Every year almost 10 million children die before reaching
the age of five despite the fact that two-thirds of these
deaths could be prevented by effective low-cost
interventions. To combat this, the World Health
Organization (WHO) and UNICEF developed the
Integrated Management of Childhood Illness (IMCI)
treatment algorithms.
In Tanzania, IMCI is the national policy for the treatment
of childhood illness. This paper describes e-IMCI, a system
for administering the IMCI protocol using a PDA. Our
preliminary investigation in rural Tanzania suggests that e-
IMCI is almost as fast as the common practice and
potentially improves care by increasing adherence to the
IMCI protocols. Additionally, we found clinicians could
quickly be trained to use e-IMCI and were very enthusiastic
about using it in the future.
This paper presents our work in the design of a
SDS for the provision of health information to caregivers of HIV
positive children. We specifically address the frequently debated
question of input modality in speech systems; touchtone versus
speech input, in a new context of low literacy users and a health
information service. We discuss our experiences and fieldwork
which includes needs assessment interviews, focus group sessions,
and user studies in Botswana with semi and low-literate users.
Our results indicate user preference for touchtone over speech
input although both systems were comparable in performance
based on objective metrics.
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”.
Using Mobile Phones to Improve Child Nutrition Surveillance in Malawi data sheet 2725 Views
Author:
UNICEF Malawi, UNICEF Innovations, Mobile Development Solutions
Publication Type:
Report/White paper
Publication Date:
Jun 2009
Abstract:
This study is the result of a collaboration between Columbia University’s School of International and Public Affairs, UNICEF Malawi, and UNICEF’s Division of Communications Innovations Team in an attempt to use mobile communication devices to facilitate the surveillance of child nutrition in Malawi. As part of the pilot study, health workers at three district growth monitoring clinics were trained to submit child nutrition data via mobile phone SMS (text messages). Using an open-source software platform (RapidSMS), this data was received by a central server and automatically analyzed for indicators of child malnutrition. Health workers received instant feedback messages confirming the information sent and provided additional directions if malnutrition was indicated by the data received. Finally, a website was created to provide the Malawian government and other stakeholders real-time access to this data and its analysis. The report details the pilot study’s findings and outline recommendations for the future use of RapidSMS in Malawi.
This pilot study yielded a number of findings that may be applicable to other development projects using similar mobile phone technology. The results of this particular program included: Significant reduction in data transmission delay compared to Malawi’s current paper-based system. increase in data quality reported by health workers, elimination of the need for time-consuming manual data-entry, increased two-way flow of information between stakeholders at the national government level and health workers in the field, increased system and personnel monitoring capabilities, and elimination of costs related to transporting paper forms and manually entering data.
However, technology can only aid development within a limited scope. The true value of this innovation will be dependent on several other factors, including the integration of RapidSMS into the larger context of health activities and policy making in Malawi; the willingness of the Government of Malawi to take ownership of the platform; the ability to build and develop local technical capacity; and the maintenance of training and monitoring at all levels of participation.
Towards the Development of an mHealth Strategy: A literature review data sheet 1959 Views
Author:
Mechael, Patricia N.; Slonininsky, Daniela
Publication Type:
Report/White paper
Publication Date:
Aug 2008
Abstract:
This report maps out what is known about a broad range of mobile and wireless technologies and the contributions that they are making towards achieving health care objectives in low and middle income countries.
The report is divided into six sections: overview of mHealth as a critical domain within eHealth, review of health-related applications associated with mobile technologies, exploration of how various technologies are being used to achieve health objectives, documentation of key leaders and partnerships that have emerged to test and expand mHealth in low and middle income countries, critical considerations based on early initiatives and research, and key recommendations for next steps in the area of mHealth.
The report is based on an intensive study of peer-reviewed literature, program evaluation and industry reports, grey literature, and communication with a broad range of stakeholders. Recommendations include that key mHealth stakeholders focus their energies on the testing and scale-up of interventions. These interventions should show promise in achieving the key health outcomes as laid out by the Millenium Development Goals (MDG's) for health. Further, the report recommends that the World Health Organization (WHO) serves as a convener of key partners and a broker of mHealth strategies, information, and frameworks.
The potential of mobile communication technologies to reduce professional isolation, facilitate the work of overstretched human resources, and yield cost savings and efficiency is recognized. However, the report concludes that technological solutions should be designed according to local realities and meet local needs in away that practically and measurably contributes to the MDG's or health.
In Uganda, medical clinics keep track of patient and medical payment records on paper. They then carry these often error-ridden forms to a management agency, where the information is manually entered into a database to receive reimbursements for the care provide. The process is tedious, time-consuming and leads to errors that can be costly for the local clinics. Melissa Ho, a Ph.D. candidate at the University of California Berkeley School of Information in the United States, believes that a mobile phone can make the process more efficient and accurate, saving money and resources for local clinics.
Using mobile phones has enormous potential for increasing access to healthcare for poor people aroundd the world, and for improving clinical outcomes. Now a new association, the mHealth Alliance, has been launched to support this emerging field and increase the scale and impact of the many small prokects around the world.
So new, the Alliance has so far no website, press release, or organization yet, it was announced to the BBC as part of the GSMA World Congress in Barcelona. The mHealth Alliance is currently under the auspices of three foundations, the UN and Rockefeller Foundations in the United States, and the UK-based Vodafone Group Foundation.
Deploying mobiles in health care in developing countries is not only promising for health outcomes, it is also a hot and potentially lucrative business area. There is enormous interest by NGOs, donors, telcoms, mobile vendors, researchers, and governments in the the use of mobile phones for increasing healthcare for the poorest people in the world.
UPDATE: Henrietta Fore, the administrator of USAID, announced today the winner of the USAID Development 2.0 Innovation Challenge focused on mobile technology. MobileActive was a judge for the Challenge. The Challenge, a co-production between USAID's Development Commons and Netsquared, focused on mobiles in development. The winner of the $10,000 award is Child Malnutrition Surveillance and Famine Response.
Yesterday I attended the session "OpenRosa mHealth in Tanzania" presented by Gayo Mhila and Neal Lesh. Gayo told us about CommCare, an OpenRosa mobile data collection application which enables community health workers (CHWs) to easily collect patient data through their mobiles. OpenRosa is a consortium for mobile data collection and decision support.
Community health workers serve poor, rural populations, promote preventative care, convey health information, and collect data. Their challenge in being able to use applications such as CommCare include limited network coverage, the fact that it's hard to charge phones in rural areas (solar charger, anyone?), airtime management of personal calls in the case of granted airtime, and understanding of technology.
I asked Gayo about how the CHW's found patients to survey, especially since privacy is such an issue for the population with HIV and TB. He said that health workers direct patients to go to the NGO to get help, so it is their initiative to work with them.
Another audience member mentioned how complicated navigation on donated cellphones was an issue in her project.
How are social movements in the global South taking advantage of the ubiquity of mobile phones? Melissa Loudon, a researcher now working at the University of Capetown, looked at how the South African Treatment Action Campaign (TAC) is using mobiles in their work to advocate for a comprehensive HIV/AIDS policy in South Afric, and wrote this article based on her research.
Kevin Gillan, a researcher on the British anti-war movement, describes social movements as “definitionally collective and communicative”. Co-ordination of protest action, mobilisation of financial resources and strategic interaction would be almost unthinkable without information and communication technologies (ICTs). Although the importance of mass media to social movements has long been recognised, new ICTs burst on the scene in 1999 when demonstrators in the 'Battle of Seattle' orchestrated unprecedented protest action using mobile phones, email and the Internet. Ever since, ICTs have been accepted as an integral part of mobilisation in the North.
Krishnan Ganapathy, a practicing neurosurgeon, is the former president of the Neurological Society of India and current president of the Apollo Telemedicine Networking Foundation. He is also the co-founder of the Telemedicine Society of India, a member of the National Task Force on Telemedicine and an adjunct professor at IIT Madras and at Anna University. He is currently involved in preliminary studies on the clinical evaluation of patients based in rural areas of India, Bhutan, and Bangladesh using wireless telephony. Along with his colleague Aditi Ravindra, Dr. Ganapathy is one of the leading thinkers on mobile health in India and around the world.
DS: A lot of people don't have an understanding of what mHealth is, what telemedicine is, and how mobile phones are being used by physicians, surgeons, and health care professionals. You've been on the cutting edge of all this for a long time ... can you talk to me about how the way you treat patients has changed over the years with the use of mobile phones?
In a mobile phone game in India, a cricket match is played between the teams Demons XI and Safety XI. A report about the game describes it as a “cricket-based game involving balls in the form of condoms, faithful partners, information on HIV and the symbolic AIDS red ribbon.” A team wins by avoiding “googlies and doosra balls - unsafe sex, infected blood transfusions, infected syringes and the company of bad friends.”
The game is part of a growing market of "edutainment" mobile phone games -- games that are designed to provide entertainment and be educational at the same time. MobileActive interviewed Hilmi Quraishi, project director of ZMQ Software Systems, to learn more about the project. Hilmi said that when ZMQ was founded in 2003, it wasn't with the intention of developing games for mobile phones. "Initially we were focused on designing technology solutions for the Internet, but then we realized that in order to expand our reach we need to use technology that is reaching the common man," he said.
Can I get HIV after having sex for the first time? So goes one of the ten thousand SMS messages that teenagers in Nigeria have sent to Learning about Living.
Learning About Living is a project by One World UK, Nigerian NGOs, the MTN Foundation, and the Nigerian Department of Education using computers and mobile phones to teach Nigerian teenagers about sexuality and HIV/AIDS prevention.
Owning a mobile is becoming an indispensable element of young people's lives all around the world. This well-done 30-min video focuses on mobiles in education, explores whether mobiles are a force for good, or an example of technology gone awry; and offers a lot of cultural analysis of how young people use mobiles.
Produced by teachers.tv about young people's use of mobiles (albeit UK-focused), it is a good look at the world of young people with mobile phones, and the impact on schools and education. Young people are mobile natives and schools and NGOs better take heed.
