The Case for mHealth in Developing Countries data sheet 2569 Views
Author:
Patricia N. Mechael
Publication Date:
Jan 2009
Publication Type:
Journal article
Abstract:
The aim of this paper is to encourage reflection and discussion around the potential of mHealth in developing countries and to consider how early experiences can inform the way forward. Toward this aim, I synthesize many reviews and presentations from the eight years I have been studying the evolution of mobile phones and health in developing countries. I include observations and discussions that are now shaping the creation of mHealth as a field, to highlight the ingredients we need to move from a series of pilot projects and isolated business opportunities to a full-scale maximization of health-related benefits.
I begin by reviewing the strategic priorities within global health, where mobile telephony can have the greatest impact, along with organic health-related uses of mobile phones, and examples of formal mHealth interventions. I then demonstrate the potential for mobile phones to become an extension and an integral component of eHealth, describing how information and communication technology (ICT) can be used in health care, as well as mHealth, as a subset of mServices: using mobile devices to deliver services such as banking and health. I also show how trends and interests are converging among key stakeholders within the mHealth ecosystem, thus forming a foundation on which we can scale up and sustain more and better mHealth activities. Finally, I present some tactical guidance for a way forward that will further the objectives of both public health and business, particularly in outreach efforts to emerging markets, the bottom of the pyramid, and the next billion mobile phone subscribers.
Every ChildCounts: The Use of SMS in Kenya to Support the Community-Based Management of Acute Malnutrition & Malaria in Children data sheet 2743 Views
Author:
Berg, Matt, Wariero, James, and Modi, Vijay
Publication Date:
Oct 2009
Publication Type:
Report/White paper
Abstract:
Baseline under five child mortality in Sauri, Kenya as of 2005 was estimated to be 148 deaths per 1000 live births. By 2008, the rate had dropped to 81 deaths per 1000 live births due to Millennium Village Project (MVP) interventions. A review of child deaths revealed that among other causes, such as malaria, acute febrile illnesses, diarrheal illnesses and HIV, malnutrition contributed to more than 50% of all child deaths. Community health workers (CHWs) led several interventions, namely community-based management of acute malnutrition, home-based testing for malaria and diarrheal illnesses and immediate dispersal of appropriate treatments.
To support these interventions, MVP ran a pilot project where CHWs were equipped with mobile phones to use SMS text messages to register patients and send in their data with the goal of improving child health and empowering community health workers. This report seeks to detail the methods used, illustrate early results and initial findings of the ChildCount mHealth platform that CHWs have now been using since early July of 2009.
Components of SMS-Based Data Collection and Service Delivery data sheet 2913 Views
Author:
Matt Berg
Publication Date:
May 2010
Publication Type:
Report/White paper
Abstract:
An overview of the components, approaches and techniques used to build mobile phone-accessible applications that use SMS text messages as a conduit for data collection and service delivery. SMS-based applications represent a paradigm shift allowing innovative new approaches to monitoring and data collection fundamentally changing the way we can approach the delivery of critical health, economic and social services in resource-poor settings. SMS has the potential to fill significant connectivity and service gaps, particularly for the world’s poor, until data networks and phones that can support them become more ubiquitous.
This guest post was written by Nicolas di Tada, Director of Platform Engineering at InSTEDD. He writes about an ingeniousway for health workers to accurately transmit semi-structured data via mobile. His post is reprinted here with permission.
During August 2009, we went on a number of field trips to health centers in remote areas of Thailand and Cambodia. The idea was to conduct a few usability tests on Geochat syntax alternatives that we were exploring. Our goal was to simplify the interaction between health workers and the system to ultimately allow them to report disease cases in a semi-structured way.
The case information always originates at the local health center level - this is where the patient comes and gets diagnosed. Most of the case reports are made through phone calls to the district level (the higher administrative level). Case details get lost when the district level summarizes the information by disease and reports the quantity of each to the provincial level.
The use of mobile phones for quick-time data collection is proliferating around the world. To get a better understanding of the scale and scope of these new data collection efforts, we partnered with UN Global Pulse initiative to conduct a survey of present and planned mobile data collection efforts. The survey results will help identify new, quick-time data sources.
The first findings of the global survey have been compiled in an inventory. The inventory is a living document that will be regularly updated as we become aware of new projects. If you are managing a mobile data collection project and you would like to have it featured in the inventory, please contact us or leave a comment.
We are also currently conducting for UN Global Pulse a mobile phone survey across multiple countries including Uganda, India, Mexico, Ukraine and Iraq. The survey is being conducted via text message and uses simple questions to understand how populations in different parts of the world perceive. We are drawing on our extensive network of partners on the ground to conduct the survey and will make the results publicly available (albeit in an anonymous and aggregate format). The survey is an exercise in rapid, bottom-up data collection. Questions in the survey focus on economic perceptions, including:
This guest-post is by Arturo Morosoff who completed recently a project with D-Tree International and BRAC Tanzania to provide videos on mobile phones to assist Community Health Workers (CHWs) for health education. It is posted here with permission.
I recently completed a five week volunteer project working with Irene Joseph and Gayo Mhila of D-Tree International to provide videos on mobile phones to Community Health Volunteers with BRAC Tanzania in the Mbagala district of Dar Es Salaam.
A bit about me: I have no formal training in ICT or public health. My background is in technology and business and I live and work in the San Francisco Bay Area in California. I was on a two month trip in Tanzania and volunteered to help D-Tree with this project. As such, the project needed to be completed in a short time and we began with modest goals.
Among BRAC’s programs to help alleviate poverty is its health program, which relies on an all-female team of Community Health Volunteers (CHVs) to conduct monthly home visits to provide health education and support. Each CHV visits 150 – 200 homes each month, asking health related questions and providing healthcare information. In Tanzania, D-Tree has been collaborating with BRAC to provide the CHVs with a mobile phone-based tool called Commcare, to help improve the effectiveness of their home-based programs. About a year ago there was discussion with the CHVs of providing them with health education videos suitable for use on phones to provide additional support for their home visits.
Text Messaging as a Tool for Behavior Change in Disease Prevention and Management data sheet 3580 Views
Author:
Heather Cole-Lewis and Trace Kershaw
Publication Date:
Mar 2010
Publication Type:
Journal article
Abstract:
Mobile phone text messaging is a potentially powerful tool for behavior change because it is widely available, inexpensive, and instant.
This systematic review provides an overview of behavior change interventions for disease management and prevention delivered through text messaging. Evidence on behavior change and clinical outcomes was compiled from randomized or quasi-experimental controlled trials of text message interventions published in peer-reviewed journals by June 2009. Only those interventions using text message as the primary mode of communication were included. Study quality was assessed by using a standardized measure. Seventeen articles representing 12 studies (5 disease prevention and 7 disease management) were included. Intervention length ranged from 3 months to 12 months, none had long-term follow-up, and message frequency varied.
Of 9 sufficiently powered studies, 8 found evidence to support text messaging as a tool for behavior change. Effects exist across age, minority status, and nationality. Nine countries are represented in this review, but it is problematic that only one is a developing country, given potential benefits of such a widely accessible, relatively inexpensive tool for health behavior change.
Methodological issues and gaps in the literature are highlighted, and recommendations for future studies are provided.
Comprised of data from 17 articles representing 12 studies (five of which focused on disease prevention and seven of which focused on disease management), the authors draw conclusions on the effectiveness of using mobile phones (and more specifically, text messaging on mobile phones) to change health behaviors.
As we are completing an inventory of mobile date collection projects around the world that are focused on vulnerable populations and early warning, we've come across a few efforts that are worth highlighting. One is the SMS and PDA-based surveying of the World Food Programme (WFP). WFP's food security monitoring systems are set up in many countries. While some countries are still submitting paper records, there is a push to incorporate PDAs or SMS data transmission for faster and more reliable monitoring of food security.
The data collected includes both food security baseline data and food insecurity indicators. The bulk of WFP's data collected focuses on nutritional indicators, market prices, import, cross border trades, socioeconomic indicators, and health indicators. The UN agency is trialing both FrontlineSMS and RapidSMS, two mobile data collection software tools, in its current projects, as well as PDAs but is likely going to standardize its operations using one of the two with some custom gateway software.
In the process of collecting data, WFP always collaborates with governments and other UN partners. WFP staff are involved with the supervision, training and coordination but but the people who conduct interviews and collect the data are usually government staff, university students, or NGO workers As one WFP staffer noted, "We have huge armies of data collectors."
The scope of the work is accordingly large. Some of the efforts cover an entire country. In Senegal, for example, WFP has 250 numerators covering the country – 22 teams of 11 people each who are collecting data for six weeks, visiting 2,000 villages.
The video below features George Muammar of the WFP Vulnerability Analysis and Mapping Unit. He describes rapid data collection in an Emergency Food Security Assessment in Goma, N. Kivu, Democratic Republic of Congo.
Mapping SMS Incident Reports: A Review of Ushahidi and Managing News data sheet 17496 Views
Author:
Melissa Loudon
Abstract:
In this how-to, we test out two systems for SMS incident mapping: Ushahidi and Managing News. Incident mapping is a simple but powerful concept that does what it says - using SMS to report a given incidence and mapping the data geographically. This article compares the two platforms, their pros and cons, and outlines when to use either.
In this how-to, we test out two systems for SMS incident mapping. Incident mapping is a simple but powerful concept that does what it says - using SMS to report a given incidence and mapping the data geographically.
It has been used in various scenarios ranging from reports from natural disasters to tracking violent crime, citizen reporting in elections.
Ushahidi, a platform for map and time-based visualizations of text reports, has been used most prominently in crisis mapping. The first instance of Ushahidi tracked the post-election violence in Kenya in 2007, closely followed by an instance covering outbreaks of xenophobic violence in South Africa in early 2008. Following the Haiti earthquake in early 2010, an Ushahidi deployment at Tufts University provided a platform for aggregating, translating and disseminating incident reports and requests for assistance. Ushahidi is an open-source PHP/Javascript platform.
EMIT: Mobile Monitoring and Evaluation data sheet 4900 Views
System Description
EMIT is an application that allows facilitators to capture field data on cellphones and submit it via GPRS to a centralised database. Surveys are customised and data is monitored, verified and prepared for analysis in real time. Read more here.
From Pilot to National
The pilot was performed with the Community Media Trust (CMT), who used EMIT as a monitoring and evaluation (M&E) tool to capture information on their HIV prevention and treatment literacy sessions in clinics, their training programme and open day events held in public spaces in communities where they work. CMT had been struggling with long turnaround times:
During the last FailFaire (well, actually the first one to date) we were reminded by a guest rather sternly that NGOs often forget who their users are and, more importantly, what the needs of these users are. When we, collectively as a field, implement mobile deployments with constituents or groups, do we tend to forget user needs and capabilities, getting too enchanted with the tech (and ourselves) and then fail when, not surprisingly, there isn't any uptake? We have seen many a project fail for precisely this reason. Our grouchy attendee had a point even if he did not deliver it very gracefully.
To this end, we are reposting here a recent report from Zambia. Project Mwana is UNICEF Innovation project that is "working with the Zambian Ministry of Health, UNICEF Zambia, the Malawi Ministry of Health, UNICEF Malawi and many implementing and technical partners to find appropriate, scalable and impactful ways that mobile technologies can strengthen health services for mothers and infants in rural health clinics."
As part of a "Mobile Telemedicine" initiative undertaken by the Millennium Villages Project in Ghana, I have been researching and documenting existing software platforms that enable and support remote consultation activities.
Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status or for educational purposes. It includes consultative, diagnostic, and treatment services.
Mobile health information technology (mHealth) typically refers to portable devices with the capability to create, store, retrieve, and transmit data in real time between end users for the purpose of improving patient safety and quality of care.
ChildCount: Monitoring Children's Health Through SMS data sheet 7877 Views
Many mobile projects struggle with scale and impact. While a mobile health project may run well with a small number of patients in one hospital, expanding the scope of a project until it is large enough to have real impact takes money, time, and widespread support of key stakeholders in a given community. ChildCount is well on its way to show scale and, so we hope, significant health impacts using mobile technology for patient support.
In a little over eight months, ChildCount has enrolled nearly 10,000 children under five in their catchment area into the ChildCount health monitoring system – an acceptance rate of more than 95%.
The Millennium Villages project is led and executed by the communities on the ground in Africa. Throughout the continent, more than 400,000 people are leading this bold initiative, giving their time, skills, and resources to make the project a success and one that is relevant to local conditions. Because Millennium Villages are an investment toward a sustainable end to extreme poverty, Millennium Village communities strengthen their local governments and institutions and certify the preparation and implementation of the interventions in their community. This is necessary to ensure that their development will become sustainable and self-sufficient.
The Millennium Village project is based on the findings of the UN Millennium Project and is led by the science, policy and planning teams at The Earth Institute, Millennium Promise and the United Nations Development Programme.
The Vodafone Americas Foundation is announcing the last call for nominations for the second annual Wireless Innovation Project, a competition to identify and reward the most promising advances in wireless related technologies that can be used to solve critical problems around the globe. Proposals will be accepted through February 1, 2010, with the final winners announced on April 19, 2010 at the annual Global Philanthropy Forum in Redwood City, California.
Editacuja is a Brazilian startup focused in knowledge management and contend development services for education, training and culture.
Integrate emerging technologies to provide innovative solutions to companies, universities and schools, enabling cross border iniciatives with high ROI
Works with a multi-media approach, enabling mobile, press, audiovisual and web media services and products.
With a multi-disciplinary team, Editacuja adds value and knowledge for projects that can educate and relate.
We will be blogging and twittering this week from a workshop we are co-hosting on Innovations in Mobile Data Collection for Social Action in Amman, Jordan.
Co-hosted by UNICEF’s country office in Iraq, UNICEF Innovation, and MobileActive.org, this three-day gathering is bringing invited experts from around the world together to explore some of the key issues related to using mobiles for data collection and analysis of some of the toughest social issues.
Why are we hosting this event?
With the ubiquity of mobile technology, data collection and monitoring of key indicators from the ground up by affected populations is now possible. Mobile technology in the hands of people can now be more than a person-to-person communication medium but can be used for capturing, classifying and transmitting image, audio, location and other data, interactively or autonomously.
Two of the fastest-growing and popular mobile data collection tools have recently seen some exciting upgrades in newly released versions.
Open Data Kit recently released v1.1 of ODK Collect. Open Data Kit (ODK) is a suite of tools to help organizations collect, aggregate and visualize their data. ODK Collect is powerful phone-based replacement for paper forms. Collect is built on the Android platform and can collect a variety of form data types: text, location, photos, video, audio, and barcodes. ODK Collect can be downloaded in the Android marketplace or here. The developers also have a demo video that describes the new features of the release. Open Data Kit is a member of the Open Mobile Consortium of which MobileAtive.org is a founding member.
Some of the new features of ODK Collect include barcode scanning, image/audio/video capture and playback, editing of saved forms, and device metadata (phone number, IMEI, IMSI) support. GPS acquisition and form processing is a faster, and the developers added review data entry. The user interface has been field tested and reworked to make training and use much easier. ODK Collect also supports question grouping, repeats, constraints, complex logic, and multiple languages.
ODK is currently deployed for HIV counseling with AMPATH in Kenya, user feedback gathering for Grameen's AppLab in Uganda, war crime documentation with the Berkeley Human Rights Center in the Central African Republic, and forest monitoring with the Brazilian Forest Service.
Meanwhile, our friends over at Datadyne have released version 2.0 of their popular mobile data collection platform EpiSurveyor. For some of the very cool GPS features of that, see the video below. EpiSurveyor is a free, user-friendly mobile-phone-and-web-based data collection system. Version 2.0 has many new features such as GPS (users with GPS-enabled phones (like the Nokia E71) can automatically create a "GPS stamp" for every record collected AND automatically see the results on a Google map, all within EpiSurveyor.org), advanced logic, including skip logic; numeric range limits for data entry; and a much better user interface for the web-backend.
EpiSurveyor is used by organizations around the world. One organization, TulaSalud in Guatemala, uses EpiSurveyor for maternal health. The video below (en Espanol) explains how the organization is using the tool.
Video informativo de TulaSalud, sobre la aplicación del sistema de monitoreo epidemiológico aplicado con la tecnología de EpiSurveyor, el cual pretende tener a tiempo real el reporte epidemiológico de las comlunidades.
Qton provides development and government organisations in the emerging markets with appropriate mobile and web based applications.
With extensive experience in mobile applications and software development Qton has a knowledgeable team committed to supplying affordable and effective solutions.
Aim
To assist organisations achieve their aims by enabling basic mobile phones to:
Innovative Use of Cell Phone Technology for HIV/AIDS Behaviour Change Communications: Three Pilot Projects data sheet 5050 Views
Author:
Katherine de Tolly, Helen Alexander
Publication Date:
Mar 2009
Publication Type:
Report/White paper
Abstract:
The opportunities in South Africa for using mobile technologies to support initiatives in the HIV/AIDS sector are enormous. A huge number of people have cellphone access, and there are a range of innovative ways in which cellphones can be used to support treatment, disseminate information, provide anonymous counselling, gather data and link patients to services.
Cell-Life is an NGO based in Cape Town, South Africa, that seeks to improve the lives of people infected and affected by HIV through the appropriate use of technology.
This paper describes three pilot interventions that use cellphones for behaviour change communication; i.e. that are experimenting with different cellphone technologies to disseminate information, undertaken as part of Cell-Life’s Cellphones4HIV project: ARV adherence SMSs, USSD content delivery and content delivery via MXit. Challenges around measuring impact in behaviour change communications are briefly discussed, and some of Cell-Life’s upcoming initiatives are outlined.
As Kaplan points out in his 2006 literature review of the subject, “There is almost no literature on using mobile telephones as a healthcare intervention for HIV, TB, malaria, and chronic conditions in developing countries”. Although the initiatives discussed in this paper are very much in their infancy, we hope that by sharing our ideas and approaches with others in the field we will generate discussion around some of the practicalities of mHealth.
As part of our 'deconstructing mobile' series, we have been looking closely at the claims that have been made about mobile technology for a more realistic assessment of mobiles in social development that is based on data, rather than hype. Unlike more recent reporting on the topic, the Financial Times has an interesting article that questions whether mobile tech can actually "fill the gap left by underdeveloped healthcare system,' particularly in Africa.
As has been reported, the challenges in delivering health care in many African countries are stark. As the Financial Times points, out, there is 'an acute shortage of resources and trained staff means that more than 50 percent of the region’s population is estimated to lack access to modern healthcare facilities."
Mobile Phones and Development: An Analysis of IDRC-Supported Projects data sheet 3220 Views
Author:
Ahmed T. Rashid, Laurent Elder
Publication Date:
Jan 2009
Publication Type:
Journal article
Abstract:
In the context of the rapid growth of mobile phone penetration in developing countries, mobile telephony is currently considered to be particularly important for development. Yet, until recently, very little systematic evidence was available that shed light on the developmental impacts of mobile telecommunication.
The Information and Communication Technology for Development (ICT4D) program of the International Development Research Centre (IDRC), Canada, has played a critical role in filling some of the research gaps through its partnerships with several key actors in this area.
The objective of this paper is to evaluate the case of mobile phones as a tool in solving development problems drawing from the evidence of IDRC supported projects. IDRC has supported around 20 projects that cut across several themes such as livelihoods, poverty reduction, health, education, the environment and disasters. The projects will be analyzed by theme in order to provide a thematic overview as well as a comparative analysis of the development role of mobile phones. In exploring the evidence from completed projects as well as the foci of new projects, the paper summarizes and critically assesses the key findings and suggests possible avenues for future research.
The Department of Infectious Disease Epidemiology is located on the St. Mary's campus of Imperial College London and promotes interdisciplinary research in the epidemiology, population biology, evolution and control of infectious diseases.
Here are some mobile events for the month of October that we thought are noteworthy and of interest to the MobileActive.org community. If you know of others, please mail us at info at MobileActive dot org.
The first Mobile Web Conference in Africa is a two-day event in Johannesburg that focuses on some of these key questions: How will the mobile industry evolve to a point where the vast majority of people have access to the mobile web and the content they want to view? How can societal and economic problems be tackled by the development of the capabilities of the mobile device?
PopTech explores major trends shaping our future, the social impact of new technologies, and new approaches to addressing the world’s most significant challenges. Several PopTech Fellows are part of the MobileActive.org community, including Deb Levine from Isis.inc, a leader in using mobile phones for sexual health education.
