement.
Support strategic communications, including producing publications and organizing public events with partners and other stakeholders.
Advise USAID and buy-in clients on research and measurement activities that establish the evidence base for quantifying impact and enabling learning.
Conduct business process re-engineering, including assisting in negotiating change management around monitoring, evaluation, and learning related issues.
Support Mission staff in aligning policies, practices, and processes with lessons learned. Provide recommendations to respond to lessons learned.
Facilitate the development of learning agendas and share best practices.
Design, execute, facilitate workshops, events, conferences, pause-and-reflects, and other CLA activities.
Produce reflections on the implications of new learning and develop plans for adapting programs.
Establish and maintain a network of key stakeholders.
Ensure monitoring and evaluation information is shared and fully utilized through knowledge sharing and strategic learning processes.
Work with the Mission CLA Community of Practice to promote CLA Activities for strategic collaboration to identify possible program and context gaps at the strategy level and offer periodic opportunities to reflect on progress.

Qualifications:

Master’s degree in development or a related development field, such as economics, evaluation sciences, political science, public administration, business administration, or other discipline related to development assistance required.
A minimum of eight years of progressive professional experience in communications, change management, adult learning, knowledge management, and monitoring and evaluation.
Experience designing and facilitating tailored learning activities.
Experience in developing and implementing capacity strengthening approaches that leverage multiple learning approaches and media.
Experience in organizational development and human-centered design preferred.
In-depth knowledge of development theory, systems thinking, and organizational change management.
Experience leveraging digital technologies and information systems to adaptively manage programs and drive results.
The ability to work well under pressure and skilled in change management, crisis management, and problem solving.
Demonstrated knowledge of USAID Evaluation Policy; the Collaborating, Learning, and Adapting (CLA) Framework; and other initiatives.
Previous experience working on USAID-funded projects preferred.
General professional proficiency in English and Bahasa Indonesia (preferred).

How to Apply: To respond to this position, please send your resume to jobs@integrallc.com with the title of the position in the subject line of your email.

Closing Date: October 31, 2024

Only shortlisted candidates will be contacted.

Integra provides equal employment to all participants and employees without regard to race, color, religion, gender, age, disability, sexual orientation, veteran or marital status.

September 13, 2024/by jschur

Asia, Asia, Health, Health, Open Project Positions

Chief of Party (COP) – USAID Indonesia

Position: Chief of Party (COP)

Location: Jakarta, Indonesia

Position Description: Integra is seeking a Chief of Party (COP) to lead and manage the anticipated USAID/Indonesia MECLA activity. This will be a full-time, key personnel position, pending award. The COP will require experience in leading a team of experts in both management and technical areas, with a proven track record of programmatic accomplishment in MEL, professional achievement, management competence, and interpersonal skills. The selected individual will also have work experience in Asia.

This position is expected to be based in Jakarta, Indonesia, contingent upon award, and will be responsible for providing oversight on all activities to be conducted in Indonesia.

Duties and Responsibilities:

Lead Integra’s team and serve as the primary point of contact with USAID regarding day-to-day activity implementation and management matters.
Lead technical operations to ensure that project tasks are completed, and the objectives of the MECLA platform are successfully met.
Develop systems that mitigate against performance and contractual risks and manage issues in collaboration with Integra staff.
Prepare and submit reports and deliverables as included in Integra’s contract.
Lead internal and external planning and reporting meetings with Integra and USAID. Coordinate with USAID and liaise with key counterparts.
Assure that all assistance provided under the contract, whether by international or local experts/personnel, is technically sound and appropriate for the needs to be addressed.
Plan, manage and supervise the work of all experts/personnel provided under the contract, providing mentorship and guidance.
Contribute technical leadership on MEL and CLA activities.
Ensure all activities of the project are compliant with USAID requirements and regulations, including the Automated Directives System (ADS) Chapter 201 – Program Cycle Operational Policy, ADS Chapter 508 Privacy Program, ADS Chapter 579 USAID Development Data, the USAID Evaluation Policy,
Understand and implement USAID initiatives, strategies, policies, and procedures related to MEL and CLA, including USAID Gender Equality and women’s empowerment policy, USAID Disability Policy, Policy on Promoting the Rights of Indigenous Peoples, LGBTQI+ Inclusive Development Policy, Local Capacity Strengthening Policy, Youth in Development Policy, and Knowledge Management and Organizational Learning Policy.
Oversee partners, team members, short-term consultants and subcontractors, ensuring effective consortium communication and collaboration, in coordination with team’s finance and operations, administration, and human resources staff.
Work with Integra staff to ensure project activities are implemented on schedule and within budget.
Ensure quality control and client responsiveness fit the requirements of USAID.

Qualifications:

Advanced degree in economics, public policy, public administration, international relations, economics, business administration, law or a related discipline.
Minimum 10 years of experience in aiding USAID in evaluations and assessments, of similar size and scope in developing countries and comparable experience with learning and adaptive management.
A track record for successful implementation of development programs in Asia required.
Familiarity or experience working with local or regional MEL organizations preferred.
Experience providing technical and administrative oversight of partners and subcontractors in a multicultural setting.
Strong knowledge of USAID’s CLA framework and Program Cycle.
Strong familiarity with USAID policies and procedures required.
Strong management, communication, writing and interpersonal skills, including a proven ability in quality assurance for technical, reporting and other deliverables.
Exceptional proficiency in written and spoken English, with fluency in Bahasa Indonesia a plus. Indonesian nationals strongly encouraged to apply.

How to Apply: To respond to this position, please send your resume to jobs@integrallc.com with the title of the position in the subject line of your email.

Closing Date: October 31, 2024

Only shortlisted candidates will be contacted.

Integra provides equal employment to all participants and employees without regard to race, color, religion, gender, age, disability, sexual orientation, veteran or marital status.

September 13, 2024/by jschur

Agriculture, Health, Originally posted on the GBI Portal

Where to Turn When Researching: A Database for Innovative Global Health Initiatives

Photo Credit: Results for Development Institute

While working on a mhealth project that expanded across three countries, I was tasked with researching both the public health and mobile sectors in each country. Having worked on a number of strategic plans to implement mhealth, I knew what technology was being used in the field and the challenges that mobile technology can solve. But I had less knowledge about the public health challenges and the innovative, non-mobile health projects in these nations. In need to fully understand these two areas, I came upon the Center for Health Market Innovations (CHMI) website. CHMI has an extensive and straightforward database to research the numerous innovations going on in developing countries. I was able to customize my search and focus on the three nations as well as the health focus (ie maternal and child health, HIV/AIDS, chronic diseases, etc) and its technology (ie mobiles, GPS, radio, etc). It gave me knowledge of the specific health challenges in those nations as well as how mobile technology could be leveraged in existing programs and policies.

About CHMI

The origins of CHMI were born out of a study in 2008-2009 entitled “The Role of the Private Sector in Health Systems.” It focused on further understanding how the private sector participated in the health care sector in the developing world. CHMI was created as a continuation of the initial research through funding from the Gates Foundation and the Rockefeller Foundation. The goal was to expand on the research in order to support the advancement of health markets. CHMI’s role is to identify and analyze programs and policies that improve private sector health care delivery and financing for the poor. These include mHealth programs, health franchises, health savings programs, consumer education programs, and many more. By developing this database, governments, NGOs, and social entrepreneurs can include their own innovative health programs as well as search for others. To date, there have been 978 completed programs with 117 still in the pipeline, all across 104 countries. As mentioned above, the database allows users to customize their search based on the categories below:

Profile Status (completed or not)
Program Type (type of innovation)
Health Focus
Country
Target Population
Legal Status (private, nonprofit, government, etc)
Target Geography
Reported Results
Source of Funding
Technology Used

Along with researching innovative programs, the database allows users to connect directly with organizations running these programs and provides content about new programs and update others already in it. It is also downloadable so users can play with the data for their research. The ability to discover and develop profiles of the programs has been primarily done by both partner organizations and CHMI staff. But recently third parties with no CHMI affiliation, such as researchers or program managers, have also submitted profiles. By having a community approach, the database has the most up-to-date information and data. CHMI also takes responsibility to verify information with the organizations on the ground when possible. If this is not possible, the CHMI staff tries to be as transparent with this knowledge. This includes rating the quality of the information source. Here is how they break it down:

High: Interview with high-level employee of the organization and/or a site visit.
Medium: High-quality website or contact with a high level employee of the organization, trusted secondary source (e.g., a report published by a collaborating organization)
Low: Secondary online sources or other publicly available resources

In the end, CHMI wants to increase the information available about recent health innovations, assist donors/investors in identifying new models to fund, give policymakers greater knowledge about designing health policies, connect implementers in order to share lessons and knowledge, and provide data and impact evaluations submitted by partners or third parties.

With information about innovations in development (mostly around mobile technology) spread throughout the internet, CHMI has taken the reigns to promote and show the ground-breaking health market innovations. The partnership approach and focus on gathering the most accurate information gives the CHMI an extensive and trustworthy database of knowledge for practitioners, policy makers, and donors to learn the most innovative approaches.

If you have any questions or would like to include an innovative health program in the database, please contact CHMI at chmi@resultsfordevelopment.org.

April 23, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Alerta MINSA: The First mHealth Project in Latin America

Photo Credit: rcrwireless.com

In the news and blogosphere on ICT4D, there is a heavy focus on Sub-Saharan Africa, mostly because mobile phones have exploded across the continent. But we have missed many of the innovations that are going on in Latin American and the Caribbean. In an effort to reach back to the history of mHealth, I was able to connect with one of the first individuals to work in mhealth, even before the term mhealth had been coined – Ernesto Gozzer, currently working as a Researcher and STC with the World Health Organization and is an Associate Professor at Universidad Peruana Cayetano Heredia.

While he could not confirm that the project was the first in the world, Alerta MINSA was the first in Latin America. Originally launched on February 6^th, 2001 in the Cañete Town Hall Auditorium (in the southern part of Lima), Ernesto admitted they had no idea they were pioneering mhealth. “We thought we were helping to improve the health information systems for critical health issues. The aim was using available technology to connect the unconnected, to help to reduce the digital divide.”

Alerta MINSA stands for Alert Ministry of Health and was initially funded by InfoDev. The tool allowed for disease surveillance to send via text messages and through the internet. The information is then consolidated in a database. Alerts can then be sent when thresholds have been surpassed as well as automated reports and compiling data in tables, graphs, and maps in dashboards. Currently Alerta is the “official disease surveillance system” of the Peruvian Air Force, Navy, and Army. It also has been used in other countries including Ecuador, Panama, Tanzania, Rwanda, Colombia, and Paraguay.

My favorite idea that Ernesto talked about was the following: “So, this was not a pilot but what I call a local innovation that expanded beyond borders.” I love this quote because an innovative solution was created to solve a specific problem using mobile phones. Instead of it being the sexy thing to do, it was done out of necessity. The developers use the power of mobile phones to provide a solution to a problem. This is an important lesson that has been mentioned before in the mhealth space. Start with the problem first and then develop a solution around it. This is as true today as it was 11 years ago.

April 14, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

More Randomized Controlled Trials in mHealth Please!

mHealth is by no means the magic bullet (I believe there is no magic in international development; every situation is so different and complex for one solution). But it could help to improve the public health workforce or women’s health in developing countries. In order to determine this, there needs to be further field research. And it needs to focus around the true impact of the intervention. While the social sciences are imperfect and it is very difficult to know an intervention’s true impact (meaning if the mobile device is removed, how different would the outcome be), there is a best practice to assess the true impact – Randomized Controlled Trails.

There are multiple examples of projects providing “evidence,” but they tend to only show who has been reached (reproductive health information was received by 20,000 mothers). We need further evidence to show that mobile phones and/or their content are creating the sought behavior change. mHealth could be like microfinance where there has been a lack of evidence showing the impact of it on families. But, knowing this, microfinance is still essential for the bottom of the pyramid to access necessary formal financial services (savings/insurance/credit). In the same light, mhealth tools help fill in gaps (ie sending information via text message instead of walking it in paper form). But does it really make a community health worker (CHW) more effective and efficient at their jobs? It will give women and families reproductive health information. But does it improve ART intake or change a women’s behavior? These are the questions that must be answered in order to know the true impact of mhealth applications.

To the benefit of the sector, RCTs have and are being conducted. At the ICTD 2012 Conference in Atlanta a few weeks ago, Brian DeRenzi, who completed his Ph D at University of Washington in the department of Computer Science and Engineering, presented his paper entitled “Improving Community Health Worker Performance Through Automated SMS.” As the title indicates, the focus of his research was testing the impact of reminders via SMS to CHW’s follow up visits to their patients. The study was conducted in Tanzania and in collaboration with D-Tree International, Pathfinder International, and Dimagi. It included one pilot project and two larger studies. In the end, the reminders reduced the average number of days between follow up visits to patients by CHWs. This is a clear benefit to helping improve the care provided to patients. But the study also provided further knowledge into issues with patient reminders to CHWs. This included the benefit of having the supervisor of the CHWs receive a SMS reminder if their employee did not conduct a follow up visit. When the supervisor was taken out of the equation, the performance of CHWs decreased considerably. This is an important design aspect to the program that could have been missed without a RCT. By testing the removal of the supervisor, it showed that the mobile phones helped but combining it with the supervisor’s real time knowledge of their work provided greater incentive to the CHWs to follow up with greater regularity with their patients.

Another example of an RCT currently in progress is in Ethiopia. In a very similar study, Kate Otto, from the World Bank, is working in collaboration with Addis Ababa University to test the impact of mhealth interventions on the care provided by Health Extension Workers (HEWs) in rural areas to women and child (In Ethiopia, the HEWs are equivalent to CHWs in Tanzania). The research question is “does the use of a mobile phone-based tool enabling patient registration, appointment reminders, and inventory management – in the hands of Health Extension Workers – result in improved maternal and child health outcomes in a rural Ethiopian setting?” The goal is to find evidence supporting the use of mhealth interventions with HEWs.

Since these RCTs seem very similar, it would be easy to say that the World Bank and Addis Ababa University should have simply copied the intervention and implementation of the best practices learned in Tanzania. But this is the power of RCTs. Since each region is different with varying degrees of complexity, solutions that work in one area will not produce the same outcomes in another. Just because a program and intervention worked one place does not mean the same model or theory will work in another setting (see m-Pesa). The benefit of RCTs is that it will assist in finding interventions that will provide a solution for the region/country. This is especially necessary in the mhealth sector as the complexity of each situation dictates the need for specific program requires. But we are not sure what those are. The benefit of RCTs is that it can remove these variables and focus directly on the how and why interventions work or not, especially in behavior change. And as shown in Tanzania, it helps us understand what is and provides insight into areas of improvements.

Funding is always going to be an issue with RCTs. But the knowledge gained makes up for the investment by further understanding the true impact (if any) of the device. In the end, we need to find answers to what changes behavior, especially the role of mhealth in the change. There has been a greater increase in RCTs in mHealth projects to test how mobile phones and their applications are improving health. But there needs to be more done.

For those interested in learning more about M+E in global health programs, there will be a panel through GHDonline.org at the beginning of April. Please find further information about the panel here.

April 3, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Opening the Discussion of Data Privacy in mHealth

Photo Credit: Technorati.com

During New America’s Mobile Disconnect talk on February 9th, Katrin Verclas, Co-Founder and Editor of MobileActive.org, brought up an interesting question about data privacy in mhealth – what is being done to protect patient data in mhealth projects in developing countries?

“If you are gathering sensitive health data over completely clear text and insecure SMS, somebody’s HIV status, sensitive information protected by HIPAA standards in this country, completely unregulated by development organizations, they don’t self-regulate. Countries certainly don’t have any privacy or data protection stipulations…If we are talking about mobile telephony and mobile phones in development, we need to talk about how we protect the data that we are gathering, the information that we are distributing…”

Data privacy is an important, yet undiscussed topic. As Katrin mentioned, an individual’s health information is extremely personal, especially because it can be used against the person to make them a social outcast. But there is little talked about how patient information is being protected, especially the structure and framework of data protection on a large scale. As mentioned in the white paper “Barrier and Gaps Affecting mHealth in Low and Middle Income Countries” by the Earth Institute at Columbia University, many mhealth studies expressed the need for data protection and some measures were taken. But further security steps need to be taken as projects scale into national programs.

First, security is a tough question to answer in any setting. In the U.S., there are strict laws that require health information to be protected (HIPAA). Corporations holding patient health information must internally regulate how this information is being stored and transmitted in order to avoid penalties (both monetary and brand loss) if data is lost or there is a security breach. Along with setting user policies to further protect this sensitive data, corporations also leverage security software to protect against internal and external data lost. This includes protection against network attacks or unprotected lost/stolen devices. In these cases, the companies not only spend money on security measures but also employ a team solely focused on security. Chief Information Security Officer is vastly becoming an important and necessary role with large enterprises.

But the reason for all these security measures is the value individuals and families put on the privacy of their health information. Similarly to people protecting information about their finances, people want to keep their personal and family health information private. With the stigma of specific diseases or the unknown of the future as testing, diagnosis, and treatment is occurring, individuals and families want to have the power to inform others when they are ready. Do individuals and families in other countries place the same value on their health information? My guess is very much so.

But, as Katrin mentioned, many of the countries using mobile phones for data transmission do not have strict data privacy laws to regulate how patient data is protected. This leads to a lack for incentive for development organizations to create their own data protection policies which includes user policies and technology solutions to protect the storage and transmission of patient information. The GSMA recently began a movement to support data privacy on mobile devices. This includes providing principles, guidelines and resources in order to tackle the new challenges of data protection on global mobile networks. The International Telecommunication Union (ITU) and infoDev have created the ICT Regulation Toolkit to provide insight and best practices for policy-makers, government regulators and the telecommunication sector to implement telecom policies. There is a section directly focused on Data Protection and Privacy Laws. While these are steps forward, they are more generally focused on the over telecom industry. There needs to be a greater focus on the mhealth sector as it continues to grow.

Some organizations have included data privacy in mhealth projects. eMOCHA, developed by Johns Hopkins Center for Clinical Global Health Education, is a program for Android smartphones that stores and transmits data. Included in the program is security on both the endpoint device (the smartphone) and the servers. The servers that store the data are encrypted to protect against internal leaks. The smartphones also utilized encryption to send messages. They also are password protected in order to prevent data access if the phone is lost or stolen. Dimagi has also used technology to protect both internal and external leaks. This includes individual logon passwords and full data encryption on handsets and full server database encryption and auditing of who has logged into the database. It would be great to hear from other mhealth developers to see what they are doing to protect data. As is the case with the open dialogue of discussing best practices implementing and scaling programs in the mhealth community, it would be beneficial to the sector to share advice on data privacy.

MobileActive has been focusing on data security lately with the release of their SaferMobile website. It has helped to open the discussion and provides knowledge and advice to activists, human rights defenders and journalists to better protect their mobile privacy in their jobs. Those in the mhealth community should piggyback on their work. The discussion of data protection has been brought up before, but it is time to have it on the forefront of developers and implementers minds working on mhealth projects in developing countries. The goal is to understand all issues of data privacy (from the regulatory, technological and social aspects) and how we can make sure to always be aware of the patient’s right to privacy. It will be interesting area to continue to follow, and I hope this at least opens the door to a more in depth discussion on the topic.

March 28, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Two Guides You Must Read Before Using Mobile Technology for Behavior Change

Photo Credit: Larissa Frei

As the desire to utilize mobile phones in international health projects has increased in the last few years, organizations continually ask a similar question, “We want to use mobile phones. Now what?” But the decision to introduce or start a mhealth project needs to come after answering many questions before “now what?” especially when dealing with behavior change communication projects. Enter Abt Associates, FrontlineSMS, and Text to Change. Two guides have recently been released to help organizations assess whether or not mobiles are the right tool, and if they are, the process moving forward. One is from Abt Associates and is entitled mBCC Field Guide: A Resource for Developing Mobile Behavior Change Communication Programs. The other one was created in collaboration between FrontlineSMS and Text to Change and is entitled Communications for change: How to use text messaging as an effective behavior change campaigning tool.

mHealth is a sexy term these days but it is not always the best approach to creating behavior change. Simply using mobile devices will not instantly make your project/program better. But when designed and implemented with the end user in mind, they can be a cheaper and more direct tool to pass information along in order to change behaviors.

Reason for the Guides

Abt and FrontlineSMS/Text to Change saw the need to have a guide that can lead practitioners through the necessary steps in order to see if and how a mobile solution could be used in the field. Each guide clearly shows the need to analyze on how a mobile intervention would fit into a program. They both do a great job pointing out that every situation is different and that a mhealth intervention must fit into the context and infrastructure of the region. But they are structured in very different ways and have noticeably different lengths (50 pages vs 7 pages). The Frontline/Text to Change guide is structured more like a checklist and mostly focused on text message interventions. The mBCC guide is longer and walks the reader thoroughly through the assessment process. But the guides show how to strategically think about behavior change communication projects.

The mBCC Field Guide

Abt Associates broke down the guide into 6 chapters with each chapter focusing on a specific topic. Each chapter lays out the necessary research and design that must be conducted in order to successfully utilize mobiles for behavior change. The chapters are in order of how one should follow the process (even though you can pick and choose chapters if you have already completed a chapter before reading). The chapters include Situation Analysis, Audience Segmentation, Behavior Change Objectives, Message Development, Tools & Technologies, and Monitoring and Evaluation. Each chapter also includes tools in the form of Excel templates that can be utilized to complete the assessment discussed in the chapter. With a high level of detail along with the structured worksheets, this guide is designed for those who are new to mhealth and are seeking a step-by-step walk through from the start.

Frontline/Text to Change

As mentioned before, the FrontlineSMS and Text to Change guide is more of a checklist of things to research and discuss before designing and implementing a mobile-based behavior change project. With a DOs and DON’Ts list, it covers context, content, developing campaigns, and monitoring and evaluation. This skeleton format is a quick read and is probably better suited for an organization that either has worked with mobile devices before or is somewhat knowledgeable about mhealth.

Both are very useful guides for the intended audiences. With mhealth still only mostly being used in pilot projects, we need to find answers to what changes behavior. The greater number of projects that use mobile devices for behavior change communication (when they are deemed most appropriate) means more data and evidence will be produced in order to show the true impact of mobile devices. These guides give the necessary direction to organizations to start leveraging mobile devices in health projects and discover what does and does not work along with why, which is the most important question of all.

As an ending note, the mBCC Field Guide was presented by Gael O’Sullivan, Stephen Rahaim, and Shalu Umapathy from Abt Associates during the latest mHealth Working Group meeting. They explained that the guide needed to be a “living document,” and they requested feedback about it from mhealth practitioners, especially those in the field. Please visit their website (http://www.mbccfieldguide.com/) in order to provide any feedback. To provide feedback to FrontlineSMS and Text to Change, please find used the contact information here and here.

March 21, 2012/by actualize

Agriculture, Health, Mobile Money, Originally posted on the GBI Portal

The Intersection of mHealth and mFinance: A mHealth Alliance Report

Photo Credit: mHealth Alliance

The mHealth Alliance recently released their second white paper on the interconnection between mobile health and mobile finance services. Entitled “Advancing the Dialogue on Mobile Finance and Mobile Health: Country Case Studies” and co-authored by Menekse Gencer, Founder of mPay Connect, and Jody Ranck, the report focused on four separate countries with varying degrees of intersection between mHealth and mFinance – Ghana, Haiti, Kenya, and the Philippines.

The report was commissioned in order to further explore how business models in the mHealth sector have leveraged mobile financial services (MFS) to improve the access and reach of health care in developing countries. The objectives included identifying new use cases that have shown promise at strengthening health systems, showing the characteristics in markets that have allowed MFS to improve the health care system, and recognizing the trends and challenges in how MFS can be implemented into mHealth projects. The goal is to continue to open the eyes of health providers, NGOs, MNOs, and government health agencies in developing countries to the ways that MFS can increase the care provided to the poor.

Benefits of Using MFS in Health Care

The authors make the argument in the report that mHealth can be assisted by MFS along the entire continuum of care (pre-pregnancy, pregnancy, birth, and postnatal) at multiple levels – patient, provider and administrative. Its uses at the patient level include all aspects of formal financial services (savings, insurance, and credit) to help smooth consumption as well as mobile money transfers to pay for medical services or transportation via cash. For providers, MFS allows for quicker remote payments to occur for health services and products along the supply chain and settlement of patient vouchers. Finally, at the administrative level, mobile payments allow remote and unbanked health workers to receive their salaries and reimbursements as well as for families to receive conditional cash transfers.

Countries

The countries selected have a diverse infrastructure in the MFS market and drivers from the private or public sectors, but the authors discovered three trends in each country:

1. A significant health concern that needed to be met

2. MFS had already launched in the markets

3. Either the business model, the quality of the services, or the accessibility of critical healthcare services was suboptimal without the use of MFS.

In Ghana, insurance has been pushed by the government. In a partnership with two MNOs (MTN and Tigo), Microensure has provided customers on the networks with life insurance. The drivers for this service included the need for assistance in covering funeral costs, the lack of a public option for life insurance, and consumer demand of insurance products which was caused by the government’s push to educate its citizens on health.

In Haiti, the driver of MFS in mHealth was the effect of the earthquake in 2010. After grants were provided to MNOs to develop mobile money services after the earthquake, the MNOs saw an opportunity to expand their services into mHealth with the cholera outbreak. This includes utilizing MFS to dispense medical supplies to stop the spread of the disease across the country.

The Philippines is the first country to heavily adopt MFS, and now they are leveraging the large adoption rate to provide health services. The government is now supporting the use of mHealth to reduce maternal and neonatal mortality rates through the well-developed MFS infrastructure. This includes payment for health products and vouchers for health services.

Finally, Kenya has utilized M-Pesa to pay for medical services and transportation at the patient level, payments for remote diagnostics at the provider level, and dispensing of conditional cash transfers and salary payments at the administrative level. M-Pesa was the driver along with Universal Health Care (UHC) in Kenya.

Key Challenges and Future Trends

The authors noted that there were multiple challenges discovered in their research and included brief look into the future of MFS and mHealth. The challenges included the MNOs desire for exclusive partnerships, scaling of services that need greater customer information, risks of cross-sector initiatives in markets with low mobile money adoption rates, shared phones which make it difficult to implement ID management systems, and exorbitant setup costs because of lack of interoperability between mobile money providers. As for the future, the authors see that these challenges will decrease with increased adoption rates of MFS and the decrease of the costs of utilizing MFS in the mHealth sector. Finally, the authors see a greater need for quality data to be accessible by both healthcare and financial service providers. The idea is that more quality data about a patient’s health and finances will allow for micro-insurance to be provided. It would allow for re-insurance to be provided to private or public insurance schemes to provide greater protection to those providing the insurance. The authors see a lack of movement in this space because of this lack of data. They see technology as a tool that would provide this information and expand the reach of insurance to the poor.

March 16, 2012/by actualize

Case Studies

Contact Details

Quick Links

About

Expertise

Impact

Join

Sign up for Updates