Sana Mobile: Connecting Big-City Care to Patients in Remote Villages data sheet 6117 Views
Decision making support for nurses and health workers, even when connectivity is poor or low, is possible with Sana Mobile, an Android-based mobile health application. Formerly known as Moca Mobile, the Sana technology facilitates remote consultations between health care specialists and community health workers in remote areas.
Sana Mobile started at MIT's NextLab, where developers, faculty and students collaborate to tackle a problem using mobile technology. The Sana technology was developed by Sidhant Jena, Sana team lead and Harvard Business School student and Russell Ryan, lead engineer and MIT student.
When general practitioners lack the expertise to diagnose a case, they refer patients to specialists, who may not be easily accessible. The Sana technology addresses the lack of accessibility to specialty care in places, where specialist doctors and tertiary care centers are sparse.
How does Sana Mobile work?
Basic Information
Organization involved in the project?:
Project goals:
One of the largest problems facing the developing world is a lack of trained physicians. While there is not a shortage of untrained or semi-trained workforce, many health workers in many developing nations are not able to dispense adequate care due to a lack of expertise.
The Sana technology seeks to address the lack of accessibility to specialty care in places, where specialist doctors and tertiary care centers are sparse.
Brief description of the project:
Oral cancer is one of the most common cancers in India. It is related to the cultural practice of chewing paan masala and gutka, forms of chewing tobacco. It is estimated that about 40% of men and 15% of women chew tobacco on a regular basis. Detecting risk of oral cancer earlier is important for affordable treatment as late stage tumors can be very expensive to treat. To survey the risk of oral cancer in their community, Mazumdar Shaw Cancer Center and the Narayana Hrudayalaya Health to ran a pilot test in and around Bangalore over six months. One pilot was run in Belgaum, Raichur, a rural town about 12 hours away from the city of Bangalore. The other pilot was run in Bangalore. Equipped with the Sana application, ASHAs (community health workers) went door to door in and around Bangalore, asking questions and taking pictures of oral lesions, which were evaluated by oral surgeons. In six months, they were able to screen about 400 high-risk cancer patients and detected numerous lesions using Sana. Twenty ASHAs were trained in using the Sana software in Belgaum.
Target audience:
For this pilot, risk of oral cancer was assessed for men and women chewing tobacco. But the Sana application is also being used to do a large scale risk assessment for cardiovascular disease, to screen maternal complications (e.g. preclampsia) and assess nutritional status of children.
Detailed Information
Length of Project (in months) :
What worked well? :
Sana invested in building local developer capacity in India. Local developers cost less than having an international technology consultant to conduct training.
Lots of enthusiasm from leaders at the Narayana Hrudayalaya hospital
Funding for Sana developers at MIT to travel to India to test and train users came from external support, not from program budget of the clients.
What did not work? What were the challenges?:
Semi- to low-literacy amongst community health workers can be a challenge if an application is available in limited languages. CHWs in Belgaum did not speak Kannada (the local script) or English. Developers adapted Sana to replace text in the medical procedures with voice prompts and pictorial labels
Health workers/nurses were not familiar with the touchscreen and needed some additional training and practice in order to understand how to use it (i.e. using fingerpad or fingernail to enter data)
Cost of phone was a major limiting factor
Some resistance faced from physicians, who were not quick to adopt a technology-based work flow management tool
The Sana Team is a volunteer based organization, and it is difficult for the team of developers to contribute time resources, but they consistently offer feedback to Sana users on their google group.
