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Agriculture, Family Planning, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal, Women in Development

mHealth for Women: A Diverse Set of Applications

Photo Credit: Anupam Nath / AP

In an ode to International Women’s Day, we wanted to review a few of the mobile health projects and programs directly focused on women’s health issues. mHealth has a great variance in the type of applications used to promote and assist in women’s health. This ranges from sending health information about pregnancy via basic text messaging to more advanced tools that allow community health workers to collect data, diagnosis diseases, and refer patients. As the need and ability to extend health information to women in developing countries increases, here is a diverse set of examples that have been used or are in current use.

MOTECH

Launched in Ghana, the Grameen Foundation’s Mobile Technology for Community Health (MoTECH) initiative has a duel focus – providing health information to pregnant women and arming community health workers with applications to track the services provide to women and children. This project was funded by the Gates Foundation and has worked in partnership with Columbia University’s Mailman School of Public Health and the Ghana Health Service. The “Mobile Midwife” application provides pregnant women with time-specific information about their pregnancy via text or voice messages. This includes reminders about seeking care, advice on how to deal with specific challenges during pregnancy, and knowledge about best practices and child development. The Nurses’ Application allows community health workers to register and track the care provided to patients in the region. By recording patient data in the MOTECH Java application and sending it to the MOTECH database, the system captures the data and can send automatic reminders to nurses for when and what type of follow up care to provide. For more information about the MOTECH as well as the lessons learned, read the report from March 2011, “Mobile Technology for Community Health in Ghana: What It Is and What Grameen Foundation Has Learned So Far.”

MAMA

Launch in May 2011, MAMA (Mobile Alliance for Maternal Action) is a public-private partnership focused leveraging mobile connectivity to improve information and access to health care for pregnant and new mothers in developing countries. USAID and Johnson & Johnson are the founding partners, and the United Nations Foundation, the mHealth Alliance, and BabyCenter are supporting partners. This initial 3-year, $10 million investment from USAID and J&J is being used to build and expand global capacity of new and current mHelath programs in three countries – Bangladesh, South Africa, and India. The beauty of the MAMA Partnership is the focus on country ownership through these partners. And each country has a separate focus based on the specific needs and problems of the maternal health. In Bangladesh, the focus is to decrease maternal morbidity and mortality through stage-based health messages via mobile phones to low-income and at-risk mothers. The public-private partnership network in Bangladesh has already been established. Lead by D.Net, it includes technology developers (InSTEDD, SSD-Tech), corporate sponsors (BEXIMCO), outreach NGOs (Save the Children, BRAC), mobile operators (Airtel, Grameenphone, Banglalink), content providers (MCC Ltd), media (Unitrend Limited, Brand Forum), researchers (ICDDR, B), and government agencies (Ministry of Health and Family Welfare). In India, MAMA is completing a landscape analysis to understand the complex cultural environment and see in what areas mobile phones can be utilized to improve maternal health throughout the country. Finally, in South Africa, MAMA has partnered with the Praekelt Foundation (lead partner), Wits Reproductive Health and HIV Institute, and Cell-life to provide messages to pregnant and new mothers about receiving earlier antenatal care, prevention mother-to-child HIV transmission, and exclusively breastfeeding.

CycleTel

Developed by the Institute for Reproductive Health (IRH) at Georgetown University, CycleTel is an innovative solution, combining a previously used family planning technique with mobile phones. In 2001, IRH created the Standard Days Method (SDM) as a low-cost alternative to family planning based on a women’s menstrual cycle. By avoiding intercourse on a woman’s most fertile days during her menstrual cycle, days 8 to 19, there is only a 5% chance of becoming pregnant. Having developed the system, IRH saw a natural fit with mobile phones. In the original set up, women would use Cyclebeads (multiple colored beads used to represent specific days of a menstrual cycle) to keep track of when they are more likely to become pregnant. Using the same idea, the CycleTel replaced the beads with a mobile phone. Each month on the first day of menses, a women text messages the system. Utilizing FrontlineSMS, it then responds by sending a message showing which days she could get pregnant. In 2009, IRH conducted a research study in the region of Uttar Pradesh, India. The pilot showed the need to tweak the system to fit the region context including the local languages and women’s past experience using mobile phones. But it also showed the willingness of women and men to pay for the service in order to avoid unwanted pregnancies. This program is being operated under to the Fertility Awareness-Based Methods (FAM) Project which is funded by USAID.

Dunia Wanita

Dunia Wanita, which means World of Women, was launched in February 2010 by Telkomsel, a MNO in Indonesia. It is a part of the MNO’s value-added services applications and is specifically for women to receive information on a number of different topics, including health. The subscription costs $0.12 per day. By dialing *468#, women have access to a “one stop info service.” By selecting “Cantik Sehat” (Health and Beautiful), women can receive health information and advice from famous Indonesian doctors. The voice messages include information about sexual health, pregnancy, and healthy living.

These are just a few examples of mobile health applications that are available to women in the developing world. The applications vary in information provided, media used, and business models utilized. This is a great illustration of how diverse mobile health can be in order to reach a targeted group within a country, based on infrastructure, location, health knowledge, and mobile usage/connectivity.

March 8, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

What Big Aid Can Learn from the Ugandan Ministry of Health

“If you want to do M4D in Uganda, you have to be willing to coordinate.” This is the underlying message of UNICEF Technology Specialist David McCann’s blog, “A Ugandan mHealth Moratorium Is a Good Thing.” According to McCann, proliferation of Big Aid-supported mobile interventions, coupled with a severe lack of integration and collaboration, has hindered Uganda’s ability to take ownership of its development.

The Ugandan Ministry of Health, on the other hand, is quickly becoming a leader in mobile integration. By migrating its databases to free open source District Health Information software (DHIS2), the Ministry is encouraging community collaboration and reducing dependency on the tracking of aid-biased health indicators. According to McCann, the Ministry’s adoption of DIHS2 is now forcing Big Aid to “do M4D in a more coherent way.”

To learn more about this pioneering initiative, read McCann’s blog here.

Initiative:

mHealth Systems Integration

March 1, 2012/by actualize

Agriculture, Family Planning, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal, Women in Development

50 Ideas and Solutions that Deliver for Girls and Women

As you may have heard Women Deliver is celebrating the progress made on behalf of girls and women worldwide. Building on its 2011 competition, which featured inspiring people who have delivered for girls and women, this year they have chosen to spotlight top ideas and solutions in the following five categories:

•   Technologies and Innovations
•   Educational Initiatives
•   Health Modernization
•   Advocacy and Awareness Campaigns
•   Leadership and Empowerment Programs

Out of hundreds of submissions, a selection committee has chosen 25 per category. The top 125 have been posted here, where viewers can choose and vote on ten favorites per category. Several of the chosen innovations and solutions incorporate the use of mobile technologies for health, showing the increasing inclusion of this type of innovation for the advancement of women’s health. Finalists include the Mobile Alliance for Maternal Action (MAMA), Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) by M-PESA, and many, many others.

In addition, the mHealth Alliance’s Catalytic Grant Mechanism for Maternal, Newborn, and Child Health (MNCH) and mHealth has been chosen as one of the top 25 ideas and solutions in the health intervention category. The Innovation Working Group, part of the Every Woman Every Child initiative, Norad, and the mHealth Alliance have partnered in the creation of a competitive and catalytic grant mechanism with a special focus on growing programs with sustainable financing models and early indications of impact. The projects supported through this grant mechanism harness the reach and popularity of mobile phones to help women, their families, and their health care providers in low-income settings combat inequitable access to quality health services. Funding is awarded through annual competitions managed by the mHealth Alliance and allows winners to take mHealth pilot programs to scale. You can find out information on this year’s grantees here.

Please show your support for mobile innovations and vote. The top 50 winners will be announced on March 8th, International Women’s Day. Vote now!

Initiative:

Maternal Newborn mHealth

February 27, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

mHealth in the News This Week

From conference and summit features to global health technology innovations: here’s what the news had to report on mHealth this week.

mHealth Alliance

“Barcelona’s GSMA to spotlight mHealth technologies,” Yahoo Philippines, February 24.
The Mobile World Congress will feature a mobile health conference to discuss the emergence of remote monitoring, wellness, and assisted living technologies, and their role in transforming the healthcare industry around the globe. To learn more about the mobile health sessions, click here.

“HIMSS takes over the mHealth Summit,” Government Health IT, February 21.
Last year, HIMSS became an organizing partner of the mHealth Summit, and they now own the event. This year’s summit will take place Dec. 3-5 at the Gaylord, located just outside of Washington, DC. The theme will be “Connecting the Mobile Health Ecosystem.”

“Kenya’s Startup Boom,” Technology Review, March/April.
Local programmers and homegrown business models are helping to realize the vast promise of using phones to improve health care and save lives.

e/mHealth

“eHealth Africa Conference – Integrating mHealth into eHealth Strategy Implementation,” All Africa, February 23, 2012.
This multi-stakeholder conference will take place in Nairobi, Kenya on the 18th and 19th of April 2012. The conference will identify best practices and lessons learned from previous experiences of developing national eHealth strategies and will also focus on integrating mHealth into eHealth strategy implementation. Click hereto learn more about the conference.

“Mobile technology boost health care,” Gant Daily, February 23.
Recent mobile phone initiatives in Bangladesh are allowing patients to reach a health worker for advice at no cost 24 hours a day, receive prenatal care reminders and even send complaints about patient care.

“Monitoring Your Health With Mobile Devices,” New York Times, February 22.
Dr. Eric Topol says that the smartphone will be a sensor that will help people take better control of their health by tracking it with increasing precision. He is already seeing signs of this as companies find ways to hook medical devices to the computing power of smartphones. Devices to measure blood pressure, monitor blood sugar, hear heartbeats and chart heart activity are already in the hands of patients.

“Africa to generate $1.2b revenue from mHealth by 2017 – GSMA Report,” Ghana Business News, February 20.
The mobile health market’s worth is predicted to reach $23 billion in terms of revenue by 2017, according to a new report. In terms of the market opportunity, the research found that the provision of pervasive mHealth services and applications worldwide could provide mobile operators with revenues worth approximately $11.5 billion by 2017 while “device vendors could benefit from a revenue opportunity of $6.6 billion, content and application providers $2.6 billion, and healthcare providers $2.4 billion by 2017.”

“mHealth Innovation and Developers Challenges,” Department of Health and Human Services, February 17.
Last July, HHS CTO Todd Park announced the availability of the HHS Challenge Toolkitand highlighted the department’s use of Developer Challenges as a tool to engage technology innovators to build creative and useful health solutions. The toolkit itself provides guidance, examples, and best practices for creating and running a challenge. Having participated in the design and judging of mHealth challenges/competitions, the author of this article, Audie Atienza, offers some reflections on his experiences.

February 27, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Qualcomm’s Wireless Reach mHealth Project to Improve Cardiovascular Disease in Resource Scarce China

Qualcomm’s Wireless Reach™ initiative, the strategic initiative of the wireless chipset manufacturer, has partnered with Life Care Networks and the Community Health Association of China to start a mHealth project focused on improving prevention and care of cardiovascular diseases (CVD) in rural China. The project, Wireless Heart Health, was launched back in September in community health clinics in three provinces (Shandong, Anhui, and Sichuan) and one municipality (Chongqing).

Photo Credit: Qualcomm

In the past, most mHealth projects in rural areas have focused on acute diseases. These diseases are easier to handle via treatment and/or prevention, which allows for numerous mHealth interventions including appointment and pill reminders as well as data collection and information dissemination. But chronic diseases are becoming a larger public health issue in rapidly developing countries. Within China, CVD is the leading cause of death. By leveraging mobile technology to reach the rural community clinics, patients and health workers in rural areas can be connected directly with trained medical personnel in an urban area. While this type of connection is common in many countries (see MTN CareConnect in South Africa), the level of technology sophistication in this project allows for more in-depth data to be gathered and transferred to trained doctors.

Project Details

Life Care Networks developed a cardiovascular monitoring system that uses China Telecom’s 3G network to send heart data to cardiac specialists, who can provide rapid patient feedback. The system includes an electrocardiogram (ECG) senor on a smartphone, electronic medical record software, and workstations at the community clinics. The ECG-enabled smartphone has a gold rim around the outside part of it which is the senor. The patient simply holds the top and bottom of the phone in order for it to read their heart data. The medical records software is web-based and includes all past data collected in the clinic. This allows for both the community health workers and the doctors in the call center to have access to historical data in order to provide better care to the patients.

Within the project, the community health clinics are connected via the 3G network directly to cardiac specialists in the Beijing Life Care Networks Call Center. Using the ECG sensor along with the software and workstations, the patient data is sent to the call center and allows for real-time feedback either by SMS or voice. The call center is open 24-hours a day, and their services range from monitoring and diagnosis to treatment and referral. Referrals are especially important in these clinics as the clinic staff often do not have the knowledge and expertise to treat complicated cardiovascular issues. Because the smartphone sends the patient information directly to a trained doctor, it allows for referrals to happen swiftly, cutting down the time it usually takes. Also the smartphones are available for patients to rent in order to monitor their cardiovascular information.

Partnership Model

By leveraging a partnership model, Wireless Reach has been able to expand many services into rural or resource scarce areas by working with both for-profit and nonprofit organizations. With the Wireless Heart Health project, Life Care Networks is a for-profit company that has a commercially available ECG monitoring service as well as products and services for personal care. They offer different levels of service, depending on the needs and desires of their clients. The other project partner, the Community Health Association of China, is a nonprofit organization that supports the efforts of the Ministry of Health in helping to strengthen the Community Health Clinics throughout China.

Wireless Reach’s partnership model does not only include bringing together for-profits and nonprofits to strategically work together. An important aspect of all Qualcomm’s Wireless Reach projects is that they tie directly to government policies and initiatives. For example, this project addresses one of the specific issues outlined in the recent 2009 Chinese Health Care Reform, which focuses on strengthening the country’s grassroots medical institutions to provide equitable health care for all citizens.By partnering with Community Health Association of China, Qualcomm is able to engage in a project that supports the Chinese government’s efforts to develop a primary health care system.

Sustainability and Scale

Another important aspect of Wireless Reach projects is the goal for them to sustain as well as reach scale. In some cases, the project and its products/services become commercialized. In other cases, they have been sustained by the relevant country’s government. Since this project is only months old, the long-term model has not been decided yet. But there is a plan to create sustainability in the short-term and answers the age old question of “who pays?” In the model, patients are charged a small fee to its patients to rent the specialized phone. This allows the clinics to generate revenue and creates incentives to actively use the products and services.

Current Results

As mentioned before, each of Qualcomm’s Wireless Reach projects are focused on reaching sustainability and increasing scale. For this project, Wireless Reach is focused on gathering information and creating best practices in order to keep the project sustainable and eventually scale up. New impact data has recently been received and ranges from September 2011 to the end of January.

46 community health clinic doctors have been trained on how to use the system.
A total of 1033 patients have participated in the project.
These patients have sent 2172 pieces ECG data.
Out of that data, 513 pieces were identified as abnormal.
Out of all of the patient participants, 208 were screened for serious cardiovascular conditions and referred to higher-level clinics for further evaluation and testing.

Wireless Heart Health is an interesting example of how creating strategic partnerships, utilizing current technology and infrastructure (both telecommunications and health), and tying the project goals to current government policies can create a sustainable and scalable mobile health model.

Please also find below a video of the project:

View More Qualcomm Videos

February 17, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

How Design and Collaboration Can Improve mHealth

We have all seen or heard of an organization developing and implementing an innovative solution and then one or two months later the product is in the corner of the health clinic. It has not been used since the organization finished its initial training. While the outsiders who came in saw it as innovative, it clearly did not resonant as a solution to the users. But why? It seemed so obvious to the developers that this product would solve a glaring problem. Why wouldn’t these health workers want to use this application?

Photo Credit: Tecca

But not to worry. This is something that all organizations and companies deal with. Do you remember Windows Vista, Nokia’s N-Gage, and HP’s TouchPad? Well, each company would hope that you do not. There is an endless list of failed technology products and services. With the movement of leveraging high tech products in international development, especially in global health, failure has become a part of the dialogue in the sector. So much so that MobileActive began hosting FailFaire, where organizations utilizing technology in their projects can come and speak about their “failures.” The idea is to learn from mistakes that others have made. In the most recent FailFaire in New York, many of the stories were focused around design and collaboration issues. Not simply physical design issues (like there were too many buttons on the device), but multiple issues that the designers and implementers did not take into account.

While design has been on the forefront minds in the corporate world for many years (see iPhone and IDEO), design in the social sector is a relatively new idea. In order to decrease the number of failures, organizations have created partnerships with design firms. They are bringing user-centered design to the social sector. Below are some examples:

Reboot has worked with United Bank Limited (UBL) in Pakistan and the Gates Foundation to expand branchless banking via mobile phones.

IDEO.org is assisting Evotech in the further development of their low-cost endoscopy device. It is used during obstetric fistula procedures in developing countries.

Frog Design teamed with the Aricent Group, PopTech, iTeach, the Praekelt Foundation, and Nokia Siemens to design programs to support HIV/AIDS patients as well as expand awareness and knowledge about the disease.

Design Strategy

By focusing on the human-centered design, the product/service takes into account the culture and needs of the targeted consumer. As the pioneer in human-centered design, IDEO wrote a paper in 2010 for the Stanford Social Innovation Review entitled “Design Thinking for Social Innovation.” In the paper, they discuss some of the issues with design in social projects. Along with looking into the culture and needs of the end-users, they mentioned that the project failed because the intervention had not been properly prototyped with the users and receive direct feedback from them. Human-centered design also sees a need to have the intervention fit into the infrastructure of the communities. The overall idea is to have the product/service that solves a problem that the user or community has. In order for this to occur, IDEO sees the solutions coming from focusing on those on the ground instead of the design process occur from outside the targeted community. Along with the design, they also believe that there must be a well thought out distribution and implementation strategy because that can kill a project too. Their most important strategy to the human-centered design process is observing people in their experiences and behaviors. This will tell the designers more than any survey because it can be difficult for people to explain what they need, especially if they do not know what that really is.

Collaboration

In order for the human-centered design to occur, there is a need for greater collaboration in mHealth. mHealth is a complex web of networks as it includes individuals from all areas affected in the sector – mobile operators, ministries of health, telecommunications regulators, community health workers, doctors, technology developers, global health NGOs, etc. As mentioned before, by understanding the problem and how a solution would be used in the field, the technology is more likely to be adopted. The creation process needs to understand all the aspects involved in the usage of the product/service. By creating a collaborating environment, no matter who the end user is (a mother, family, community health workers), the team has the experience and knowledge to look deeply into all the internal and external issues that are causing the problem. Once those are understood, then the group can start to see how the intervention can be both designed and implemented in the field with the end-user in mind. With this focus, there will be a clear incentive for the end-user to utilize the technology. Without understanding how a technology will improve their lives, there will be a low adoption rate. And then the technology becomes useless and another wasted investment.

The process of creating greater collaboration and utilizing a design strategy is easier said than done. Clearly money is an issue when including a design firm in the development of a mHealth product. It would be beneficial to include extra funds in budgets for the design process. The funds should be used to design the look, functionality, and business plan of the mHealth intervention as well as allow for greater collaboration. The end goal of developing a design strategy and increasing collaboration is to create products/services that will solve a problem but also that will be used by the indented users.

February 10, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

A Course on e-Health and m-Health: Using Information Technology to Improve Health in Low and Middle-Income Countries

E-HEALTH AND M-HEALTH:
USING INFORMATION TECHNOLOGY TO IMPROVE HEALTH IN LOW AND MIDDLE-INCOME COUNTRIES

Course URL: http://bit.ly/xo0DG9

International Health – online – Location: Internet

Course Instructors: Edward Bunker – Bill Weiss

Description:

Explores eHealth and mHealth in Low and Middle-Income Countries (LMIC). Students consider practical approaches to assess appropriate application of information and communication technologies to solve public health problems and improve health.

Students also identify and discuss challenges for developing and deploying eHealth and mHealth systems.

Through analysis of case studies and interactions with practitioners, students assess and articulate requirements for eHealth and mHealth systems.
Covers current topics and issues, including: “lessons-learned” from recent mobile health initiatives; challenges of creating, developing, and supporting systems within low-bandwidth or no-bandwidth environments; electronic health records (EHRs); role of mobile data collection within program monitoring and evaluation; and role and use of open source systems.

Although not exclusively, faculty and guest lecturers will draw upon their work and experiences related to HIV/AIDS in Africa.

Student Evaluation: Individual assignments (10%); Quizzes (10%); Exercises (10%) participation in group work and discussion (20%); two case study write-ups (30%); exploration of one emerging ICT, eHealth, or mHealth initiative (20%).

Learning Objective:

(1) articulate basic definitions and terms relevant to eHealth, mHealth, and Health Informatics;
(2) apply frameworks and other tools in the assessment and evaluation of eHealth and mHealth projects;
(3) consider how to elicit health-related needs and goals and determine if and how information technology can help meet those needs and goals;
(4) consider how information technology is or could be used to address health needs in LMIC;
(5) assist public health agencies and donors to develop or select information and communication technology to better solve problems and achieve objectives in LMIC;
(6) critically participate in discussions about basic system requirements for proposed systems by writing “Use Case” narratives and requirement statements;
(7) prepare Work Flow and/or Data Flow diagrams;
(8) identify the main drivers for the deployment of mHealth services in LMIC;
(9) describe and be familiar with the basic functions of an Electronic Health Record (EHR) Systems and discuss the potential role an appropriately applied EHR System might play within an eHealth ecosystem;
(10) examine and describe a variety of current mHealth and eHealth initiatives; and
(11) critically discuss and debate current eHealth and mHealth issues, challenges, and opportunities.

February 7, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Best Practices in Creating and Maintaining mHealth Partnerships

During the most recent mHealth Working Group, Kelly Keisling, Co-Chair, passed out a publication of mHealth cases studies developed by GBC Health. Entitled “Building Partnerships that Work: Practical Learning on Partnering in mHealth” and created in collaboration with Dalberg Global Development Advisors and the mHealth Working Group, its goal is to provide best practices for future mHealth partnerships. GBC Health sees partnerships as playing a key role in expanding mHealth into the mainstream of global health.

Photo Credit: The University of Akron

The case studies focused on diverse set of organizations, ranging across multiple sectors – technology, NGOs, and multilateral institutions. Those included were the Carlos Slim Health Institute, Deloitte, HP, Intel, Nokia, Novartis, the Stop TB Partnership, UNICEF, USAID, and Vodafone. The research revealed overlapping topics and ideas that could be used to create sustainable partnerships for mHealth programs. Below is a list of best practices that the publication pulled from the case studies:

Partnership Selection

Shared Agenda and Vision: Look for partners whose vision is aligned with yours.

Organizational Capacity: Make sure that your prospective partner will be able to adequately support the initiative at all stages of relevant involvement – from development and implementation to scale-up.

Local Expertise: Work with partners who are already working in-country and possess relevant local expertise.

Complementary Assets: Identify partners who can bridge gaps in your organization’s expertise and knowledge.

Reputation and Integrity: Consider referrals from trusted partners to identify new partners with a good reputation in the market.

Structuring for Success

Clearly-Defined Problem and Solution: Solidify and remain transparent about objectives from the beginning of your conversations with potential partners.

Roles and Responsibilities: Ensure that each partner has unique core competencies to contribute.

Shared Value: Create shared value by ensuring a ‘win-win’ for all partners.

Leadership: Identify a “champion” in each of the partner organizations to lead the campaign within their organization.

National Priorities and Program: Align projects with government priorities at the outset to help with scale and rollout.

Community Involvement: Engage the end-users in the design and on-going feedback loop to continually refine the program.

Multi-stage Planning: Establish a clear and committed plan for funding, implementation and maintenance among partners, from the beginning.

Strict Project Management Process: Develop a structure project management plan with supporting documentation.

GBC Health is a worldwide coalition of over 200 companies and organizations focused on using their resources to improve global health. Dalberg Global Development Advisors is a strategic consulting firm that works to raise living standards in developing countries and address global challenges. mHealth Working Group is a collaborative forum composed of 150 global organizations and more than 500 individual, for sharing and synthesizing knowledge on mHealth.

February 2, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

mHealth Alliance to provide technical support for 8 innovative mHealth projects in 2012

Map with location of mHealth projects pinned

Last month at the third annual mHealth Summit held in Washington, D.C., the Innovation Working Group, part of the UN Secretary-General’s Every Woman Every Child effort, and the mHealth Alliance announced the recipients of eight catalytic grants for mHealth programs. The grants, funded by the Norwegian Agency for Development Cooperation (Norad), are designed to identify and foster innovative uses of mobile technology to advance maternal and newborn health, with a particular focus on supporting programs with sustainable financing models and early indications of health impact.

The eight mHealth projects receiving grants span from Africa to Southern Asia. They address such diverse issues as malnutrition on the small Tanzanian island of Zanzibar to childhood immunization drop-outs in Karachi, Pakistan. Each project has already demonstrated initial pilot level efficacy, and the grants will be used to take the programs to regional or national scale and make progress towards Millennium Development Goals 4 and 5. A link to each of the 2011 Competition Winners’ websites can be found below.

The mHealth Alliance will work to provide the necessary resources and skills to support national scale-up processes and enable expanded reach to communities in need. Throughout the two-year grant period, the mHealth Alliance will provide technical support and establish opportunities for collaborative learning among the grantees, as well as facilitate the formation of public-private partnerships to further support long term impact and sustainability. “Each of the eight recipient initiatives has demonstrated innovative mobile technology solutions to obstacles in health and healthcare practices,” said Patty Mechael, Executive Director of the mHealth Alliance. “From providing maternal and newborn health information via mobile phones to building technology that supports clinical decision-making, these initiatives all focus [on] helping the world’s most vulnerable populations lead a healthier life.”

The next round of catalytic funding will be announced early this year. mHealth projects that have already demonstrated efficacy at pilot level and that have a viable plan for sustainability and scale are encouraged to submit applications. Check back with the HUB for application instructions and for monthly blog posts from the eight catalytic mHealth projects as they share their experiences going to scale.

2011 Competition Winners include:

Clinton Health Access Initiative (CHAI)

Dimagi, Inc

D-tree International

Grameen Foundation

Interactive Research and Development (IRD)-Pakistan

Novartis Foundation

Rwanda Ministry of Health

Cell-Life

Initiative:

Maternal Newborn mHealth

January 31, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Guide to Scale and Sustainability in mHealth: Moving Past Pilot Projects

A white paper release by the Advanced Development for Africa (ADA) last month laid out the necessary steps to scale mHealth projects in the developing world. Its goal was to provide governments, donors, and the private sector with the essential knowledge to push mHealth from pilot projects to scalable and sustainable solutions.

The report, entitled “Scaling Up Mobile Health: Elements Necessary for the Successful Scale Up of mHealth in Developing Countries” and authored by Jeannine Lemaire, preformed an extensive review of the sector. It focused on multiple case studies and pulled best practices and recommendations from organizations and thought leaders in the sector. With the current mHealth in a transition stage from proof of concept to widespread scale and adoption, there is a need to show key stakeholders that scale and sustainability is possible and necessary to improve health outcomes in the developing world. The ability to be sustainable and scale will push the sector forward and make the case for greater investment by governments, donors, and the private sector.

The author provided nine case studies including TulaSalud, TXTAlert, mPedigree, and ChildCount+. She also included the insights from thought learners in mHealth (David Aylward – Ashoka, Patricia Mechael – mHealth Alliance, Brooke Partridge – Vital Wave Consulting, Anne Roos-Weil – Pesinet, and Getachew Sahlu – WHO).

Photo Credit: IICD

Through the interviews and case studies, multiple best practices were established in order to properly implement a pilot with the ability to scale and be sustainable in the future. These best practices included the idea that sustainability and scale must be planed from the program’s inception, the necessity to perform a needs assessment for the local region, facilitating collaboration in order to avoid duplication, the inclusion of targeted users and beneficiaries during the development phase, getting buy-in from multiple stakeholders (governments, communities and local healthcare providers), collaborating with local implementation partners, creating partnerships with a focus on scale up, and including M&E to assess the impact off the interventions.

The research also provided recommendations at multiple levels of mHealth policy and development – programmatic, operational, policy, and global strategy. The recommendations were:

Programmatic:

Integrate the program within existing healthcare structures.
Employ an integrated solution and/or holistic approach rather than a silo single-solution approach. Identify innovative ways to incorporate other mobile services using cross-sectoral approaches.
Identify a sustainable and scalable business model that is applicable for large-scale implementations and can bring in valuable strategic partnerships to support scale up.
Build partnerships with the private sector after a successful pilot phase.

Operational:

Seek out and invest in building local capacity to minimize costs and support local ownership of the project.
The software and mHealth application should be geared towards the objectives of the program, suitable for local conditions and designed with the end-user in mind.
Identify what motivates the end-users, not just what the objectives of the program are. Use incentives to promote the consistent and effective use of the mHealth tool.
Perform social marketing.
Empower users through the mobile phone technology, particularly women.
If an area of the project is failing, fail quickly and publicly; adjust the program accordingly.

Policy:

Mainstream mHealth in the MOH and relevant government bodies.
Establish an e/mHealth structure to support the multi-sectoral mainstreaming of mHealth and advise the decision-makers on creating an enabling policy and regulatory environment for mHealth scale up.
Create an inter-ministerial working group and collective agreement involving stakeholders from the various ministries to support the scale up of mHealth programs.
Identify and promote the use of specific data, technology and interoperability standards.
Advocate for the integration of mHealth within local public and private healthcare initiatives; prioritize mHealth training for healthcare workers.

Global Strategy:

Establish a global network of key institutional players to inform an overall global approach to support the scale up of mHealth in developing countries.
Establish a global repository of mHealth applications, tools, best practices, recommendations and evaluation data. Institutional players must be willing to share and connect their existing repositories.
Create frameworks for success targeted towards informing policymakers, project designers and implementers, and donors.
Advocacy by institutional players to both internal and external stakeholders, particularly to donors, to utilize and integrate mHealth into programs in developing countries.
Donors and institutional players need to support the evaluation of initiatives in developing countries and the creation of common metrics, indicators and methodologies to evaluate impact on health outcomes.

The ADA is African-based nonprofit which focuses on scaling development in Africa through innovative solutions. This includes building capacity, transferring technology, hosting forums, and establishing cross sector partnerships. Jeannine Lemaire is the Director of eHealth and New Media at Actevis Consulting Group.

January 25, 2012/by actualize

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