The Grameen Foundation
recently released an in-depth report on the
state of MoTeCH, a multi-part project that uses mobile technology to
send pre- and post-natal health information to Ghanaians and allows
community health workers to collect and share health data. Launched in
July 2010 in the Upper East Region of Ghana, the system rolled out
the next phase of the pilot in April 2011 in the Awutu
Senya distract in the Central Region of Ghana. The report, "Mobile
Technology for Community Health in Ghana: What It Is and What
Grameen Foundation Has Learned So Far," takes an honest look at the
progress and challenges the organization has faced while implementing a
long-term, large-scale mHealth project.
Using mobiles for data collection is increasingly common, particularly in the area of mobile health and with a focus on community health workers. eMOCHA is a program using a smartphone Android application for storing and transmitting data easily.
Developed by the Johns Hopkins Center for Clinical Global Health Education, eMOCHA (which stands for “Electronic Mobile Open-source Comprehensive Health Application”) uses video, audio, touchscreen quizzes, GPS and SMS to collect and analyze large amounts of data. Larry William Chang, director of field evaluations for eMOCHA, explains in an interview with MobileActive.org that the inspiration for developing the tool came out of researchers’ experiences in the field and their desire to build solutions to gaps in health care data collection systems.
Fellow team members include Miquel Sitjar, lead developer for eMOCHA, and Robert Bollinger, director of the Johns Hopkins Center for Clinical Global Health Education. Chang says, “We all had these public health problems and these education and training problems that we were looking to solve, and we wanted to build a mobile-based platform that could address all the different challenges we were facing. So we designed eMOCHA to address some of the public health and patient care problems that we were seeing with our other work.” eMOCHA’s first deployment began in October of 2010, and new pilots have been announced for 2011.
Up Close and Personal with TulaSalud's m-Health work in Guatemala data sheet 3091 Views
Mohini Bhavsar was a summer 2010 research intern at MobileActive.org. Shortly after, she volunteered with TulaSalud in Guatemala to observe what it takes to implement and scale a mobile health program.
Innovation in mobile health is not quite as widespread in Latin America as it is in Africa and Asia. Of the m-health programs in Latin America, little sharing of region-specific strategies has taken place.
TulaSalud is an organization based in Guatemala that is leveraging ICT -- specifically mobile phones -- to improve the delivery of health care services for indigenous communities. Through this case study, we hope to share some of what TulaSalud has learned over the years.
TulaSalud partners with the Ministry of Health and the Cobán School of Nursing and receives support from the Tula Foundation based in Canada. The organization's vision is to use ICT and mobile technology to reduce maternal and infant mortality and to monitor disease outbreaks in the remote highlands of Alta Verapaz. Using mobile phones, TulaSalud has been able to improve the flow of information between health professionals based in hospitals and community health workers (CHWs) in remote villages.
Alta Verapaz has the largest rural and poor indigenous population in the region with limited access to health care services. In an area with one million inhabitants, 93% are indigenous and share the highest burden of maternal mortality.
TulaSalud's community health workers, known as tele-facilitadores, use mobile phones to:
Information access by low literate users is a difficult task. Critical information, such as in the field of healthcare, can often mean the difference between life and death. We have developed spoken language interface prototypes aimed at low-literate users, and tested them with community health workers in Pakistan. We present results showing that 1) in contrast to previous reports in the literature, well-designed speech interfaces significantly outperform touch-tone equivalents for both low-literate and literate users, and that 2) literacy significantly impacts task success for both modalities.
Mobile Learning for HIV/AIDS Healthcare Worker Training in Resource-Limited Settings data sheet 2045 Views
Author:
Zolfo M. et al.
Publication Date:
Sep 2010
Publication Type:
Journal article
Abstract:
We present an innovative approach to healthcare worker (HCW) training using mobile phones as a personal learning environment. Twenty physicians used individual Smartphones (Nokia N95 and iPhone), each equipped with a portable solar charger. Doctors worked in urban and peri-urban HIV/AIDS clinics in Peru, where almost 70% of the nation's HIV patients in need are on treatment. A set of 3D learning scenarios simulating interactive clinical cases was developed and adapted to the Smartphones for a continuing medical education program lasting 3 months. A mobile educational platform supporting learning events tracked participant learning progress. A discussion forum accessible via mobile connected participants to a group of HIV specialists available for back-up of the medical information. Learning outcomes were verified through mobile quizzes using multiple choice questions at the end of each module.
In December 2009, a mid-term evaluation was conducted, targeting both technical feasibility and user satisfaction. It also highlighted user perception of the program and the technical challenges encountered using mobile devices for lifelong learning.
With a response rate of 90% (18/20 questionnaires returned), the overall satisfaction of using mobile tools was generally greater for the iPhone. Access to Skype and Facebook, screen/keyboard size, and image quality were cited as more troublesome for the Nokia N95 compared to the iPhone.
Training, supervision and clinical mentoring of health workers are the cornerstone of the scaling up process of HIV/AIDS care in resource-limited settings (RLSs). Educational modules on mobile phones can give flexibility to HCWs for accessing learning content anywhere. However lack of softwares interoperability and the high investment cost for the Smartphones' purchase could represent a limitation to the wide spread use of such kind mLearning programs in RLSs.
Responding to the Human Resource Crisis: Peer Health Workers, Mobile Phones, and HIV Care in Rakai, Uganda data sheet 1828 Views
Author:
Chang, L.W. et al.
Publication Date:
Jan 2008
Publication Type:
Journal article
Abstract:
Two challenges to successful antiretroviral therapy (ART) scale-up in resource-limited settings (RLS) are human resource and healthcare infrastructure limitations.
We read with interest the modeling study by Bärnighausen et al. which describes the complexities of ensuring adequate human resources to treat HIV/AIDS (HRHA). The authors suggest that factors needed to achieve universal ART coverage include “changes in the nature or organization of care,” training health workers with skills specific to the developing world to reduce emigration, and developing systems that decrease the number of traditional HRHA required to treat a fixed number of patients.
The Rakai Health Sciences Program (RHSP) PEPFAR-funded ART program has been actively pursuing innovative HIV care strategies that directly address these important points. In 2006, we piloted a novel program utilizing peer health workers (PHW) and mobile phones to monitor patients in a rural ART program in Rakai, Uganda.
The Use of Mobile Phones as a Data Collection Tool: A Report from a Household Survey in South Africa data sheet 2281 Views
Author:
Mark Tomlinson, Wesley Solomon, Yages Singh, Tanya Doherty, Mickey Chopra, Petrida Ijumba, Alexander C Tsai and Debra Jackson
Publication Date:
Dec 2009
Publication Type:
Journal article
Abstract:
Background: To investigate the feasibility, the ease of implementation, and the extent to which community health workers with little experience of data collection could be trained and successfully supervised to collect data using mobile phones in a large baseline survey
Methods: A web-based system was developed to allow electronic surveys or questionnaires to be designed on a word processor, sent to, and conducted on standard entry level mobile phones.
Results: The web-based interface permitted comprehensive daily real-time supervision of CHW performance, with no data loss. The system permitted the early detection of data fabrication in combination with real-time quality control and data collector supervision.
Conclusions: The benefits of mobile technology, combined with the improvement that mobile phones offer over PDA's in terms of data loss and uploading difficulties, make mobile phones a feasible method of data collection that needs to be further explored.
Every ChildCounts: The Use of SMS in Kenya to Support the Community-Based Management of Acute Malnutrition & Malaria in Children data sheet 2801 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.
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.
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.
GUIDE: Getting Medical Information into the Hands of Community Health Workers data sheet 5088 Views
For community health workers who are far from medical libraries and urban centers, staying up-to-date on the latest medical advancements and disease treatments can be difficult. GUIDE, developed by AED-Satellife, is a conversion and content management system that transforms medical literature into HTML forms that are easily accessible over a mobile phone.
GUIDE currently runs on smartphones (Samsung I780) in a pilot program in Port Elizabeth, South Africa. For the last year, 50 nurses from three different branches of local hospitals have used mobiles to stay up to date on medical developments.
ChildCount: Monitoring Children's Health Through SMS data sheet 8122 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.
Community Health workers (CHWs) play a vital role in serving poor and rural populations. CHWs are typically in the best position to promote preventive care and convey important health information. CHWs can encourage prompt care-seeking behavior, and detect and refer those at risk for tuberculosis, malaria, and other important diseases. CHWs also have the potential to collect information that is needed at the national level about disease burden and barriers to adopting necessary health practices. CHWs, however, often receive relatively little medical training, have high turnover, and have limited opportunities to reinforce their knowledge once they begin working in the field. They typically lack effective tools required to maintain the longitudinal records required to provide truly effective care. Furthermore, CHWs are difficult to organize and manage for the very reason they are so effective: that they live in the community and only rarely have contact with their supervisors.
Dimagi and D-Tree international are leading CommCare, a mobile-phone based application enables community health workers (CWHs) to provide better, more efficient care while also enabling better supervision and coordination of community health programs
Dimagi and D-Tree international are leading CommCare, a mobile-phone based application enables community health workers (CWHs) to provide better, more efficient care while also enabling better supervision and coordination of community health programs. Each CHW will have a phone running the CommCare software that will assist them in managing household visits and planning their day. CommCare will collect and report data that will help monitor and evaluate community health programs themselves.
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.
