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.
Engineering Rural Development data sheet 2779 Views
Author:
Parikh, Tapan S.
Publication Date:
Jan 2009
Publication Type:
Journal article
Abstract:
Presented here is an overview of the operational needs of NGOs and CBOs and the role information systems can play to increase their accountability and efficiency. Information systems need to fit the diverse operational needs of NGOs and CBOs, which include coordinating activities, training and monitoring staff, documenting results, accounting, reporting, decision making and learning, acquiring external information and encouraging community participation.
Unfortunately, there are gaps in information systems that impede the ability of NGOs to embrace ICT. To name a few, the lack of open, accessible, cross-platform mobile development tools, limited opportunities and resources provided to local small software companies to engage with NGOs, and the lack of long distance networking technologies to reach remote locations.
Two examples of technologies that were applied successfully are shared: Self Help MIS, an application to monitor activities of small microfinance organizations and credit groups and DigitalICS, an application for data collection used by agricultural cooperatives. The author stresses that ICTs should be viewed as a tool to allow local change agents to be more effective and accountable and shows how computing is able to support local organizations by inspiring innovation, implementation and dissemination of projects, and measuring impact.
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.
Texting with a Purpose: Catholic Relief Services in India data sheet 4642 Views
Catholic Relief Services' maternal and neo-natal health monitoring program in Uttar Pradesh, India is incorporating mobiles into its work. The pilot project, which launched in June 2009, uses mobiles to increase volunteers' ability to share and gather health information.
The program uses SMSs to allow ASHAs (Accredited Social Health Activists who are local volunteers) to report statistics on maternal and neo-natal health metrics. According to O.P. Singh, who gave a presentation on the program as part of the SHOPS/mHealh Alliance online conference, several problems in the current system led to the adoption of mobiles: the existing paper system was difficult to use, workers at village and block levels had limited access to information from headquarters, and the paper system was slow. The organization hoped that incorporating mobile phones would give the volunteers a better sense of the health landscape, since they would have access to real time information and be able to instantly share their results. During the presentation, Singh illustrated the system with the following graph:
Catholic Relief Services carries out the commitment of the Bishops of the United States to assist the poor and vulnerable overseas. We act to promote human development by responding to major emergencies, fighting disease and poverty, and nurturing peaceful and just societies; and we work with local, national and international Catholic institutions and structures, as well as other organizations, to assist people on the basis of need, not creed, race or nationality.
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:
ChildCount: Monitoring Children's Health Through SMS data sheet 7876 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 project is two-fold. One service targets what Tim Wood, director of the Grameen Foundation’s Mobile Health Innovation and ICT Innovation divisions calls “pregnant parents,” and another targets community health workers.
SMS Uprising: Mobile Activism in Africa is a new collection of essays and case studies examining how SMS has been used in Africa for acticism. Essays include Amanda Atwood’s report on Kubatana’s experiences in Zimbabwe setting up mobiles as a means of sharing news outside of government propaganda, to Bukeni Waruzi’s essay on collecting data on children’s rights violations in the Democratic Republic of Congo in 2004. SMS Uprising is published by Fahamu, a British-based organization with a focus on information services for Africa.
SMS Uprising provides the reader with a decent understanding of the state of mobile SMS usage in Africa today. The essays are written by writers, developers, activists, and researchers who are committed to Africa, and cover a multitude of ways SMS can be applied for advocacy work – everything from alerts about political unrest to sharing health information. The book is divided into two parts: context and case studies.
SMS Uprising is significant for many reasons not least because it has been edited by an African woman activist. Often initiatives in Africa are studied by people who are quite distant from the continent or are academics who are remote from the grassroots of the subject under discussion. The book is also unique in giving an insight into how activists and social change advocates are addressing Africa’s many challenges from within, and how they are using mobile telephone technology to facilitate these changes...The intention is that the information contained within the book will lead to greater reflection about the real potential and limitations of mobile technology.
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.
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.
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.
For the International Planned Parenthood Federation, the number 15 just made sense. It is now 15 years since the Cairo International Conference on Population and Development, when 179 governments agreed on a yet-unfulfilled plan to provide universal sexual health services by the year 2015. With the children born the year of the conference now 15 years old, the foundation felt it was time to act.
So the campaign 15andcounting was born. The campaign aims to engage young people in sexual health advocacy, mainly by having them sign a petition and complete a survey accessible both on the web and on a mobile WAP site. The petition will be presented to the United Nations in mid-October.
"They need access to condoms and high quality information, and all these services that were talked about in 1994," said Chris Wells, creative design director of the International Planned Parenthood Foundation, of the 15-year-olds born the year of the conference.
In India, especially in rural areas, men are often in charge of the family mobile phone. But Subhi Quaraishi, CEO of ZMQ Software Systems, thinks that phones are a great way to reach women as well.
"The goal of our program is to use technology to empower women," said Quaraishi, of ZMQ's new pilot program.
ZMQ is currently running a program to provide women with information on prenatal care via SMS. The messages, which are all in Hindi, contain information on vaccinations, exercise, diet, medication, and how to deal with emergencies that arrive during pregnancy. This is the only program of its kind in India, although other programs -- like a Grameen Bank sponsored program in Ghana -- also use SMS to give advice on prenatal care.
MoTeCH: mHealth Ethnography Report data sheet 1568 Views
Author:
Mechael, Patricia N.; Dodowa Health Research Center
Publication Date:
Aug 2009
Publication Type:
Report/White paper
Abstract:
The number of mobile phone subscriptions has increased by approximately one billion between the end of 2007 and the end of 2008 (ITU, 2009). At the beginning of 2009, the number has surpassed four billion. With this, the use of mobile phones and networks in the mobile health has become increasingly popular in low- and middle-income countries, including Ghana where a broad range of mHealth initiatives are now being implemented.
This offers many opportunities to translate information and communications technology into gains, particularly for fighting disease and improving population health. This mHealth Ethnography serves as a critical entry point to both assess the initial state of information, communication, and mobile phone use for maternal and newborn health both within the health sector and the general population in the Dangme West District in the Greater Accra Region of Ghana.
Key study findings illustrate that there is a strong foundation upon which the MoTECH Project can build to advance the use of mobile telephony to support the achievement of the Millennium Development Goals for health. These can be divided into two broad categories – those within the health sector and those that extend services to target beneficiaries in the general population.
The recently released mHealth Ethnography Report is an important addition to the growing body of knowledge about the potential for community health initiatives supported by mobile technology. As we have noted before, much of the health care in rural communities is provides by community health workers, largely untrained paraprofessionals.
The report hones in on the potential of SMS/text messages and voice services accessible via mobile to reinforce outreach services and support for these community health workers. The authors assess the initial state of information, communication, and mobile phone use for maternal and newborn health in the health sector and the general population in the Dangme West District in the Greater Accra Region.
It indicates that mobile phones are already used by many healthcare workers and by the general population to seek health related information or coordinate related transportation in emergencies.
The Peace Corps traces its roots and mission to 1960, when then-Senator John F. Kennedy challenged students at the University of Michigan to serve their country in the cause of peace by living and working in developing countries. From that inspiration grew an agency of the federal government devoted to world peace and friendship.
Since that time, more than 195,000 Peace Corps Volunteers have served in 139 host countries to work on issues ranging from AIDS education to information technology and environmental preservation.
RapidResponse is a m-health platform built on RapidSMS developed for the Millennium Villages Project with support from the UNICEF Innovation Group. RapidResponse uses SMS text messages to facilitate and coordinate the activities of health care providers in the field. These are usually lay community health care workers who tend to provide the majority of patient care in many developing countries.
Using simple text messages, the community health workers are able to register patients and send in health reports to a central web dashboard that allows a health team to closely monitor the health of a community. Powerful messaging features help facilitate communication between the members of the health system and an automated alert system helps reduce gaps in treatment.
This video gives an overview of the platform in a clear and accessible step-by-step manner. While Rapid Response in this case is focused on child malnutrition, Rapid Response has applicability in many other health and non-health settings.
mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World data sheet 5460 Views
Author:
Vital Wave Consulting
Publication Date:
Feb 2009
Publication Type:
Report/White paper
Abstract:
Mounting interest in the field of mHealth—the provision of health-related services via mobile communications—can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the ‘digital divide,’ billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services—even in some of the most remote and resource-poor environments.
This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth’s scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth’s full potential. The report is organized into the following sections:
1. Identifying the potential of mobile phones to improve health in the developing world
2. Defining mHealth within the context of eHealth
3. Meeting health needs through a broad array of mHealth applications
4. Examining the impacts of mHealth projects
5 Assessing mHealth and future health needs in developing countries
6. Identifying the building blocks for sustainable and scalable mHealth programs
7. Understanding the incentives for multiple players: mHealth value chains
The Aceh Besar Midwives with Mobile Phones Program: Design and Evaluation Perspectives using the ICT for Healthcare Model data sheet 2780 Views
Author:
Chib, Arul
Publication Date:
May 2012
Publication Type:
Report/White paper
Abstract:
This paper examines the design process of the health communication process within the framework of the ICT-for-healthcare-development model (ICT4HC) (Author, Lwin, Ang, Lin, & Santoso, 2008). The paper analyzes the planned deployment of an ICT4H project that introduced a mobile telephony-based system to a specific group of users, rural midwives, and examine the myriad impacts and constraints that arise. The broad research question the paper aims to answer pertains to the design and evaluation of mobile phone-based ICT4H projects using a generalizable theoretical frameworks, specifically the ICT4HC model.
This spring, UNICEF Malawi and the UNICEF Innovations Team deployed RapidSMS to monitor child growth and nutrition. We wrote about it previously here.
Now there is a detailed report (pdf), evaluating the effort (pdf). The report, released on June 16th, was issued by Columbia University's School of Public Policy and Affairs (SIPA), UNICEF Malawi, UNICEF's Innovations team, and Mobile Development Solutions (MDS).
The report details the findings of the deployment, and outlines recommendations for the future use of SMS in Malawi. Raymond Short of Mobile Development Solutions says that,
“while there have been innumerable ICT development applications introduced recently, there have not been many independent studies of their efficiency”.
