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Ethopia again this year has experienced crippling droughts.  Faced with the possibility of famine, UNICEF Ethiopia launched a massive food distribution program to supply the high-protein food Plumpy'nut to under-nourished children using mobile phones for monitoring and delivering supplies its more than 1,8000 feeding centers in the country. 

To coordinate the distribution and maintain appropriate stocks, field monitors reported on supplies and number of children fed through an SMS reporting system using a UNICEF-built mobile data collection and monitoring software, RapidSMS.  We have previously reviewed RapidSMS here, comparing it with a less scaleable lower-end tool, Frontline SMS. 

The emergency food supply chain before RapidSMS

Before the use of texting to record and monitor, the roving 30 field monitors traveled around the country, visiting feeding sites, recording data, and then faxing data sheets to Addis Ababa once a week.  This low frequency of reporting did not allow UNICEF to quickly respond to increased need or low supplies of food supplements in remote areas. The inefficiency of this system was also error prone, and resulted in reporting on only about 20% of the Plumpy'nut distribution centers - a small percentage of the 1852 distribution centers in the country.

To increase turnaround, increase accuracy, and to improve speed and efficiency of supplying food to the centers, UNICEF devised a mobile phone-based reporting system so data could be analyzed and responded to as soon as it is known in the field.

The RapidSMS Solution

UNICEF Ethopia, with the organization's New York-based Innovation Center, evaulated how the open-source RapidSMS platform could be customized to provide a solution that would take advantage of the widespread availability of mobile phones In Ethopia to improve the monitoring and delivery of supplies.  The result of these customizations is RapidSMS - a flexible distribution monitoring package - which can be reconfigured to any supply or situation (eg, drug supply, bed-net distribution, etc), and deployed at short notice. A GSM modem attached to a webserver receives the incoming SMS messages, replies with a confirmation message, and automatically saves the entry into a database.

RapidSMS can be accessed from anywhere on the Internet (with proper login credentials) to monitor reporting activity, send custom messages to field monitors, generate reports, and export data to Excel. Field monitors are able to send any additional information in the form of 'alerts' which are forwarded by email or SMS to UNICEF staff, so action is taken immediately. Reported data can be automatically plotted on a map to show a visual summary of field conditions.

How RapidSMS Was Used

The field monitoring staff interacted with the system exclusively using SMS from their mobile phones. Monitors received a 2-hour training and printed documentation containing instructions and examples of how to submit SMS reports.  The documentation also contained instructions on how to summon additional "help" by sending "alerts", which are relayed immediately by email or SMS to UNICEF staff. All incoming and outgoing messages are logged and counted, so field monitors can easily be reimbursed for their expenses.

The UNICEF staff used the web-based interface of RapidSMS to monitor the field reporting activiies, to view and analyze incoming supply reports immediately, send custom messages to field monitors, broadcast announcements and updates to all field monitors, generate reports and visualize data (delivery status, number of new beneficiaries, stock levels, etc) on a map, and generate graphical summaries of activities.

Results

The RapidSMS Ethiopia project went live on 27 October, 2008. As of 4th December, 2008, the organization had received 939 unique reports -- which amounts to about 10-50 reports every day.  The total number is similar to reporting with the traditional pre-SMS system, however, reports were received every day instead of fortnightly and information was automatically entered into database.  Each of the reports contained information about the number of new admissions to the fedinc center, and the quantity of Plumpynuts received and consumed, as well as information on the stock balance, location of the distribution center, and information about the field monitor. 

As the pilot continued, field monitors became more familiar with RapidSMS and explored its advanced functionality voluntarily.  Based on their interaction, UNICEF continued to improve  the usability of the system to reduce reporting errors.  The urgent alert system proved particularlyimportant.  In the two months since the pilot started, UNICEF received dozens of alerts above and beyond the standard data collected, such as "The supply room was left unlocked" to "There is NO STOCK remaining at this OTP!"

Frield monitors used the system well. Despite travelling in pairs, 21 of the 33 field monitors  successfully submitted reports: a 64% participation rate, even though only 50% is required for full coverage. The initial target by the UNICEF Ethiopia field office was a "limited snapshot" of the conditions at 20% of distribution centers, similar to what the old faxing reporting method yielded. Of the 1852 distribution centers initially imported into RapidSMS, reports have been received for 939: a 44% coverage in five weeks.

UNICEF Ethiopia supply and logistics staff are currently (as of 4th Decemeber, 2008) reviewing the results of the RapidSMS pilot, the data collected, and comparing it to the traditional phone/fax method of reporting that was conducted in parallel during this period.

Implementation requirements

Every country has a different telecommunication infrastructure which determines the inputs needed for RapidSMS to work.  This makes it hard to determine  the precise cost of deployment. However, an estimation of a deployment includes discussion with staff, customization of RapidSMS as needed, installation in the country, user training,  a webserver (a low-end PC is sufficient), an Internet connection, a GSM modem (around $120 USD), 2 prepaid and 1 contract SIM card (and two mobile phones for testing).

Next Implementation

The next use of RapidSMS will be in Malawi between January and April 2009 to transmit nutritional data from growth monitoring clinics to government and UNICEF databases, while providing instant feedback to mothers on the changing status of their child’s growth.

The Child Malnutrition Surveillance and Famine Response project is an effort by a team of six students at Columbia University’s School of International and Public Affairs (SIPA) to use mobile technology solutions to improve the speed and quality of nutrition surveillance data for children in Malawi. Again, mobile technology will replace the paper/mail data collection process currently in use at Malawi’s child growth monitoring clinics with instantaneous data transmission via mobile devices.

The project will enable the Government of Malawi, UNICEF Malawi, and their partners to geographically map and track child malnutrition trends accurately and in real time. This tool will provide a critical means of intervention into rapidly unfolding food and nutrition crises.

To recognize the innovations of RapidSMS and UNICEF's work, this project is a finalist in the USAID Development 2.0 Challenge.

MobileActive has been a judge in the Challenge.

Reviews of RapidSMS and Frontline SMS can be found in our tool reviews.