Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana data sheet 606 Views
Author:
Vélez, Olivia
Publication Date:
Jan 2011
Publication Type:
Report/White paper
Abstract:
Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study's purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce the reporting burden for midwives at the Millennium Villages Project site in Ghana.
From the design science field, the Information Systems Research Framework guided this study through two research cycles: 1) Relevance, and 2) Design. The first phase of the Relevance Cycle took a user-centered approach to assess the people, organizations, and technology of the midwives’ environment through participant observation, contextual inquiry, and interviews. In the second phase, structured requirements specification was used to categorize the data into goals, system qualities, and constraints. From the categorized data, use cases were developed for patient registration, antenatal care, malaria, family planning, and referrals. Use cases then informed the development of functional requirements. In the Design Cycle, we first used functional requirements for patient registration and malaria to develop the mClinic prototype as part of a coded-in-country initiative. Next, we examined usability of the mClinic prototype by conducting field testing, heuristic evaluation, and usability surveys. Additionally, low-fidelity prototyping was used to determine applicability of the other use cases to the midwives’ environment.
Midwives reported inability to access critical data, high patient loads, and extensive reporting requirements. Low technical self-efficacy and inadequate infrastructure were identified as barriers to implementation. Heuristic evaluation noted issues related to hardware selection, workflow, and security. Midwives ranked the tool as useful in the usability survey; however, ease-of-use rankings were neutral. Interviews indicated this was related to low technical self-efficacy. Applicability checks found support for touch-entry prototypes over those that included lengthy forms or text-entry.
Mali has one of the highest infant mortality rates in the world. There are roughly 111 deaths for every 1000 live births in the country and the under-5 mortality rate is 191 out of every 1000 children. The need for early detection of diseases and stronger local health structures led to the creation of Pesinet, a non-profit that uses mobile technology to provide regular health checkups and affordable health insurance for young children in Mali's capital, Bamako.
Roughly 600 children are currently enrolled in the program in the neighborhood of Bamako Coura, under the care of four Pesinet agents (each covering around 150 children). Pesinet combines both early warning systems and insurance. Families pay 500 CF a month for each enrolled child; the payments cover doctor examinations and half the cost of any medications the child needs if he or she gets sick.
Enrolled children are tested weekly for symptoms of illness such as fever, cough, diarrhea, low weight, or vomiting by community health workers who enter data from each visit into a custom-designed Java application on their phone. The data is sent via GPRS to an online database. Doctors at local community health centers monitor the patient data for sudden changes in health. If changes occur, the community health workers receive an alert on their phones and then go back, in turn, to alert the family that the doctor needs to give the child a checkup.
We recently attended the mHealth Summit 2011 to learn more about the latest developments in the mobile health field. The conference brought together developers, practitioners, NGOs, representatives from corporate industries, and government officials to discuss the current state and future of mobile health.
Several key trends emerged among the discussions, focusing on: local buy-in and capacity building, the importance of building partnerships and trust among communities, and the need to transition from short-term pilots to scalable, sustainable mHealth projects.
Scale, Sustainability, and Hype
There was a lot of discussion at the mHealth Summit 2011 about the number of failed pilot projects and the hype around mobile health. More productively, there was considerable discussion on what steps can be taken to reduce the waste (including financial, time, and community good-will) that results from launching unusable, unscalable, or unsustainable mobile health projects. The honest assessment of challenges in the m-health field led to discussions about scalability and sustainability.
This case study analyses the ways in which the Cell-Life initiative, a collaboration between UCT‘s (University of Cape Town) departments of Civil and Electrical Engineering and the Cape Peninsula University of Technology (CPUT), utilises technology-based solutions (in particular, cellphone technology) for the life management of patients living with HIV/AIDS.
Cell-Life is a model example of a socially responsive endeavor which utilizes technology to overcome limitations and constraints. The use of cellphones to save lives by aiding adherence to the ARV medication regime and gather data is a remarkable contribution to the fight against the HIV/AIDS pandemic and signifies an intersection between the academic endeavour, innovation and the lives of ordinary people on the ground. The open approach taken by the organisation in sharing its work also illustrates how research is able to contribute to the 'undead count' (i.e. the number of lives saved) of academic research, which must surely be considered the greatest achievement of any endeavor.
Case Study for Incorporation of Mobile Technology in Maternal, Neonatal and Child Health (Manoshi) Program at BRAC Health data sheet 861 Views
Author:
ClickDiagnostics
Publication Date:
Jan 2009
Publication Type:
Report/White paper
Abstract:
After extensive studies of BRAC’s health services for mothers, neonates and children in rural and urban areas (MNCH and Manoshi, respectively), ClickDiagnostics has developed a mobile phone-based solution for streamlining BRAC’s data collection procedures in Manoshi, enabling BRAC to take a more pro-active approach in strategizing and reaching the women most in need in the urban slums.
ClickDiagnostics is in the concluding stages of piloting thissolution jointly with BRAC, and after the completion of the project in January, will support BRAC in refining the model and scaling up for nationwide implementation in MNCH and Manoshi projects, and possibly also in BRAC Health’s other program.
One important reason why many pregnant mothers succumb to death or preventable miscarriages is that it is expensive for government or non-government health organizations to track pregnant mothers to assess their level of risk and prioritize its limited resources for targeted intervention. A model in which community health-workers use ICT to gather real-time information about pregnant women and send to a specialist can help to address this gap and help health organizations take precautionary measures about risky cases of pregnancies.
Improving Standards of Care with Mobile Applications in Tanzania data sheet 964 Views
Author:
Bogan, Molly, Jan van Esch, Gayo Mhila, Brian DeRenzi, Caroline Mushi, Timothy Wakabi, Neal Lesh, Marc Mitchell
Publication Date:
Apr 2009
Publication Type:
Report/White paper
Abstract:
In this paper, we present D-tree International’s work with medical algorithms and mobile applications to improve the standards of care in clinical and community settings. In particular, we present a mobile phone-based application called CommCare which helps community health workers (CHWs) to provide home-based care and social support to HIV, tuberculosis and other chronic patients. The application guides the CHWs through a series of questions which they answer using the phone’s number pad. The data then can be submitted directly to a central database over a cellular GPRS network.
We report on our experience developing and testing the application in Tanzania, including the iterative development process with the CHWs and training them to use the program. We include an account of some of the hardware and software issues encountered and resolved during the process, and some initial reactions from the first CHWs and clients to use the program. While the formal evaluation of the program is still in progress, initial findings show that the phonebased system is generally viewed positively by the users and by the clients as more discreet and better for privacy than the paper-based system.
uReport: Citizen Feedback via SMS in Uganda data sheet 3470 Views
For aid organizations, knowing what local communities and beneficiaries want and need is the key to running successful, sustainable programs. In Uganda, UNICEF is using mobile phones and broadcast media to get direct feedback from Ugandans on everything from medication access to water sanitation. The project, called uReport, allows users to sign up via a toll-free shortcode for regular SMS-based polls and messages. Citizen responses are used both in weekly radio talk shows to create discussion on community issues, and shared among UNICEF and other aid organizations to provide a better picture of how services work across Uganda.
Sean Blaschke, a Technology for Development specialist at UNICEF Uganda, explains that uReport gathers information from participants and informs citizens of their rights and available services. Recent polls have included questions about school dropouts, water point availability, mosquito net usage, and youth employment, all collected via SMS polls.
The collection and analysis of information from the field is a big part of ensuring that programs are working correctly. Recently, journalist Justin Smith interviewed George Mu'ammar of the World Food Programme's Vulnerability Assessment and Mapping Unit on how his department uses mobile technology to collect data. Listen to the podcast below:
Whether in the developing world or the business sector, the majority of mobile data collection efforts parallel the processes set down by their largely paper-based predecessors. In traditional data collection systems information is collected from a variety of sources, funnelled to a single point and eventually compiled, sorted and (hopefully) acted upon. In many cases this workflow meets the basic needs of data consumers and in some cases is preferable.
Let's consider some of the challenges posed by traditional one-way data collection systems.
The people performing data collection (usually referred to as "mobile workers") don't have access to the wealth of raw information available to data consumers. This makes mobile workers outsiders to the big picture and lessens their potential contributions to the overall data collection effort.
Solutions pull collected data into a black hole: once it's submitted there's very little the mobile worker can do to access it for review or to make corrections.
Implementations often force knowledgeable team members to work in a void. If data cannot be easily and seamlessly shared between team members collaborative efforts will be impeded and their overall effectiveness reduced.
When team members cannot "see" what others in the group are doing, the chances of double-entry and redundant information are all the more likely.
When aggregated data finally returns to mobile workers it is often severely outdated.
Solutions are not really mobile if they require workers to access desktops or laptops to complete tasks essential to the data collection process. This is also true if the tools make it impossible to take pertinent portions of the data set with them for online & offline use.
Group Complete has coupled the power and open architecture of Open Data Kit and XForms standards with CouchDB to provide a mobile and real-time collaborative data collection platform.
Tool Category:
App resides and runs on a mobile phone
App resides and runs on a server
Is a web-based application/web service
Key Features :
Share collected data between mobile team members and data consumers in real-time
Allow team members to collaborate on data entry and review collected data, regardless of their locations
Reduce double entry, increase team cooperation and still employ more traditional workflows when needed
Perform all of the major functions of data collection on a smartphone (form building, data entry & export)
Use Group Complete Mobile to work offline
Integrate with Open Data Kit and XForms workflows
Main Services:
Voting, Data Collection, Surveys, and Polling
Location-Specific Services and GIS
Mobile Social Network/Peer-to-peer
Information Resources/Information Databases
Display tool in profile:
Yes
Tool Maturity:
Currently deployed
Release Date:
2011-03
Platforms:
Android
Linux/UNIX
Current Version:
0
Program/Code Language:
Java/Android
Javascript
Other
Organizations Using the Tool:
n/a
Number of Current End Users:
100-1,000
Number of current beneficiaries:
100-1,000
Support Forums:
http://www.groupcomplete.com/help
support@groupcomplete.com
Languages supported:
English (multi-lingual capable)
Handsets/devices supported:
All versions of Android 2.2, 2.3 and 3.x supported. Support for Android 2.1 coming soon.
Water is becoming one of the most contested resources in the world as populations increase and the availability of fresh water decreases. MobileActive spoke to the team behind NextDrop, an organization that uses mobile technology to monitor water flow in urban India.
Designed by a team of Berkeley and Stanford graduate students, the idea for NextDrop came out of a class at Berkeley's School of Information on how to use information technology for sustainable development. A group of students wanted to track intermittent water supplies in India. NextDrop was born. Ari Olmos, one of the team members running NextDrop, explains, “There was an opportunity to use information technology to improve the situation and create a schedule and feedback loop.”
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.
Cutting Costs, Boosting Quality and Collecting Data Real-Time: Lessons from a Cell Phone-Based Beneficiary Survey to Strengthen data sheet 1591 Views
Author:
Schuster, Christian and Perez Brit, Carlos
Publication Date:
Feb 2011
Publication Type:
Report/White paper
Abstract:
A 2010 Country Governance and Anti-Corruption (CGAC)-funded pilot in Guatemala employed entry-level mobile phones in conjunction with EpiSurveyor, a free, web-based software for data collection, to drastically reduce cost, facilitate accuracy and accelerate implementation of a nationally-representative beneficiary survey of Guatemala‘s conditional cash transfer program.
As such, it illustrates the potential of mobile phone-based data collection to strengthen program monitoring, evaluation and implementation, in particular in remote and marginalized areas highly populated by indigenous peoples.
Roughly 13 percent of the world’s population still lacks access to a regular supply of clean drinking water, and monitoring current water pumps and sanitation points is an important part of making sure that areas that have gained access to clean water don’t lose it. Water for People is a non-profit organization that monitors water and sanitation points in the developing world; last February, the organization began to investigate how mobile technology could help their work and from this, FLOW was born.
FLOW (Field Level Operations Watch) is an open-source, Android application that allows field workers to use mobile phones to document how well water pumps and sanitation points in the developing world are functioning, then transmit that data to create an online tagged map of target regions.
Open Data Kit: Tools to Build Information Services for Developing Regions data sheet 1338 Views
Author:
Hartung, Carl, Yaw Anokwa, Waylon Brunette, Adam Lerer, Clint Tseng, and Gaetano Borriello
Publication Date:
Dec 2010
Publication Type:
Report/White paper
Abstract:
This paper presents Open Data Kit (ODK), an extensible, open-source suite of tools designed to build information services for developing regions. ODK currently provides four tools to this end: Collect, Aggregate, Voice, and Build. Collect is a mobile platform that renders application logic and supports the manipulation of data. Aggregate provides a “click-to-deploy” server that supports data storage and transfer in the “cloud” or on local servers. Voice renders application logic using phone prompts that users respond to with keypad presses. Finally, Build is a application designer that generates the logic used by the tools. Designed to be used together or independently, ODK core tools build on existing open standards and are supported by an open-source community that has contributed additional tools. We describe four deployments that demonstrate how the decisions made in the system architecture of ODK enable services that can both push and pull information in developing regions.
If you're interested in using mobiles and ICTs for data collection, the sheer number of tools and projects can be overwhelming. With so much out there, the need to highlight good projects and consolidate practical information is clear. Here is a handy reference guide to all the data collection information we've accumulated on MobileActive.org.
The Ultimate Resource Guide
We recently created the Ultimate Resource Guide, an easy-to-use spreadsheet that breaks down our data collection content into clear categories:
Web content: A compilation of blog posts, case studies, and regular posts that focuses on data collection.
Peer Reviewed Research: A collection of journal articles, research papers, and literature reviews related to mobile data collection.
Reports and Evaluations: A matrix of 20+ case studies, broken down by issue, area of practice, target country, and type of evaluation.
How-Tos: Instructions for setting up many of the most popular data collection tools, such as ODK, RapidSMS, and EpiCollect.
Inventory: An inventory of current data collection projects around the world, compiled through user submissions and MobileActive's research. Thanks to all who contributed!
Comparison Matrix
We developed a comparison matrix assessing ten different mobile data collection tools against a core set of metrics, both technical (platforms, data type collected, required operating systems, security, etc...) and non-technical (such as cost, language, and support). If you want to implement a data collection project, the comparison matrix can help you to determine which tool is best for your project.
Research
There is a great deal of academic and analytic research on mobile data collection. For example, check out these two practical pieces that examine how mobiles and ICTs are used in the field:
Our slidecast that examines the effectiveness of PDA-based questionnaires vs. paper questionnaires for collecting health data in Fiji.
A literature review that provides an overview of the components, approaches, and techniques used to build mobile phone-accessible, SMS applications for data collection and service delivery.
We recently developed a comparison of mobile data collection tools. Thank you to all of you who provided valuable feedback. Here's what's been added and changed from the draft version:
We added two tools: GeoChat and GATHERdata.
Added FrontlineForms to the FrontlineSMS description.
Three fields have been added to all tools: form question and logic overview, native data analysis/reports, and data export.
Integrated comments on existing material into the spreadsheet.
We'll add and revise tools regularly. Please comment and tell us what's missing!
Audience
The matrix is aimed at program managers, or those in similar roles, whose responsibility it is to choose the best mobile data collection technology for their project.
Today, December 1st, is World AIDS Day, a day that is all about raising awareness, countering prejudice, and helping stop the spread of HIV/AIDS. MobileActive.org has put together some of the mobile projects and organizations we've covered recently that are innovating with mobile tech in the fight against HIV and AIDS.
RedChatZone: HIV Counseling via Mobile Instant Messaging Chat
This project is an innovative mobile-based platform for youth and young adults to learn more about HIV and to get support by offering them the ability to communicate anonymously and privately via MXit with a trained counselor.
The PoiMapper application allows a user to create a case-specific questionnaire, collect data, and upload it to a database. PoiMapper also allows the user to take photographs of specific points of interest (POIs) being recorded and these images are also uploaded to the database. Another feature is that the system can be used to update existing data.
Tool Category:
App resides and runs on a mobile phone
Is a web-based application/web service
Key Features :
1. Define program specific point-of-interests (POIs), routes and areas with associated data to be collected. Data can be of multiple types: text, numbers, single and multi-choice alternatives, conditional sub-questions.
2. Capture pictures to be included for POIs.
3. Collect data with affordable mobile phones with GPS and camera.
4. Upload data directly to a central database over the cellular network or via an internet connected computer, edit existing data in the mobile device during follow-up visits.
5. Back-office reporting and analysis.
6. Visualize the collected data in different ways.
PoiMapper: Mobile Data Collection Through Points-of-Interest in Kenya data sheet 3487 Views
PoiMapper, a product from Pajat, is a mobile application for data collection, hosting, and sharing. It works on a feature phone with Java capability and allows a user to design a case-specific questionnaire to collect field data, including numbers, text, and photo images. Through this, it supports the collection of point-of-interest (POI) data -- hence the name, PoiMapper -- and is currently being tested in this capacity in Kenya in collaboration with Plan Kenya, Plan Finland, Helsinki University of Technology, and University of Nairobi. The pilot is ongoing and an evaluation is to be done a month from now.
Zambia: Implementing The End Use Verification Survey Using Mobile Phone Technology data sheet 1992 Views
Author:
USAID
Publication Date:
Nov 2009
Publication Type:
Report/White paper
Abstract:
In November 2009, the USAID | DELIVER PROJECT office in Zambia, with technical assistance from the home office, conducted the End-Use Verification activity to assess the performance of the logistics management and supply chain systems for selected essential drugs, malaria and family planning commodities.
The survey was used in conjunction with the ongoing Essential Drugs Logistics System Pilot in Zambia, and overall objective was to assess how the logistics systems managed selected commodities at public health institutions, as well as provide a snapshot of how malaria was being diagnosed and treated at lower level facilities. This report presents the findings of the assessment as well as the short- and long-term recommendations to successfully implement the End-Use process, as well as the use of EpiSurveyor for regular data collection purposes.
Mobile Phones and Development: An Analysis of IDRC-Supported Projects data sheet 3184 Views
Author:
Ahmed T. Rashid and Laurent Elder
Publication Date:
Jan 2009
Publication Type:
Report/White paper
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.
Web based platform for collecting structured data using various mobile devices. Design surveys and share them through URLs with any mobile user. No installation required.
Tool Category:
Is a web-based application/web service
Key Features :
Unlimited forms, pages and fields
Upload custom Excel or CSV lists
Fully exportable results
No software installation required
Compatible with all recent mobile devices
Optimized mobile user interface
10 different input field types
Quick entry using barcode scanning
Main Services:
2D Barcodes
Voting, Data Collection, Surveys, and Polling
Display tool in profile:
Yes
Tool Maturity:
Currently deployed
Release Date:
2010-08
Platforms:
Android
Blackberry/RIM
Mac/Apple/iPhone
Windows Mobile
All phones/Mobile Browser
Current Version:
1
Program/Code Language:
Python
Number of Current End Users:
Under 100
Languages supported:
English, Slovenian
Handsets/devices supported:
* Windows Mobile 6.1 or later (Internet Explorer Mobile)
* Google Android 1.6 or later (built-in browser)
* Symbian^1 or later (Nokia)
* iOS 3.x or later (iPhone Safari)
* Opera Mobile 10 browser or later
Want to use mobiles for data collection? Don't know where to start your research or where to read evaluations of existing and past mobile data collection efforts? You're in luck! We've produced the resource guide you've been waiting for.
Recently, MobileActive.org collaborated with UN Global Pulse to crowdsource an inventory of mobile data collection projects around the world. While this growing inventory shows there is enormous interest to leverage mobile technology for data collection, technical reports and evaluations of deployments and pilots are scattered.
So, we took the lead and compiled the existing literature (as best as we could) in an easy-to-use spreadsheet here.
One of the the key functions of mobile phones is their use in data collection. We have seen lots of online discussion here at MobileActive.org and elsewhere on the subject.
Here, we feature a peer-reviewed journal article from our growing list of resources on mobile data collection. In this 2009 paper, Ping et al. evaluated the effectiveness of PDA-based questionnaire verses a paper-based method for public health surveillance in Fiji.
