Mobile-based projects for social change can be found in any issue area: mobile health, mobile money, initiatives that promote advocacy, citizen journalism, democratic participation, and economic livelihoods. While projects vary in scope, objectives, and platforms, one consistency between many successful projects is a good working relationship with the mobile network operator in a given country.
Mobile network operators, or MNOs, go by many names: mobile providers, cell providers, telecommunications companies. In this article, we focus on MNOs in the traditional sense: companies that provides mobile network services.
Mobile phones are being tried and tested in myriad ways in health care. They are used for data collection and disease surveillance, for ensuring treatment compliance, for managing health information systems and point-of-care support, for health promotion and disease prevention, and for delivering emergency medical services. Clearly, m-health, as this growing field is dubbed, is here to stay.
At the same time, achieving scale and sustainability in most m-health projects has been a challenge. One of the key aspects of beginning to think about ways to integrate m-health into health systems in a sustainable way is to establish financial systems to pay for health services and to ensure financial accountability within programs.
The Vodafone Americas Foundation and the mHealth Alliance are announcing a call for entries for the annual Vodafone Americas Foundation Wireless Innovation Project mHealth Alliance Award, a competition to identify and support promising wireless-related technologies to address critical social issues around the globe. Proposals will be accepted from September 27, 2010 through December 15, 2010, with the final winners announced in April 2011.
Sana Mobile: Connecting Big-City Care to Patients in Remote Villages data sheet 6810 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.
Mobile Learning for HIV/AIDS Healthcare Worker Training in Resource-Limited Settings data sheet 2445 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.
Sana, is a student organization based at the Massachusetts Institute of Technology (NextLab, Center for Transpotation and Logistics, Engineering Systems Division) that offers an end-to-end system that seamlessly connects health workers to medical professionals. In addition, the group assists its partner organization with implementation through collaborative innovation. The team consists of volunteers with diverse background – medicine, computer science, clinical informatics, health policy, social sciences, and business and operations management. It strongly believes that there is a need to bring together experts from various disciplines in order to design an operating system around the delivery of care that is facilitated by mobile technology. The technology is crucial, but not the sole component of the solution. It is the centerpiece of a learning system that is designed not only to improve clinical outcomes, but the health delivery process itself.
Improving Efficiency of Monitoring Adherence to ARV at PHC Level: Case Study of Introduction of Electronic Technologies in SA data sheet 2899 Views
Author:
Xanthe Wessels; Nicoli Nattrass; Ulrike Rivett
Publication Date:
Oct 2007
Publication Type:
Journal article
Abstract:
This paper presents a case study of the efficiency gains resulting from the introduction of electronic technologies to monitor and support adherence to highly active antiretroviral therapy (HAART) in Guguletu, South Africa. It suggests that the rollout of HAART to such resource-poor communities can be assisted significantly by the introduction of modified cellphones (to provide home based support to people on HAART and improve the management of adherence data) and simple barcoding and scanning equipment (to manage drug supplies). The cellphones have improved the management of information, and simplified the working lives of therapeutic counsellors, thereby enabling them to spend less time on administration and to devote a constant amount of time per patient even though their case loads have risen threefold. It has helped integrate the local-level primary health service provision of HAART with the kind of centralised data capture and analysis that could potentially support a national HAART rollout.
Open Source Data Collection in the Developing World data sheet 2699 Views
Author:
Yaw Anokwa, Carl Hartung, Waylon Brunette, Gaetano Borriello and Adam Lerer
Publication Date:
Oct 2009
Publication Type:
Journal article
Abstract:
The ability to collect data is key to the success of many organizations operating in the developing world. Given the weaknesses of current tools and the surge in mobile phone growth, there's an opportunity for mobile and cloud technologies to enable timely and efficient data collection. This paper discusses Open Data Kit (ODK), a suite of tools that enable efficient and timely data collection on cell phones. ODK is designed to let users own, visualize, and share data without the difficulties of setting up and maintaining servers. The tools are easy to use, deploy, and scale. They also go beyond open source - they're based on open standards and supported by a larger community.
The Use of Mobile Phones as a Data Collection Tool: A Report from a Household Survey in South Africa data sheet 2576 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.
The usage of mobile phones is abundant in our daily lives in various aspects from making phone calls or sending text messages to checking e-mails or news updates to planning our activities or managing our budget. This project aims at making use of this wide spread usage of mobiles to help in the data collection process. It designs and develops a web based system called “MobiCollect” that is used for creating forms or questionnaires to be later accessed by the data collectors using their mobile phone web browser in order fill in the form with the appropriate data.
Once the system design and implementation is completed it will be tested and evaluated to ensure the satisfaction of at least the minimum requirements of the proposed system.
This paper provides an overview of the implications of this trend for the delivery of healthcare services and population health. In addition to addressing how mobile phones are changing the way health professionals communicate with their patients, a summary is provided of current and projected technologic capabilities of mobile phones that have the potential to render them an increasingly indispensable personal health device. Finally, the health risks of mobile phone use are addressed, as are several unresolved technical and policy-related issues unique to mobile phones. Because these issues may influence how well and how quickly mobile phones are integrated into health care, and how well they serve the needs of the entire population, they deserve the attention of both the healthcare and public health community.
A how-to guide on using and implementing RapidSMS for mobile data collection and communication.
Ths manual give an overview for how to implement and use RapidSMS in a mobile data collection project. RapidSMS is a SMS framework for data collection, group coordination, and complex SMS workflows. The tutorial outlines when and when not to use RapidSMS, guides the user through project steps and milestones, outlines factors for a successful implementation, and provides worksheets for project planning. Example training materials are included.
The Case for mHealth in Developing Countries data sheet 2947 Views
Author:
Patricia N. Mechael
Publication Date:
Jan 2009
Publication Type:
Journal article
Abstract:
The aim of this paper is to encourage reflection and discussion around the potential of mHealth in developing countries and to consider how early experiences can inform the way forward. Toward this aim, I synthesize many reviews and presentations from the eight years I have been studying the evolution of mobile phones and health in developing countries. I include observations and discussions that are now shaping the creation of mHealth as a field, to highlight the ingredients we need to move from a series of pilot projects and isolated business opportunities to a full-scale maximization of health-related benefits.
I begin by reviewing the strategic priorities within global health, where mobile telephony can have the greatest impact, along with organic health-related uses of mobile phones, and examples of formal mHealth interventions. I then demonstrate the potential for mobile phones to become an extension and an integral component of eHealth, describing how information and communication technology (ICT) can be used in health care, as well as mHealth, as a subset of mServices: using mobile devices to deliver services such as banking and health. I also show how trends and interests are converging among key stakeholders within the mHealth ecosystem, thus forming a foundation on which we can scale up and sustain more and better mHealth activities. Finally, I present some tactical guidance for a way forward that will further the objectives of both public health and business, particularly in outreach efforts to emerging markets, the bottom of the pyramid, and the next billion mobile phone subscribers.
Every ChildCounts: The Use of SMS in Kenya to Support the Community-Based Management of Acute Malnutrition & Malaria in Children data sheet 3293 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.
Engineering Rural Development data sheet 3377 Views
Author:
Parikh, Tapan S.
Publication Date:
Jan 2009
Publication Type:
Journal article
Abstract:
Presented here is an overview of the operational needs of NGOs and CBOs and the role information systems can play to increase their accountability and efficiency. Information systems need to fit the diverse operational needs of NGOs and CBOs, which include coordinating activities, training and monitoring staff, documenting results, accounting, reporting, decision making and learning, acquiring external information and encouraging community participation.
Unfortunately, there are gaps in information systems that impede the ability of NGOs to embrace ICT. To name a few, the lack of open, accessible, cross-platform mobile development tools, limited opportunities and resources provided to local small software companies to engage with NGOs, and the lack of long distance networking technologies to reach remote locations.
Two examples of technologies that were applied successfully are shared: Self Help MIS, an application to monitor activities of small microfinance organizations and credit groups and DigitalICS, an application for data collection used by agricultural cooperatives. The author stresses that ICTs should be viewed as a tool to allow local change agents to be more effective and accountable and shows how computing is able to support local organizations by inspiring innovation, implementation and dissemination of projects, and measuring impact.
Components of SMS-Based Data Collection and Service Delivery data sheet 3365 Views
Author:
Matt Berg
Publication Date:
May 2010
Publication Type:
Report/White paper
Abstract:
An overview of the components, approaches and techniques used to build mobile phone-accessible applications that use SMS text messages as a conduit for data collection and service delivery. SMS-based applications represent a paradigm shift allowing innovative new approaches to monitoring and data collection fundamentally changing the way we can approach the delivery of critical health, economic and social services in resource-poor settings. SMS has the potential to fill significant connectivity and service gaps, particularly for the world’s poor, until data networks and phones that can support them become more ubiquitous.
This guest post was written by Nicolas di Tada, Director of Platform Engineering at InSTEDD. He writes about an ingenious way 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.
During our visits to provincial offices, we received useful feedback which ultimately led to the design of the current syntax. However, in health centers we found a few issues that needed to be solved before any syntax at all could be used:
Most people do not know how to send SMS.
Some of them do not know how to read an incoming SMS.
Support for Khmer and Thai characters is not common in the handsets and carriers most people use.
Even if there is support for the characters, writing SMS using them is much more difficult than writing in English due to the amount of letters in the alphabet.
These posed a huge barrier to solve even before the reports could be collected. It was not about simplifying a syntax.
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.
As we are completing an inventory of mobile date collection projects around the world that are focused on vulnerable populations and early warning, we've come across a few efforts that are worth highlighting. One is the SMS and PDA-based surveying of the World Food Programme (WFP). WFP's food security monitoring systems are set up in many countries. While some countries are still submitting paper records, there is a push to incorporate PDAs or SMS data transmission for faster and more reliable monitoring of food security.
The data collected includes both food security baseline data and food insecurity indicators. The bulk of WFP's data collected focuses on nutritional indicators, market prices, import, cross border trades, socioeconomic indicators, and health indicators. The UN agency is trialing both FrontlineSMS and RapidSMS, two mobile data collection software tools, in its current projects, as well as PDAs but is likely going to standardize its operations using one of the two with some custom gateway software.
In the process of collecting data, WFP always collaborates with governments and other UN partners. WFP staff are involved with the supervision, training and coordination but but the people who conduct interviews and collect the data are usually government staff, university students, or NGO workers As one WFP staffer noted, "We have huge armies of data collectors."
The scope of the work is accordingly large. Some of the efforts cover an entire country. In Senegal, for example, WFP has 250 numerators covering the country – 22 teams of 11 people each who are collecting data for six weeks, visiting 2,000 villages.
The video below features George Muammar of the WFP Vulnerability Analysis and Mapping Unit. He describes rapid data collection in an Emergency Food Security Assessment in Goma, N. Kivu, Democratic Republic of Congo.
During the last FailFaire (well, actually the first one to date) we were reminded by a guest rather sternly that NGOs often forget who their users are and, more importantly, what the needs of these users are. When we, collectively as a field, implement mobile deployments with constituents or groups, do we tend to forget user needs and capabilities, getting too enchanted with the tech (and ourselves) and then fail when, not surprisingly, there isn't any uptake? We have seen many a project fail for precisely this reason. Our grouchy attendee had a point even if he did not deliver it very gracefully.
To this end, we are reposting here a recent report from Zambia. Project Mwana is UNICEF Innovation project that is "working with the Zambian Ministry of Health, UNICEF Zambia, the Malawi Ministry of Health, UNICEF Malawi and many implementing and technical partners to find appropriate, scalable and impactful ways that mobile technologies can strengthen health services for mothers and infants in rural health clinics."