Health – Page 2 – Integra LLC

Mobile Technology Improves Health Worker Knowledge Retention: Results from a Pilot Project in Uganda

Photo Credit: Abt Associates

SMS-based messages can improve training retention for health workers, according to the results of a mobile learning and performance support pilot in Uganda released in November. The goal of USAID’s pilot project, called Mobiles for Quality Improvement (m4QI), was to test the use of mHealth applications in the reinforcement of in-person training provided to health workers.

The outcome from the pilot showed that texts messages are a viable alternative for the continued education of health workers located in rural regions. This is a low-cost option that allows workers to learn in the field and does not interrupt their service to clients. By utilizing an open source product (FrontlineSMS:Learn), the platform can be used for free and is customizable specifically to needs and challenges in new regions. As a part of USAID’s SHOPS (Strengthening Health Outcomes through the Private Sector), the next steps of m4QI project are to seek out other markets to leverage the mobile learning platform in order to further develop the software as well increase scale. The goals of future projects include improving implementation and identifying best practices.

In using the FrontlineSMS: Learn software platform, Appfrica, a software developer company based in Uganda, created a replicable program that sent messages to health workers to support and test their knowledge retention. The platform allowed for the use of basic mobile phones in order to match the phones commonly owned by the health workers. It provided supervisors data to assess which areas of knowledge were not being properly retained by workers. The project ran from September 2010 through August 2011. The intervention was provided to 34 family planning workers on the Marie Stopes Uganda (MSU) staff in six different service delivery sites. The workers’ jobs ranged from receptionists, lab technicians, service providers, doctors, drivers, housekeepers, and managers. By reviewing the behavior of the staff, four indicators were identified as areas of improvement: hand-washing, sharps disposal, instrument decontamination, and pain management techniques. Four messages were created for each indicator in which two were reinforcing, tips, reminders, or encouragement and the other two were review questions in order to test staff knowledge of past training. In order for each of the four messages to be sent twice to the participants, each worker received one message a day, four days a week, for eight weeks.

While it was initially an eight week pilot, it was expanded until August as there were multiple technical problems which caused the delivery of messages to fail. In total, 3,449 messages were sent, and there was an 86.5% success rate of receipt. In response to the assessment questions, there was a 19% response rate. Participants indicated after the pilot that they were motivated by the reminders for hand-washing rules, utilized their training manuals when they received a question about treatment protocols, were able to re-learn steps to properly sterilize instruments, and applied the information they received about pain management during patient interaction. The interviews also revealed that the messages increased the interaction between co-workers about the topics of the messages.

The pilot also provided lessons for future projects. Those include the need for technical support in the field, a greater understanding by project stakeholders to the purpose and role of the mobile application, a more organized orientation and training for participants, and pre-paid airtime for participants to increase involvement.

The SHOPS project is funded by USAID and is led by Abt Associates and includes partnerships with Banyan Global, Jhpiego, Marie Stopes International, Monitor Group, and O’Hanlon Health Consulting. The focus of the project is to use private sector health in order to improve the quality and availability of family planning and reproductive health, maternal and child health, and HIV/AIDS treatment. Within the mobile health arena, the partnership’s goal is to identify mHealth applications and their best practices in implementation and scale.

January 18, 2012/by actualize

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

‘Smart’ Use of Smartphones for Health Services: A Case of TB in Nigeria

Photo Credit: Leah Ekbladh

Using smartphones to collect tuberculosis (TB) data within the health sector of Nigeria has eliminated the use of printed forms; minimized human error in data entry; reduced the lag time of availability of data for policymakers and managers; and helped pinpoint ways to improve delivery of TB care, reported Leah Ekbladh.

Ekbladh, who is a Senior Associate at Abt Associates was giving a talk hosted by the Global Health Council on the topic “Quality TB Care: Using Smartphone Technology for Data-driven Improvements in Nigeria” as part of the Health Systems 20/20 presentation series on Tuesday January 10. Her talk focused on TB quality improvement activity in Nigeria, the Abt Associates’ approach to quality improvement (QI), the before and after picture of supportive supervision (SS) system, next steps, and lessons learned.

TB Situation in Nigeria and the Health System

According to Leah, with Nigeria ranking 10^th among the 22 high TB burden countries in the world, the country’s TB situation could be improved. Before the HS2020 and the National TB Program’s joint intervention, the TB supervision system was largely paper-based. Results of data collected from health facilities were not available immediately for feedback and quality improvement; each state had its own paper-based system with different design of the forms and different items; data were compiled quarterly at State levels; and data entry and analysis was time consuming and prone to a lot of human error.

With support through Health Systems 20/20, the USAID flagship project for strengthening health systems worldwide, the need to strengthen the Supportive Supervision (SS) system to improve performance and treatment outcomes with Nigeria’s health sector was identified. The activity by Abt Associates aimed to shift away from the long paper-based checklists that do not support timely QI at the health facilities, towards supervision that concentrates on performance of clinical tasks, resolution of problems experienced by the health workers, and increased feedback from supervisors.

Photo Credit: Leah Ekbladh

The Activity: The Role of Information and Communication Tools

The project believes that when the new information and communication technologies (ICTs) are smartly and strategically integrated into existing development processes, they can help streamline, transform and improve services. And with the strong in-country leadership support from Nigeria to explore new and innovative ways of improving quality through SS system, the activity took off smoothly with a pilot in 4 local government areas (LGA) in 4 states.

Tools Used: Beginning with what was available at the time, and also based on the usability of the features, Personal Digital Assistants (PDAs) were used in combination with Pendragon software to help in creating forms, connecting the forms to the users, distributing the forms, and uploading the forms to a database. After a year of piloting, it was realized that the market for the PALM PDAs was declining with the increasing use of smartphones in Nigeria. Also, EpiSurveyor software from Datadyne was recommended due to its ease of use and its ability to calculate and populate the forms for data collection.

Outputs

Rapid Results Indicators (RRI): RRI form was created with the most critical items that sum up the key elements that are needed for quality data collection, analysis, use and QI for supervision. This was done through repeated iteration resulting in a consolidated checklist that streamlines and integrates the numerous checklist that exists on the paper-based system. The checklist (RRI) loaded into the smartphones, are programmed to do automatic calculations of critical indicators by reducing human error.

Training and Capacity Building: Thirty (30) out of 50 supervisors have been trained on the use of the smartphone technologies and data managers are also trained on the use and improvement of the database. (It should be noted that these people are the existing public servants of the ministry of health in Nigeria). Six rounds of data collection have been done with one using smartphones and five with PDAs.

Database: Through the system, a web-based database to house the data collected and to more easily aggregate and report information to the national level has been developed and launched. The database provides online data aggregation for analysis and dissemination, and quality control system of the data including online government approval data being published and used.

When data is uploaded, supervisors gets notified or alerted for review either on their phone through SMS or email. Updates are communicated back to the officer for review and publication.

Impact of the Activity

With the pilot activity, supervisors have reported the ease of use of the tool in data collection as well as for review and editing of submitted data. Some reported a reduction of working hours from 3 hours with paper-based system to 30-45minutes with the smartphone technology. Supervisors have indicated that the system is enabling them to monitor and assess performance of the TB health delivery system, identify problems and opportunities, and many cases take immediate action for improvement. For example, the rate of drug stock-outs has significantly decreased, and external quality control is easily obtained for quality service with far less delay.

Photo Credit: Leah Ekbadh

Lessons Learned and Steps Forward

It was discovered that careful selection of technologies (information communication technologies) for international development activities is key for success; suitable technologies in combination with human resources (socio-technical) is critical; and steps must be taken to roll-out projects incrementally and then plan for scale-up.

In terms of scaling, a total coverage of Lagos and Abia is expected soon with the training of additional 50 supervisors and full integration of the database on schedule. The project also expects to leverage other funding sources to expand further and also involve the private sector in Nigeria.

Visit Abt Associates international health programs for more information on their activities and the Health Systems 20/20 presentation series site for information on the upcoming events and also access the audio recording of the talk.

January 17, 2012/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

Don’t Miss Raj Shah on 20/20 Tonight!

BY: Raj Shah, U.S. Agency for International Development (USAID) Administrator

This Post originally appeared on ABCNews.

Raj Shah holds up his hads, with the words 1 million moms written on his palms Ensuring the safety of a mother and her newborn is not only one of the greatest development challenges we face, it is also one of the most heartbreaking.

Earlier this year, I visited South Sudan, where I met school children studying in a classroom—some of them for the very first time. Although I was optimistic about their future, I was also concerned, because I knew that for every girl I met, she was statistically more likely to die in childbirth than complete a secondary education.

This reality is simply unacceptable.

There is an incredible need to ensure the safety of mothers and infants in the critical period of 48 hours surrounding birth. To help spur progress in maternal and child health, we launched our first Grand Challenge for Development – Saving Lives at Birth – in partnership with the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada and The World Bank.

Saving Lives at Birth calls for groundbreaking prevention and treatment approaches for pregnant women and newborns in rural settings during this perilous time around childbirth. We received more than 600 proposals to our Grand Challenge, more than a quarter of which arrived from the developing world. Last week we announced our three transition-to-scale grant nominees. These nominees have proven that their ideas can deliver real results in local communities and are ready to test them on a much larger scale. While we expect our first round of grants to yield exciting innovations with the potential for significant change, we will encourage our community of innovators to push boundaries and find new ways to shape collective action.

Similarly, the Million Moms Challenge is inspiring American families to help mothers and children around the world. I am proud to accept this Challenge and will continue my commitment to this important cause.

I hope you will too.

December 16, 2011/by actualize

Education, Family Planning, Health, HIV/AIDS, Originally posted on the GBI Portal, Youth Development

Computer-based Sex Education Program Proves Effective in HIV Prevention

A recently released paper looking at systematic approaches to program adaptation of evidence-based health promotion programs focused on the computer-based sexuality education program, The World Starts With Me (WSWM), for a case study.

WSWM, introduced in 2003 by the World Population Foundation, was developed for a priority population in Uganda and adapted for use in Indonesia this year. The program’s target population includes both school-going young people and early school leavers, generally ages 12-19, and is complemented with teacher-led activities. It utilizes a comprehensive approach that includes building IT-skills and creative expression, aiming to contribute to sexual and reproductive health as well as social and economic development.

Student using The World Starts With Me program

Photo Credit: The World Starts With Me

The program provides introductory computer skills lessons as well as 14 lessons on adolescent development, decision making and sexual and reproductive health and rights. The lessons employ effective sex education methods, including practical applications to increase knowledge, develop attitudes, and help youth recognize and cope with social influences.

The paper’s authors, all public health professionals and academics, chose WSWM as their case study because of its proven success. In 2004, the program received the Golden Nica Award by Prix Ars Electronica in the digital communities category, and UNESCO used WSWM’s digital curriculum as a guideline for implementing effective sexuality education.

A meta-analysis revealed that computer technology-based programs like WSWM have similar results to traditional human-delivered interventions in terms of HIV/AIDS prevention behavior adoption. In particular, they proved to have positive results in increased condom use and reduced sexual activity, numbers of sex partners and sexually transmitted infections (STIs). Computer-based assignments also allow programs like WSWM to be student-driven, which means teachers are less burdened to talk about sensitive sexuality issues which may be uncomfortable for students. According to the meta-analysis, given computer-based programs’ “low cost to deliver, ability to customize intervention content, and flexible dissemination channels, they hold much promise for the future of HIV prevention.”

http://www.theworldstarts.org/

This research paper reveals that ICT-based HIV-prevention programs like WSWM can be effectively adapted in other contexts, which could lead to widespread reduction in HIV rates among young people.

December 1, 2011/by actualize

Health, Humanitarian Assistance, Originally posted on the GBI Portal

Using ICTs to Address HIV/AIDS in Humanitarian Emergencies

Responding to humanitarian emergencies poses a complex set of challenges that is exacerbated in areas where high rates of HIV/AIDS exist. The number of people living with HIV/AIDS hovers around 33 million and the vast majority live in sub-Saharan Africa, bringing to the forefront the complex interactions between HIV/AIDS, food security, livelihoods, and humanitarian action. This unique set of issues leads to the question of whether ICTs can be leveraged to address HIV/AIDS challenges in humanitarian crises, and if so, which groups are already doing so.

ICTs have been a used as a means for addressing HIV/AIDS issues in humanitarian situations by global aid agencies. The United Nations (UN) has recognized the impacts on HIV/AIDS on food security and is responding by integrating HIV into humanitarian responses. A priority for the UN Office for the Coordination of Humanitarian Affairs (OCHA) has been to “ensure a sustained flow of information and analysis on AIDS and [HIV] needs of populations in humanitarian situations” by producing reports, web specials, audio reports, fact files, etc. on the Integrated Regional Information Networks (IRIN) website. For example, IRIN radio produced a weekly 10-episode radio drama on HIV and AIDS for Somalis to listen to in the crisis country. The drama started on October 15^th and can be heard on the IRIN website.

FilmAid screening film at Kenyan refugee camp

Photo credit: FilmAid

Nongovernmental organizations are also using ICTs to address HIV/AIDS in humanitarian situations. FilmAid provides knowledge and empowerment to people suffering the effects of war, poverty, displacement or disaster through informational films. The organization works with communities to create films that are appropriate to the local context and relevant to community issues. One of the issue areas that FilmAid focuses on is Health & Safety, including HIV/AIDS. The organization has created various films relating to HIV/AIDS issues, such as a series of PEPFAR films that were shown in a Dadaab refugee camp in Kenya. The PEPFAR films were developed with the communities in Dadaab and promoted the prevention of mother-to-child HIV transmission, the uptake of voluntary counseling and testing (VCT), and abstinence.

The human rights organization WITNESS has created a video that tells the story of people living with HIV/AIDS in the war-torn Eastern region of the DRC, shown below. The film advocates for the provision of free testing, increased access to medical care, and prevention outreach in an area that desperately needs it.

These cases show that ICTs can be leveraged to address HIV/AIDS issues in humanitarian emergencies on many different levels, such as information flow, education, and advocacy. There is vast potential for increased ICT to more effectively and quickly address HIV/AIDS issues in humanitarian crises.

December 1, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Originally posted on the GBI Portal

CrowdOutAIDS: Engaging Youth to Develop AIDS Policy

CrowdOutAIDS, the online crowdsourcing project that engages young people in developing a UNAIDS strategy on youth and HIV, has wrapped up its fifth week. The project launched in October 2011 and will run for two months, with the final crowdsourced strategy to be produced in January.

Crowdsourcing is a technique used to quickly engage large numbers of people to generate ideas and solve complex problems. CrowdOutAIDS’ target “crowd” is young people, 3,000 of whom become infected with HIV every day and 5 million of whom currently live with the virus.

The project’s approach is to follow a four-step model:

Connect young people online
Share knowledge and prioritize issues
Find solutions
Develop collective actions on HIV

Once the fourth step is completed, the UNAIDS Secretariat will put the youth strategy into action, and the strategy could become an advocacy platform in future UNAIDS work.

Currently the project is in the second stage of sharing knowledge. Youth from all over the world have been connected through eight regional Open Forums that are in Arabic, English, Spanish, French, Russian and Chinese. The moderator of each forum starts each day with a question (such as “What is your description of a healthy relationship?”) and participants respond and interact with one another.

The first week of the project revealed some of the major problems, in the eyes of youth participants, with UN agencies’ current approaches to working with youth. Participants expressed concerns that UN initiatives of working with youth in HIV response lack strategic vision and have no clear plan, and hinder young people from participating in decision-making.

It will be interesting to see what solutions are developed after the knowledge sharing step is completed, as well as what direction the UN youth and HIV strategy takes over the next six weeks. Be sure to check out the CrowdOutAIDS website and Twitter @CrowdOutAIDS for continuous updates.

November 28, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Originally posted on the GBI Portal

Monitoring and Evaluation in mHealth: Opportunities and Challenges

Last week’s mHealth working group meeting laid out the opportunities, challenges, and potential of monitoring and evaluation (M&E) within the mHealth sector.

JhPiego circumcision promotion through texting service

Poster in Swahili promoting male circumcision through SMS service, part of Jhpiego program

Several experts in the field presented their experiences of monitoring and evaluating mHealth projects, emphasizing the considerable potential that mobile projects offer in generating robust and accurate data. Kelly L’Engle, a behavior scientist at FHI 360, discussed the need for M&E in order to gauge the impact of mHealth. She claimed that mHealth technology is not being fully leveraged and that the current mHealth research “doesn’t provide evidence on actual impacts…or answers to critical research questions…”

James BonTempo from Jhpiego presented on evaluating behavior change evidence from a text message project that promotes male circumcision (MC) for HIV prevention in Tanzania. He referred to this evidence extraction as “mining the data exhaust” – that is, the data generated as a byproduct of ICTs, the “trail of clicks” that ICT users leave behind.

The MC program offered a toll-free text-messaging/SMS service. With the service, individuals could request to receive information on the benefits of MC (using key word: TOHARA), where to find MC services (WAPI), as well as receive follow-up care information after undergoing the circumcision (BAADA). While the SMS platform was intended to capture requests to the three keywords and generate access logs for system performance monitoring, Jhpiego has analyzed this data in order to see if there was a relationship between requests for the MC data and actual utilization of MC services.

Jhpiego male circumcision project in Tanzania- behavior change evaluation

Potential link to behavior change in Jhpiego male circumcision project

The data set included 12,056 keyword requests sent by 4,954 users. After performing a Chi Square analysis on the data, the project team found that requests for information on the benefits of MC (TOHARA) was not strongly associated with going to receive the circumcision. However, it was found that those who requested where to find the data (WAPI) did have a statistically significant association with undergoing the circumcision. These results are consistent with pathway models of behavior change, indicating that those who simply wanted to know more about MC were not quite prepared to undergo the procedure, but those looking for service availability were ready to use the services.

The associations found in this particular project imply that providing text or voice messages that tell people where to get a particular service could be more effective in encouraging clients to utilize that service. M&E that finds results such as these could help project leaders design SMS services that generate more useful data.

Like most forms of M&E, there are limitations on findings that use mobile data. There is a lot of information that mobile devices do not provide, such as which phones belong to whom and who actually sends the text messages; this makes it difficult to link messages to specific individuals. In the MC case, data analysts found an association, but did not necessarily know the nature of the association. It can also be challenging to find the time or manpower to rake through the massive amount of data that is produced by mobile devices.

While M&E in mHealth has its limitations, it is difficult to find data that can be collected and analyzed as quickly, cheaply, or easily using other means. Paper, radio, and television simply do not offer the same kind of easily-mined data exhaust that mobile does.

October 25, 2011/by actualize

Agriculture, Health, Health, Health Systems, Originally posted on the GBI Portal

Will Nigeria Turn to mHealth to Achieve its Healthcare Goals?

Nigeria may be joining a number of African countries in prioritizing mHealth as a way to improve the country’s troubled healthcare system. At a recent mobile Health workshop in Nigeria that was put together by the African telecommunications company MTN, stakeholders voted for the nation to adopt a mobile healthcare system.

Omobola Johnson, Nigeria's Minister of Technology and Communications

According to some, Nigeria is among the countries leading the way in using mobile health services. Several mobile companies operate there, with MTN serving the largest population percentage followed by Globacom, Zain and Etisalat. The Nigerian Communications Commission estimates that around 105 million of the country’s 155 million people were subscribed to a mobile service provider in August 2011.

Nigeria faces many challenges in expanding its healthcare system, such as a lack of infrastructure, a shortage of trained healthcare professionals, high illiteracy rates and unreliable power sources. The nation’s government has made some efforts to address these challenges in order to meet the Millennium Development Goals. The National Primary Healthcare Development Agency operates under the Health Ministry to promote and support the development of a high quality primary healthcare system.

Photo credit: eHealth Nigeria

But is the Nigerian government prioritizing mHealth as a means to improve healthcare delivery? Omobola Johnson, Nigeria’s recently appointed Technology and Communications Minister, has been pushing toward nationwide mobile coverage as well as the implementation of emergency call centers and phone lines. However, when Johnson revealed the Ministry’s mandate at the end of August, the use of mobile devices for improved healthcare was not mentioned specifically.

Many individuals, private companies, civil society organizations, and aid agencies feel that Nigeria should embrace mHealth as a mechanism for repositioning the country’s healthcare system. Through fuller adoption of mHealth into the healthcare delivery system, many more people could be reached. But the government will need to place mHealth at the top of the agenda and support mHealth initiatives should the emerging field succeed in improving Nigeria’s healthcare.

October 19, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

How to Disseminate Maternal Health Information to Rural Women

There are numerous ICT projects that focus on maternal health, many designed to reach women in rural areas where there is a severe lack of healthcare services. Mhealth in particular – the use of mobile phones to improve health – has taken off as a tool for providing critical information to pregnant and new mothers. In USAID’s MAMA project, for example, pregnant women in Bangladesh receive weekly information updates via text or voice message.

Photo credit: Open Ideo

But what is the best method for disseminating health information to rural women? How can the women learn and interpret the information in a way in which they can understand its value, making certain behavior changes if needed? Vikram Parmar, a professor at the Delft University of Technology in the Netherlands, attempted to find this out through research conducted in India with 120 women from seven different rural villages. Parmar wanted to know how to motivate users of a Primary Health Information System (PHIS) to adopt positive health practices through designing and developing a Health Information System that maximized information dissemination.

Parmar wanted to explore how to improve information dissemination where health ICT projects had fallen short in three areas. First, he was concerned with the limited impact of Health Information Systems in educating rural users, as well as ICT-based health interventions such as film showings and radio program broadcasts that had not improved the health practices of rural target audiences. Secondly, the typical content and design of Health Information Systems did not encourage regular use due to the “non-persuasive setting of health interventions,” resulting in an information gap between rural women and primary health information. Finally, HIS deployed to rural users were based on content developed for urban users, resulting in a mismatch between the information given to rural women and the information they actually needed. In particular, maternal health and other personal women’s health issues had not been addressed.

Parmar proposed addressing these problems by employing a user-centered design framework to develop ICT interventions (see framework in full below). He tested this framework in the context of the PHIS. The results of his exploratory research indicated that the rural women’s knowledge had improved after interacting with the PHIS, signifying the importance of understanding user needs, taking into account existing social beliefs and practices related to health issues. Using this framework could improve information dissemination, resulting in positive change in rural women’s health-related practices.

October 14, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

Marketing “Mobile Midwife” in Ghana

Can information delivered on a mobile phone affect the outcome of a pregnancy in a developing country? Can communities and healthcare workers use mobile phones to save the lives of newborns? These are some of the questions that the Mobile Technology for Community Health (MOTECH) program in Ghana is trying to address. Grameen Foundation is working with Ghana Health Service and Columbia University in one of the poorest rural districts of Ghana to try to improve the health outcomes for mothers and their newborns using mobile phones. But once a service has been created, how do you generate awareness for it and ensure there is adequate participation?

In July 2010, we launched a service called “Mobile Midwife,” which enablespregnant women and their families to receive SMS or pre-recorded voice messages on personal mobile phones. The messages are tied to the estimated due-date for the woman so the information is time-specific and delivered weekly in their own language. Nurses also use mobile phones to record when a pregnant woman has received prenatal care. If critical care is missed, both the mother and the nurse receive a reminder message on their mobile phones. To date, over 7,000 pregnant women and children under five have been registered in the system. More detail about the program can be found online in our “Lessons Learned in Ghana” report.

One of the challenges we faced in the development of this system was how to generate awareness for the “Mobile Midwife” service in the first place. Unless people register for the service, they cannot receive the important information we are able to provide about pregnancy. As we talked to people in the rural villages where “Mobile Midwife” would be available, it quickly became clear that communities in Ghana, and particularly the Upper East Region, had been inundated with cartoon-like health message campaigns from myriad NGOs and government agencies. People told us that if campaigns were seen as “too slick,” people would not think the messages were relevant to them. The MOTECH team decided to pursue an approach that sought to provide “aspirational” images that were differentiated from the typical “NGO cartoon” campaign, but still were relevant to the UER population. This included using real photographs instead of drawings, and ensuring that the people in the photographs were wearing clothes in the style of those worn in the rural areas where we worked. Part of the aspirational message was dressing the models in new, clean clothing, which proved to be effective. When field testing the marketing styles, many people said they “liked the lady in the pictures and it made them feel good as one day they would like to be dressed well too.” The team also decided to create some messaging that was targeted specifically to men, in an effort to respect their roles as decision makers in the family, get them to listen to the messages with their partners, and be a part of making positive health choices throughout pregnancy, birth and early childhood. As the program evolves, we expect to experiment with broader reach marketing vehicles such as radio and community mobilization.

Initiative:

Maternal Newborn mHealth

Order:

October 5, 2011/by actualize

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