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

Recent report highlights challenges in mHealth

Africa’s first mHealth summit was held in June, in Cape Town, South Africa. As a result, the World Health Organization (WHO) produced a report entitled ‘mHealth: New horizons for health through mobile technologies’, which looked at the state of mHealth projects from 112 WHO member countries in 2009.

Photo Credit: mhealthsummit.org

According to the report, currently over 85% of the world’s population is now covered by a commercial wireless signal. Furthermore, 5 billion people own cell phones, and 3.5 billion of them are in middle to low income countries, setting the platform for increase in opportunity for mHealth growth.

The majority of member countries (83%) reported offering at least one type of mHealth service. However, many countries offered four to six programs. The report also cited the four most frequently reported mHealth initiatives as health call centers (59%), emergency toll-free telephone services (55%), managing emergencies and disasters (54%), and mobile telemedicine (49%).

Although mHealth success was lauded by officials, there was no shortage of criticisms and concerns for the future. “Although the level of mHealth activity is growing in countries, evaluation of those activities by Member States is very low (12%). Evaluation will need to be incorporated into the project management life-cycle to ensure better quality results.” said the report.

The lack of evidence prevents policymakers from supporting mHealth infrastructure and as a result funding often goes elsewhere. “In order to be considered among other priorities, mHealth programs require evaluation. This is the foundation from which mHealth (and eHealth) can be measured: solid evidence on which policy-makers, administrators, and other actors can base their decisions,” claimed the report.

mHealth report

Competing health priorities was claimed as the greatest barrier to mHealth adoption by WHO member countries. The report also points out that mHealth services are not yet integrated and are mostly small scale projects targeted for specific communities. Going forward, mHealth will need to “adopt globally accepted standards and interoperable technologies” in order to facilitate effective growth in scaling up mHealth initiatives.

The report says, “Moving towards a more strategic approach to planning, development, and evaluation of mHealth activities will greatly enhance the impact of mHealth. Increased guidance and information are needed to help align mHealth with broader health priorities in countries and integrate mHealth into overall efforts to strengthen health systems.”

In an era where mobile communication is paramount, the services of mHealth may prove to be vital in the development of many low income countries. The report did itself justice by celebrating the successes of mHealth, and then laying down the hurdles to be cleared for sustainable growth. The next mHealth summit is in December in Washington DC.

July 13, 2011/by actualize

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

SMS campaign in India to reach 5.5 million people

Blood bags. Photo Credit: anemia.org

HLL Lifecare Ltd, one of the largest blood bag manufacturers in India, launched a massive SMS blood donation campaign last month, targeting to reach over 5.5 million customers belonging to the top telecommunications company, BSNL.

The campaign, launched by state Health Minister Adoor Prakash on Blood Donation Day last month in Kerala, a southern state in India, wanted to highlight the virtue of blood donation as a civil responsibility for those who are able in order to help those in need.

Prakash also created a help desk called ‘Heart Beats’ designed to assist prospective blood donors. This was funded by the Hindustan Latex Family Planning Promotion Trust (HLFPPT), an organization affiliated with HLL Lifecare, in association with the Kerala State AIDS Control Society.

The purpose of the help desk is to funnel the donors to the patients. Individuals who want to donate blood voluntarily can register their details, including name, place, blood group and phone number either at the help desk or to the help desk via SMS. They are intended to be set up at local health care centers and can also assist patients during emergencies.

India has harbored SMS blood donation programs in the past. Indianblooddonors.com is a website that serves as a database listing for thousands of blood donors from over hundreds of Indian cities. It was launched in 2000 with the SMS component implemented a few years later.

It works in the opposite way of HLL Lifecare’s system. A person in need of blood sends out a text message to a special number, mentioning, in a particular format, his name, city and the blood group required. Within a few seconds, he gets a return SMS with the name and number of a donor in that city.

Photo Credit: HLL Lifecare

Despite having the capability of saving lives, this was a little known service in India. However HLL Lifecare’s current campaign seems to be aiming for much more publicity and awareness on blood donating.

India frequently engages with shortages of blood supply. India usually faces deficits of up to millions of units of blood per year.

Furthermore, isolated populations usually have difficulties reaching out to blood donors and suppliers and often don’t get the blood they desperately need. India’s telecommunications industry is the fastest growing in the world. Nearly 75% of the population, about 900 million people, has mobile phones. Hopefully, this SMS campaign will bring light to the issue of blood donations and help curb the burden by taking advantage of mobile phone prevalence and growth in the country.

July 12, 2011/by actualize

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

HIV/AIDS: A window of opportunity for South Sudan

Photo Credit: antiimperialism.com

As South Sudan prepares for independence, the celebrations will be tempered by the grim reality that awaits them. The nation is plagued by numerous health burdens due to decades of civil war resulting in a lack of trained health workers and poor infrastructure, and inadequate health and education systems. One such burden is HIV/AIDS. Dr. Wichgoah Piny, the state’s HIV/AIDS commissioner said that about 116,000 people are known to be infected by the virus in South Sudan, 46,000 of which are being treated at hospitals within the region. This number lies in the middle ground when looking at the rest of Africa. East Africa generally has a higher prevalence whereas West Africa exhibits a lower prevalence of the disease. Some estimates say up to 4.7 million in South Sudan are at risk of acquiring the disease.

But those numbers could grow exponentially in the coming years. The World Health Organization (WHO) has described HIV/AIDS prevalence in South Sudan as “a ticking time bomb” and a threat which needs a cooperative and collective effort to fight in the new nation. Dr. Olivia Lomoro, the GoSS Undersecretary in the Ministry of Health who spoke at a South Sudan AIDS conference warned, “HIV/AIDS is a real issue in Southern Sudan despite the efforts we have put to fight it. It remains a threat and a time bomb we are expecting.”

UNAIDS officials in South Sudan

Dr. Mohamed Abdi, the WHO Director in South Sudan said that, “AIDS is a big problem in South Sudan and we need to fight it together.” He said that in more than two years he had worked in the region, very few people were getting treatment.

The consequences of a surge in HIV/AIDS could be catastrophic. The health infrastructure is already poor as it stands. An HIV/AIDS epidemic would paralyze the health sector for years and impair growth in other sectors. This could result in a crisis that no new government would be prepared to handle.

So in a sense, this is a defining moment for the future of health in South Sudan. As the new government establishes itself and its policies, it has the opportunity to be forward looking in the development of its health infrastructure. If HIV/AIDS is afforded a chance to “blow up” as WHO fears, the country will immediately be sunk further into a health crisis.

This presents an opportunistic entry point for the implementation of ICTs into the health sector in South Sudan.

Opportunities

A survey completed in 2006 by WHO revealed that over 910 health facilities existed in South Sudan. At the time, a majority of those facilities were claimed to be in a “deplorable state”. However, Dr. Lomoro recently pledged that Lakes state now has a new hospital which is going to be used as a teaching hospital to help in delivering quality health. She also mentioned investments through the Chinese government will be used to build new health centers and rehabilitate old ones. Incorporating ICTs in the rehabilitation process will pay dividends for the health sector in the future.

South Sudan is being held captive by a number of health issues such as measles, yellow fever and tuberculosis to name a few. Furthermore, South Sudan has up to 80% illiteracy rates in some parts, which make communicating through ICTs invaluable. The most basic forms of ICTs like radio, television and mobile phones can build a communication bridge for the illiterate to keep them connected and informed.

Dr. Lomoro also pointed out that the first target for the Ministry of Health in the Government of South Sudan is the training of health personnel in all the ten states of South Sudan in order to deliver quality health services to the population in a professional standard. One way to go about this would be to include ICT training in that workforce development. Taking this route would build workforce capacity and bolster the development of ICTs in the country.

The population returning from Sudan proper and surrounding African countries are also coming back with health work force skills. So there is a hope that as people return, their skills will be used in improving service delivery.

Several factors exist that support the idea of integrating ICT into the health infrastructure of South Sudan

Present ICT Usage

The market for ICTs is ripe and growing in South Sudan. The initiatives that would make a big impact in fighting HIV/AIDS using ICTs utilize mobile phones and radios as the media for communication. These media platforms are the largest in South Sudan.

Photo Credit: biztechafrica.com

A 2007 survey entitled “Media Access and Use in Southern Sudan,” showed that radio was the main source of information for the population as a whole with 59% of respondents citing the radio as a source of information, the highest out of all forms of media. Additionally, HIV/AIDS awareness radio programs make up 17% of the most popular radio programs. This indicates that HIV/AIDS discussions already have a base in South Sudan media.

Mobile phones on the other hand don’t enjoy such high rates of usage as radio due to 30% coverage rates. However, the mobile phone network has expanded considerably since 2005 and is predicted to keep expanding in the near future. Also noteworthy is that only 14% of South Sudanese get their information from newspapers and 13% from television according to a report. It’s clear that radio and mobile phones are the most widely used avenues of communication in South Sudan.

Plans to expand broadband cables

As recently reported, South Sudan is on the shortlist to receive fiber optic broadband cables. Broadband services make it possible to interconnect affiliated healthcare facilities around the country so that they can utilize and share scarce human and technical equipment resources to deliver quality and affordable healthcare services. These cables can establish a foundation for ICTs not just in health, but for all sectors in South Sudan.

Past Successful HIV/AIDS Programs

South Sudan won’t be the guinea pig for using ICTs for HIV/AIDS either. There have been quite a few successful HIV/AIDS programs in the past that succeeded in similar environments:

Targeting Nomadic Populations – USAID and other external NGO’s worked together in Nepal in 2005 to introduce a radio program on HIV/AIDS awareness by integrating entertainment into its programming

Capitalizing on existing media penetration:

o Radio – Tanzania also introduced the Tunajali HIV/AIDS Care and Treatment Radio Program in 2010 with the help of PEPFAR.

o Mobile – Two mobile phone programs, Text to Change(TTC) and Freedom HIV/AIDS used mobile phones to reach thousands of people to educate them on HIV/AIDS

Photo Credit: freedom HIV/AIDS

South Sudan should approach some of the major NGO’s on the ground to help implement these initiatives that use ICTs. Organizations like USAID, WHO, UNICEF and the UN have spearheaded many initiatives like the ones described above in the developing world. They should at the very least try to do the same in South Sudan. They need to realize the opportunity at hand.

Possible ICT Policy

So the framework to set South Sudan off on the right foot is present just as they kick off their sovereignty. However, an HIV/AIDS epidemic is a threat. The markets for intervention exist, proven initiatives exist and they can be adopted using the aforementioned plans to establish new broadband cables. All of the stars have aligned. The tricky part is getting officials to the table and churning out an action plan. This will involve NGO officials talking with South Sudanese Government officials and making this opportunity a priority.

South Sudan has already seen its darkest days. They want to move now from being a hub for relief efforts to a hub for development. The health sector can benefit tremendously from using ICTs to prevent an HIV/AIDS disaster. Once HIV/AIDS is under control, the ICTs can be utilized strategically to tackle other health issues, as they are being done all over Africa and the developing world. If not, it may not be long before South Sudan encounters its darkest days once again.

July 8, 2011/by actualize

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

Drug traders paying pharmaceuticals for counterfeit drug detection?

U.S. based social enterprise Sproxil announced the start of its counterfeit drug detection program in India two weeks ago. This comes after the company announced it would receive a $1.8 million financial backing from Acumen Fund to expand its operations to India back in March 2011.

Sproxil is well known for its Mobile Product Authentication (MPA) architecture which fights the distribution of counterfeit drugs in developing nations. The MPA system takes advantage of the mobile phone market which is widely accessible in Africa. MPA uses scratch off cards that come with purchased drugs. These scratch off cards display a unique identifier which is texted to the pharmaceutical supplier to verify the authenticity of the drugs.

Photo Credit: Sproxil

When drugs depart the factory they are manufactured at, the scratch off card with the unique identifier accompanies every package manufactured ensuring authenticity from the source. When the drug is purchased, customers can scratch the card and text the identifier to a number provided by Sproxil from any cell phone and receive verification within seconds on the authenticity of the drugs. Sproxil says the texts are free of charge to the consumer.

Sproxil has affected the lives of many uninformed consumers before going into India. They established the first national mobile-based anti-counterfeit program in Africa and has already sold millions of anti-counterfeit labels which provide services to several global pharmaceutical companies, the company says. Drug suppliers in Africa that have lost potential revenue claimed to have covered for their losses and even experienced growth after using MPA.

Sproxil moves to a market in India that is suffering from counterfeit drug trade. “India has one of the largest pharmaceutical markets in the world, but is plagued by counterfeit (spurious) medicines made elsewhere that tarnish brand India,” said Ashifi Gogo, CEO of Sproxil. Gogo cites the recent success of a pilot program in Nigeria as the basis to expand to India. Sproxil’s Mobile Product Authentication technology has touched the lives of over 80,000 people, helping patients avoid getting ripped off by counterfeiters,” said Gogo.

Photo Crdit: SRxA

The world of counterfeit drug trade is a devastating one. According to the World Health Organization (WHO), up to 30% of drugs sold in developing nations are counterfeit with the counterfeit drug market estimated at $200 billion by the World Customs Organization (WCO). The number of deaths and drug resistance levels continue to rise due to consumption of fake drugs, which is creating a healthcare nightmare.

The MPA system is a cost effective and relatively simple way to track fake drugs for both consumers and (authentic)drug suppliers. To allay the costs of his service, Gogo thinks his system gets drug counterfeiters to pay for MPA services. “Consumers are not paying, government is not paying as well. Pharmaceuticals are paying Sproxil to recoup shares lost to counterfeiters. So in some sense, the counterfeiters are paying for this service.”

In any case, Sproxil seems poised to make a dent in India’s counterfeit drug trade, and it is much needed.

July 7, 2011/by actualize

Agriculture, Family Planning, Health, Health, Health Systems, Infectious Diseases, Maternal & Child Health, Mobile, Nutrition, Originally posted on the GBI Portal

New mHealth service gives Iraq options for monitoring health

Iraq’s largest private telecommunications company, Asiacell, announced this week the launch of its mobile health content download and SMS service which is now available to its prepaid and postpaid subscribers. Asiacell is the only mobile telecom company providing coverage for all of Iraq.

An Iraqi man holds a cell phone. Photo Credit: Mario Tama, Getty Images

The new service offers information on various health practices which can be discriminately selected by the user. Asiacell offers a weekly and a daily health update service. The daily health updates include information on women’s health, men’s health, children’s health, dieting, mental health, and diabetes. Albeit a little more limited, the weekly updates is a downloadable service which only cover topics such as sports and fitness, mental health, and emergency medicine.

Customers can subscribe to the daily SMS service, by sending a blank SMS message to the toll-free short code “2330”, and then send their preferred health topic, which they can choose from a list that will be automatically sent via SMS, to short code “2331”. This service costs IQD 2,500 ($2.14) per month.

Subscribers can also download content on a weekly basis by sending the number “1” to short code “2332” for sports and fitness information, or to “2333” for mental health information, or to “2334” for emergency medicine information. This service costs IQD 2,000 ($1.71) per month.

A similar service operates in India called mDhil which uses SMS to send health messages on various topics. The service overcame social stigmas regarding certain topics of health such as reproductive health, and became one of the most successful mHealth programs in India. Asiacell’s new service faces identical hurdles in Iraq and hopes to prevail like mDhil did.

Photo Credit: Asiacell

Asiacell is the only telecom provider to cover all of Iraq. They provide services to nearly 8 million of the estimated 31 million living in Iraq. This is remarkable given that just 5 years ago under the reign of Saddam Hussein, less than one million Iraqis had access to land lines and the average civilian did not have access to a mobile phone. Despite that and the war which ruined telecommunication infrastructure, Iraqis now have steady access to telecom services, especially mobile phones.

It is probably due to the increased access to information that has led Iraqis to become more health conscious claims Asiacell. Dr. Mustafa Adil, an Iraqi physician, said that maintaining a healthy lifestyle has become a major concern for communities, as people are more aware of the importance of following the latest health advancements and practices. He explained that Asiacell’s Mobile Health service supports the healthcare sector’s goal to promote sound health habits.

July 6, 2011/by actualize

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

Unlimited medical consultation offered in India

A telehealth service was launched in India in early May called MeraDoctor. Created by the managing director of mHealth Venture India Pvt Ltd. Dr. Ajay Nair, MeraDoctor is the first service in India to offer unlimited medical consultations with a licensed doctor over the phone.

The service is highly convenient and highly accessible, since Indians can call the service from any part of India that has phone connectivity. It sounds like a customer service hotline, but unlike customer service systems which usually provide 24 hour coverage, MeraDoctor only operates from 8am to 10pm. However they are now advertising that 24 hour coverage will be coming soon.

Photo Credit: MeraDoctor

The MeraDoctor system is quite simple. They offer two plans, one for 300 Rs and a second for 500 Rs, for 3 months and 6 months of coverage respectively. The customer has the freedom to make unlimited consultations during hours of operation from any where in India and medical help can be offered for up to 6 family members.

Customers call the number, explain the symptoms and receive a diagnosis along with a drug prescription. The drug prescription is designed to be sent via SMS to the customer. If the condition is complex or enigmatic, the doctor sends information via SMS to the customer on the location of the nearest health facilities and the medical tests to take.

Nair says the doctors are fully licensed and are not to exit the phone conversation until the customer is completely satisfied and has all questions answered. “We encourage them to call us if they don’t understand their test results or what the doctor told them. Our aim is to answer all queries until the caller is satisfied,” explains Nair.

According to Nair, calls sometimes last up to 45 minutes long. MeraDoctors train their doctors not to use medical jargon in order to make the customer comfortable. Says Nair, “all the doctors at MeraDoctor besides being trained in internationally accepted phone triage protocol, are also taught to offer a friendly ear to each caller.”

MeraDoctor has reached 900 families so far in India and looks to keep growing. Similar programs have been implemented in Bangladesh, Australia and Kenya with mixed success. However, if MeraDoctor stays true to its claims of customer friendly service, reliability and unlimited consultations, the service may become a popular fixture.

According to Nair, the patient-doctor dynamic in India is one where a patient refrains from medical consultation until the condition worsens. And when a patient sees a doctor, he/she waits at the doctor’s office for hours for only 5-10 minutes and then pays for the visit out of pocket. Nair wants MeraDoctor to serve as an avenue for thorough and convenient consulting.

Ideologically, the MeraDoctor system is precious for many Indians who have inadequate and substandard medical care. However, immediate issues surface when talking about quality of medical advice and providing accurate diagnoses. Also, if patients are referred to visit a clinic, are they still asked to pay full price for the clinic services despite paying for MeraDoctor services? That wouldn’t seem opportunistic at all. Especially when Indians spend up to an eight of their income paying for medical services. In any case, MeraDoctor seems to be gaining ground, and any success will be significant for Indians.

July 5, 2011/by actualize

Agriculture, Health, Health, Health Systems, HIV/AIDS, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Mobile health quizzes get a 2.7 million Euro boost

Text to Change (TTC), an mHealth non-profit organization based in the Netherlands, announced earlier this month that they will receive a €2.7 million grant to expand its services. TTC provides an SMS-based educational service to improve the health of citizens in eight countries in Africa and one in South America.

Already a big contributor in mHealth development, TTC hopes to become a leader in the field with the reception of its multi-million Euro grant from the Dutch Ministry of Foreign Affairs via Connect4Change (C4C), a consortium funded by the Dutch Ministry of Foreign Affairs that develops mobile based solutions on issues of poverty in Africa and Latin America. TTC will partner with C4C to expand its services to 11 more countries in Africa and South America by the end of this year.

Implementing ICT in the 11 countries is a top priority for both TTC and C4C. They are hoping the mutual partnership will make establishing ICT services an easier task as the expansion continues. According to TTC, the game plan calls for TTC to provide “low” technologies like SMS and mobile voice services while C4C provides “high” technologies such as mobile internet and video transfer. Therefore, TTC and C4C will play different roles.

C4C will also invest its time reaching out to local entities on the ground to strengthen ICT networks. TTC will focus on improving health outcomes through their established mobile phone initiatives.

TTC sets up their mobile platform through the recipient country’s mobile service infrastructure already in place. They then subscribe mobile phone users to their programs which use SMS communication to inform people of HIV testing, treatment clinics, and other health related services at no cost to the recipients.

TTC SMS system Photo Credit: TTC

TTC programs offer the information through a free educational quizzing service where participants are quizzed about a specific health topic. As participants answer the questions correctly, they are sent more rounds of questions, again at no cost. If the participant can answer enough questions correctly, he/she receives incentives such as phone credit, t-shirts and health products.

Thus far, TTC has reached thousands of individuals with their programs on HIV/AIDS, malaria, and reproductive health. Furthermore, to assess the impact of ICT in the countries they are currently working in, TTC will even conduct large scale ICT evaluations over the next few years in those countries.

TTC is poised to make an impact in ICT through their mobile services. Their work is just another example of how mobile phones are being used as a medium to educate, inform and save lives. The tag-team partnership with C4C will be expanded to all 11 target countries by the end of this year. However, we will have to wait some time before confirming the outcome of this joint strategic approach.

June 27, 2011/by actualize

Environment, Health, Originally posted on the GBI Portal

e-Development in Kenya: Electrifying Villages & the Benefits of ‘Virtual Kenya’

A metal solar panel (Credit: Capital Business)

Previously, I dubbed east-Africa’s ICT hub, Kenya, the Land of the Apps, but Kenya’s wider e-development prospects and challenges are more nuanced than that. We ought to consider a range of intersecting questions.

Last week, I chronicled the Kenyan government’s plans to channel US$10 million into its much vaunted digital village project and plans to provide computers and reliable connectivity to schools across the country.

These bold policy positions are indicative of why Kenya’s success is no fluke. In fact, its concerted focus on and sensitivity to the information poverty of its legion of unconnected people, amid a rapidly transforming and pioneering telecoms sector, is a game-changer. The range of policy positions adopted recently gives credence to this view, particularly the move to rectify the country’s ailing electricity sector and the launch of ‘Virtual Kenya’ last week.

The East-African country will spend US$62 million to electrify 460 trading centers and 110 secondary schools, among other public facilities under the rural electrification program. The ICT sector will also benefit from the $730 million allocated to the Ministry of Energy for the next fiscal year. As I have noted before, this will further bridge the digital divide because none of Kenya’s—or the wider African continent’s— ambitious ICT expansion plans will be achieved without improved electricity infrastructure. According to the World Bank, 70% of Africans are not connected to a power grid.

Resolving the energy sector crisis is pivotal, as it will not only boost the expansion of the ICT sector, but also improve livelihoods. The successful ‘Songa mbele na solar‘ (Move ahead with solar) campaign of 2010 offers lessons, too. It shows that any effort to electrify Kenya’s more rustic regions will require a diversified energy mix—and given the state’s economic constraints, solar—readily accessible and easily tapped—ought to be an integral part of that mix. The ‘Songa mbele na solar” reached over nine million Kenyans, improving productivity by extending business hours, and buttressing lives through reduced air pollution.

It is clear to me that there is a growing, albeit very slow, trend towards merging the questions of sustainable development, particularly clean energy and natural resources conservation, with the ICT4D push. I am inclined to think that the link between the two ought to be further cemented. I consider the launch of ‘Virtual Kenya’, an interactive web platform for charting human environmental health, to be a step in that direction. ‘Virtual Kenya’, which was developed by the Nairobi-based web mapping technology firm Upande Ltd, in collaboration with the US-based World Resources Institute, caters to the needs of Kenya’s unconnected as it comes with “related materials for those with no access to the internet”. So, I think this is important on two fronts: first, it tackles the information divide; second, it broadens the pool of people who have ready access to environmental and health information.

It is easy to imagine the impact this will have on an educational landscape where schools and universities are constrained by outmoded data sets and other resources. Ready access to high quality, spatial data and cutting edge mapping technology on an interactive platform is golden.

For more details on ‘Virtual Kenya’, please go here.

June 27, 2011/by actualize

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

Camels and SMS: Transporting vaccines in resource poor areas

Camel without refrigerator attached. Photo Credit: Art Center College of Design

The PATH initiative, which advances malaria vaccines, recently predicted that over ten times more vaccine storage will be needed in the developing world over the next 15 years. However, transporting and managing vaccines in developing countries faces many obstacles, including inhospitable climates, poor infrastructure, lack of electricity and disparate communities.

As a result, over 1 million people die every year in developing nations due to vaccine-preventable diseases. In some cases, vaccines may be reaching these populations, but when they do, they are no longer functional because they were not adequately cooled. Most vaccines must be stored within a certain temperature range in order to remain functional. Health organizations are increasingly turning to technology to help them do just that.

Fridge about to be loaded onto camel. Photo Credit: Art Center College of Design

Many NGOs and ministries of health make use of mobile vaccine refrigerators that harness solar energy to power the internal chamber that holds the vaccines. A particularly innovative and resourceful vaccine refrigerator came on the backs of camels. Naps’ Camel Fridge was designed back in 2005 and operates off of solar power. The fridge uses solar panels to harness energy, and sits on the backs of camels that transport the fridges to rural destinations. Over 1,500 of these camel fridges have been sold to WHO and UNICEF programs.

But if a shipment of vaccines arrives spoiled, it is important to know where in the logistics chain the temperature was breached so that changes can be made to prevent a recurrence.

However, some issues with these mobile refrigerators are temperature maintenance and vaccine spoilage. A practical gadget that has made cold chain storage more efficient is a technology that involves vaccine monitoring. SmartConnect, a technology developed by Inveneo that uses existing cell phone networks for data communication, can monitor vaccines by sending information about the arrival time and temperatures of vaccines in transit. That way, officials will know not only if a vaccine has spoiled, but when and where the problem may have occurred.

Sure Chill Vaccine Refrigerator Photo Credit: True Energy

SmartConnect is not the only project making use of SMS technology. True Energy’s Sure Chill Vaccine Refrigerators, which are WHO pre-certified, can store vaccines at a constant optimal temperature, without power, for up to ten days while using a vaccine vial monitoring system that records temperature changes and can send an SMS to indicate those changes.

True Energy has already shipped multiple units to Senegal and Vietnam under project Optimize, a WHO/PATH collaboration, and aims to ship many more units to countries like South Sudan, Kenya, Nigeria, Yemen, India and many more.

Incorporating mobile monitoring technologies and improving the efficiency of the fridges could make a tremendous impact on the success of many vaccination programs. And if PATH’s prediction rings true, they will be greatly needed.

June 24, 2011/by actualize

Agriculture, Health, Health Systems, Infectious Diseases, Mobile, Originally posted on the GBI Portal

How mobile banking and financial incentives can fight TB

Photo Credit: Stop TB Partnership

Earlier this month, the Indus Hospital in Karachi, Pakistan reported a substantial increase in Tuberculosis (TB) detection rates after the start of a program that uses mobile technology and financial incentives to get people to test for the disease.

Since the implementation of the program in January 2011, reported TB cases more than doubled at the hospital. Doctors reported a total of 420 cases in the first quarter of 2011, up from 200 in the last quarter of 2010, before the program was in place.

The program is anchored by a financial incentive scheme and use of mobile technology. In the program, doctors and community health workers who screen for TB are rewarded with a financial incentive through their mobile banking account. Health professionals are rewarded based on both the number of sputum samples that they collect and the number of patients that test positive for active TB following sputum test results.

Mobile banking centers that have emerged in Karachi make this program possible. Health professionals use SMS to send their TB data to the Indus Hospital TB Reach mobile data collection system and in return receive a text message which tells them how many cases they have helped to detect. The incentives are then tabulated and distributed at the mobile banking centers on a monthly basis by the data collection system, called OpenMRS Mobile.

Tackling TB is a big deal in Pakistan and the South Asian region as a whole. According to estimates by the World Health Organization, Pakistan developed nearly 300,000 new cases of TB in 2009, making them 8^th on the list of countries most burdened by TB. Case detection is imperative in treating TB because according to TB Reach, for every 10 additional cases detected, an estimated 5 lives are saved and 100 infections are prevented.

The Indus Hospital received a grant from the Stop TB partnership’s TB Reach program. The TB Reach program focuses on promoting increased case detection of TB cases, ensuring their timely treatment, all while maintaining high cure rates within the national TB programs. Working in two “waves,” the first wave targeted 19 countries with $18.4 million worth of funding. The project at the Indus Hospital in Karachi is a product of the first wave. Under its Wave-2 funding, TB Reach has approved US$ 31 million for 45 projects in 29 countries.

The Indus Hospital program’s success has caught local attention as the Indus Hospital health workers are now training local private general practitioners on TB screening and detection. Furthermore Indus Hospital has launched a communications campaign complete with billboards, posters and local cable television ads that encourage people to get tested for TB. The Indus Hospital, also Pakistan’s first hospital to go paperless, hopes to expand the program nationally and even beyond.

June 16, 2011/by actualize

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