Map of Peru

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 6th, 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.

Photo Credit: Agronet-Colombia

AGRONET, a National Agricultural Information and Communication Network was developed with the goal to connect small producers in Colombia and reduce the digital divide through public private partnerships and growing broadband penetration in rural municipalities.

A Government of Colombia’s initiative under the Ministry of Agriculture and Rural Development in collaboration with the United Nations Food and Agriculture Organization (FAO). The main aim is to provide information and knowledge on new techniques for sustainable food security and for the diversification of crops in order to improve productivity and opportunities in the market. While the network is aimed at policy makers, other stakeholders in the agricultural chain including small producers are expected to benefit through the platform.

Agronet platform helps in standardizing and integrating resources to offer value-added information and communication services for the agricultural sector using modern and traditional ICTs. The platform also has alliances with several actors in order to integrate other systems of information into the network and expand the content offered.

In order to serve producers with relevant and targeted information, Agronet has developed user profiles of all users based on needs assessment and users’ particular productive activities. Taking advantage of the penetration of mobile technologies in the rural users, new agricultural innovations – technologies and methods are introduced to producers systemically through SMS. Producers receive updates on Agronet’s platform, including changes in its databases and other news and events pertinent to agriculture.

Agronet offers a dedicated space for the agribusiness to view supply and demand, and to publish notices of products and services related to agriculture and agribusiness. The platform also has a digital library, policy documents related to agriculture and food security and other statistical bulletins for students, researchers and policy makers within the agricultural field. Agronet also gives its users the opportunity to train virtually from online courses available on the website. The platform also allows small producers to search for credit information for their farm inputs, market for their produce, and information of other stakeholders.

Over the medium term, Agronet plans to provide a greater wealth of content and information services to producers by adding capacity in digital television. For more information, visit Agronet.

The Ukrainian minister of ecology introduced a proposal to implement a new satellite environmental monitoring system to the country’s president the first week of April. This is a major step for Ukraine in independently setting its environmental protection agenda and integrating ICTs for sustainable development. The satellite, which offers better resolution, will be used to monitor illegal forest cutting, natural resource development, industrial and other hazardous leaks, uncontrolled emissions of garbage dumping, etc.

Photo Credit: M-Farm

M-Farm is an award winning mobile solution for agribusinesses and farmers currently being piloted in Kenya. It is an SMS and web-based application focused on improving weaknesses in the value chain. It is a transparency tool for Kenyan farmers to get information pertaining to the retail price of their products, buy their farm inputs directly from manufacturers at favorable prices, and find buyers for their produce.

Why M-Farm?

The M-Farm solution was developed based on the marketing challenges of rural farmers in Kenya. Smallholder farmers unaware of the market of the various commodities, produce in excess and are faced with the problem of getting the worth of their produce. Poor information on farm inputs and lack of access to these inputs such as fertilizer, seed, agrochemicals and other equipments are huge obstacles to increasing farmers’ productivity. The inability of the farmers to transport their produce to regional markets after harvesting also leads to the exploitation by middlemen who offer meager prices for the produce, and even delay payments for the commodities.

M-Farmers’ Approach

The M-Farm solution aims at giving farmers a voice by connecting them with each other in a virtual space for access to affordable farm inputs and also be able to sell their produce collectively. Specifically, the solution works through:

  • Price Information: M-Farm enables farmers to inquire current market prices of different crops from different regions and/or specific markets
  • Group Buying: M-Farm is able to aggregates farmers needs/orders and connect them with farm input suppliers
  • Group Selling: M-Farm enables farmers to sell collectively and connect them with a ready market thereby increasing their productivity.

M-Farms’ Solution

The M-Farmer solution has taken advantage of the on-going phenomenal growth of mobile technology across Africa. With access to the Internet yet to have impact on rural farming in these areas, M-Farm has adopted an SMS-based solution for achieving its goal.

Farmers in Kenya simply SMS the number 3535 to get information pertaining to the retail price of their produce, buy their farm inputs directly from manufacturers at favorable prices, and find buyers for their produce. Also, M-Farm has a contract with a local exporter, who buys the produce directly from the farmers using their mobile devices thereby minimizing the transportation challenge. This gives farmers access to a reliable and guaranteed market that enjoys stable year-round prices while eliminating middlemen and lowering transaction costs.

Below is a 2-minute clip on the winning of M-Farm’s IPO48 competition featuring Jamila Abass, a co-founder and CEO of MFarm Ltd (K) and other team members.

 

Access to M-Farm is by subscription with a free 30-day trial for users. For more information on M-Farm, visit here.

Image from Wikipedia

Over the last decade, Wikipedia has become as ubiquitous a research tool for the modern American student as the encyclopedia was for their parents — though even that has changed now that the Encyclopedia Britannica has gone completely digital.  But Wikipedia has remained largely inaccessible for students in remote corners of the world where English, German, French and Dutch are not spoken — languages that receive the most Wikipedia coverage.

Wikidata, a new project from the Wikimedia Foundation, plans to change that by creating a free knowledge base about the world that can be read and edited by humans and machines alike, making updating and translating processes easier and more efficient.  Through this new project, Wikipedia will provide data in all of the languages of other Wikimedia projects.  Announced in February at the Semantic Tech & Business Conference in Berlin, the new project promises to be groundbreaking in both its approach and scope of its audience:

“Wikidata is a simple and smart idea, and an ingenious next step in the evolution of Wikipedia,” said Dr. Mark Greaves, Vice President of the Allen Institute for Artificial Intelligence.  “It will transform the way that encyclopedia data is published, made available, and used by a global audience.  Wikidata will build on semantic technology that we have long supported, will accelerate the pace of scientific discovery, and will create an extraordinary new data resource for the world.”

Photo Credit: www.thehindu.com

And that’s including parts of the world that have long been left out of Wikipedia coverage because of language barriers and the digital divide. Though the project is still in its initial stages, the first phase of the project will take place over the next several months as the development team creates one Wikidata page for each Wikipedia entry for over 280 supported languages.  By using a unified data management system, data entered in any language will immediately be available in all other languages and editing in any language will be possible and encouraged by the projects completion, slated for March 2013.

 

The initial development of Wikidata is being funded in part by the Allen Institute for Artificial Intelligence and the Gordon and Betty Moore Foundation through its Science program, both of which see enormous potential for Wikidata and the role it will play in creating common formats for online data:

“It is important for science,” said Chris Mentzel, Gordon and Betty Moore Foundation science program officer.  “Wikidata will both provide an important data service on top of Wikipedia, and also be an easy-to-use, downloadable software tool for researchers, to help them manage and gain value from the increasing volume and complexity of scientific data.”

Wikipedia’s development team is not new to revolutionary ideas and raising standards.  Jimmy Wales, one of the founders of Wikipedia and the Wikimedia Foundation, was quoted several years ago for his vision of “a world in which every single person on the planet is given free access to the sum of all human knowledge.”  For students in parts of the world where online educational resources in their native language are far and few between, Wikidata promises to take one step closer to this goal.

Bus Rapid Transit (BRT) is growing in popularity worldwide as a way to provide faster, more efficient transportation that is lower in carbon emissions than traditional bus routes and less costly than light rail. BRTs are growing in popularity particularly in Latin America and Asia.

BRTdata.org was launched at the end of March by EMBARC, World Resources Institute, Across Latitudes and Cultures (ALC-BRT CoE), and International Energy Agency (IEA). The website is useful for researchers, transit agencies, city officials, and others who wish to better understand  and improve bus corridors in their cities. BRTdata.org compares BRT systems and bus corridors in 134 cities in 36 countries using metrics such as system operations, design and cost, passengers per day, commercial speed, and length of corridors. IEA wrote that, “this database will be helpful to planners, and is an essential component in calculating energy efficient scenarios which inform decision makers of practical ways of transitioning to a more secure, sustainable and affordable energy future.”

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.

Photo Credit: TV Pro Gear

An initiative being co-led by Conservation International (CI), the Council for Scientific & Industrial Research (CSIR), South Africa and the Earth Institute (EI), Columbia University, has been launched with a grant from the Bill & Melinda Gates Foundation.

The Africa Monitoring System (AMS) tool will track, monitor and diagnose agricultural productivity, ecosystem health, and human well-being in African landscapes with near real-time data to better understand the opportunities and trade-offs of increased agricultural production. The system will provide tools to ensure that agricultural development does not degrade natural systems and the services they provide, especially for smallholder farmers.

The three-year $10 million dollar grant was announced by the co-chair of the foundation, Bill Gates in Rome at the 35th Session of the Governing Council of the International Fund for Agricultural Development (IFAD) held in February. The grant lays the foundation for a new integrated monitoring system in five regions of Sub-Saharan Africa, including Tanzania, Ghana, Ethiopia, and two other countries to be determined, where agricultural intensification is targeted to meet the needs of Africa’s growing population.

Dr. Sandy Andelman, a vice president of Conservation International who will serve as Africa Monitoring System executive director said, “We face this enormous challenge that boils down to this key question: How are we going to feed nine billion people on the planet without destroying nature, especially in the face of climate change which in itself brings vast uncertainty. The answer is that we can no longer afford to make decisions without really seeing the full picture of what is happening to the planet.”

The Africa Monitoring System (AMS)

The success of the system will depend on the accuracy and timeliness of the data collection process which will happen at multiple scales to create the most accurate possible picture. This will include

  • A household scale, using surveys on health, nutritional status, household income and assets;
  • A plot scale to assess agricultural production and determine what seeds go into the land, where they come from, what kind of fertilizer is used, what yield of crops they deliver, what happens after the harvest;
  • A landscape scale (100 km2) measuring water availability for household and agricultural use, ecosystem biodiversity, soil health, carbon stocks, etc.; and
  • A regional scale (~200,000 km2) that will tie everything together into a big picture, to see the scales at which agricultural development decisions are made.

The raw data will be fully accessible and synthesized into six simple holistic indicators that communicate diagnostic information about complex agro-ecosystems, such as:  availability of clean water, the resilience of crop production to climate variability or the resilience of ecosystem services and livelihoods to changes in the agricultural system. The near real-time and multi-scale data will be pooled into an open-access online dashboard that policy makers will be able to freely use and customize to inform smart decision making.

“Rather than having a set of data over here for one issue, and other sets of data over there for other issues, what this system will essentially do is assemble the different puzzle pieces into one clear image that will allow decision makers to transparently see the parts and their sum in one centralized location”, Andelman explained.

CI Chairman and CEO Peter Seligmann praised the grant as a landmark moment in conservation which would inspire others.  “We are honored to be entrusted by the foundation to shepherd their largest investment to date in examining the relationship between agriculture and the environment, and I could not be more encouraged or appreciative for their leadership, concluded Seligmann.”

CI, CSIR and Earth Institute will collaborate with governments, other non-governmental organizations, the academic community, the private sector and key international partners over the next three years to design and implement the Africa Monitoring System. This period will represent Phase 1 (three years) of a three-phase process (10-15 years) to create an Integrated Global Monitoring System for Agriculture, Ecosystem Services and Human Well-Being, and developers expect to mobilize additional resources to leverage the Foundation’s investment.

Image from ypia.org.za

Many in the aid and ICT4E community know NEPAD — the New Partnership for African Development (NEPAD) — and probably remember the launch of the e-School Initative, first announced during the Africa Summit of the World Economic Forum in June 2003.  As part of the overarching objective of the NEPAD program to enhance Africa’s growth, development and participation in the global economy, the e-School component involves a complex implementation strategy involving a multi-country, multi-stakeholder, and multi-stage approach to introduce ICT use and support to 600,000 schools across Africa.  But now, close to ten years after the initiative was first introduced, what progress has it made?

That’s what participants and leaders of the NEPAD e-School Initiative discussed when they gathered in Accra, Ghana earlier this week for the two-day NEPAD e-School Regional ECOWAS Conference.  Reverend Emmanuel Dadebo, Head of the Teacher Education Division of Ghana Education Service, led the discussion and press event, emphasizing the project’s need for a business plan that promotes private sector investment by introducing a new Private Public Partnership (PPP) model.

The conference comes after five years of discussion and debate concerning the key findings made during the initial phase of the e-School Initiative — the “NEPAD e-Schools Demo”. The purpose of the Demo was to accrue a body of knowledge, based on real-life experiences of implementing ICT in schools across the African continent, in order to inform the rollout of the NEPAD e-Schools Initiative. The program was implemented in six schools in each of 16 countries across Africa through partnerships that involved private sector consortia, the country government and the NEPAD e-Africa Commission (eAC), which is responsible for the development and implementation of the NEPAD ICT program.

Photo Credit: computersforcharities.co.uk

Though various stakeholders and members of the aid community consider the Demo successful in some ways, like introducing ICT hubs into rural communities, most agree that it remains unsustainable in its current form.  A report released by infoDev and the Commonwealth of Learning (COL) back in 2007 entitiled “The NEPAD e-Schools Demonstration Project: A Work in Progress”, highlights the realization of this challenge within the early stages of the Demo and stressed the need for dialogue between all stakeholders:

“The expectations that implementation of the Demo would occur within a few months of it being announced in the participating countries, and, that a Business Plan would be developed to address sustainability and future rollout, were not met, and explanations for the delays were not effectively communicated.  The disappointment and cynicism that resulted in some of the participating countries underlines the oft-learned rule of project management: Communicate! Communicate! Communicate!”

Like many development projects of this kind, and on such a large scale, lessons like these take time to learn and often come from trial and error.  Shafika Isaacs, the founding executive director of SchoolNet Africa and a member of the monitoring and evaluation team for the report concluded saying this:

“Never before has there really been a program that mobilised national government participation and leadership at the official continental level in the way the NEPAD e-Schools vision has.  Further, it has brought the private sector into partnerships that, while experiencing growing pains, has mobilised resources in a way that few other projects have been able to do. And there is much yet to learn about doing this in an optimal way.”

Exactly how much has been learned between 2007 and now, has yet to be seen.  Several news articles have claimed that the program has already benefited several schools in Ghana and according to a statement given in Accra at the e-Schools conference, Ghana will launch the next phase of NEPAD e-Schools later this year.  The program’s methods of monitoring and evaluating these benefits and ensuring effectiveness and transparency are unclear.  However, with more buy-in from the private sector and the introduction of a new business model, it’s clear that some progress is being made and a more sustainable future for the e-Schools Initiative could be within reach.

WaterWiki.net, a UNDP, UN-Water initiative recently relaunched and added more features such as a LinkedIn discussion forum. WaterWiki is a useful resource and popular forum for practitioners and agencies. It features over 800 articles, case studies and reports.

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