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Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

Don’t Miss Raj Shah on 20/20 Tonight!

BY: Raj Shah, U.S. Agency for International Development (USAID) Administrator

This Post originally appeared on ABCNews.

Raj Shah holds up his hads, with the words 1 million moms written on his palms Ensuring the safety of a mother and her newborn is not only one of the greatest development challenges we face, it is also one of the most heartbreaking.

Earlier this year, I visited South Sudan, where I met school children studying in a classroom—some of them for the very first time. Although I was optimistic about their future, I was also concerned, because I knew that for every girl I met, she was statistically more likely to die in childbirth than complete a secondary education.

This reality is simply unacceptable.

There is an incredible need to ensure the safety of mothers and infants in the critical period of 48 hours surrounding birth. To help spur progress in maternal and child health, we launched our first Grand Challenge for Development – Saving Lives at Birth – in partnership with the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada and The World Bank.

Saving Lives at Birth calls for groundbreaking prevention and treatment approaches for pregnant women and newborns in rural settings during this perilous time around childbirth. We received more than 600 proposals to our Grand Challenge, more than a quarter of which arrived from the developing world. Last week we announced our three transition-to-scale grant nominees. These nominees have proven that their ideas can deliver real results in local communities and are ready to test them on a much larger scale. While we expect our first round of grants to yield exciting innovations with the potential for significant change, we will encourage our community of innovators to push boundaries and find new ways to shape collective action.

Similarly, the Million Moms Challenge is inspiring American families to help mothers and children around the world. I am proud to accept this Challenge and will continue my commitment to this important cause.

I hope you will too.

December 16, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Weaving eHealth Into the Fabric of the African Health System

The 4th Afrihealth Conference, held in Nairobi, Kenya on Nov. 30 and Dec. 1, broadened the debate on the adoption of Telemedicine, mHealth and eHealth in Africa, and brought attention to the need to integrate and mainstream eHealth into the continent’s health system.

The theme of the conference was “consolidating the gains of technological innovation in healthcare through effective management,” and some debate sparked on what direction to take eHealth in Africa.

According to Science and Development Network reporter Maina Waruru, experts attending the conference argued that “a focus on high-tech healthcare solutions could come at the expense of basic prevention such as access to clean water and sanitation, good nutrition and hygiene, and health education.” Since 80 percent of illnesses in Africa stem from preventable infectious diseases, this focus on high-tech is a move in the “wrong direction.”

But the potential for using ICTs to continue to improve basic healthcare in Africa is great, and a focus should be on ensuring that appropriate technology is utilized and effectively delivered.

One concern attendees brought up was the lack of a legal framework to determine what qualifies a person to work as an “e-health” professional. E-health is often practiced by non-professionals such as ICT technicians and nurses, and many countries have not established what qualifications are needed to be certified as a professional.

In addition, physicians in many countries are of an older generation and received their degrees before the ICT explosion. Many are not comfortable with situations where they consult with patients remotely, without actually being in the room with them.

Image from Dr. Kwankam's powerpoint presentation at Afrihealth conference

From Dr. Kwankam's presentation at Afrihealth 2011 conference

To address some of these issues, Shariq Khoja, the coordinator of the e-health program at Aga Khan University, has suggested that laws should be put into place to “accommodate and mainstream [e-health].” According to Dr. Yunkap Kwankam of the International Society for Telemedicine and eHealth, “for eHealth to take root and thrive…it must itself be transformed…we must weave eHealth into the fabric of the health system.”

Dr. Kwankam claims that Africans can benefit from technology changes by effectively managing it and charting a course for ICT in health through an organized eHealth profession, national eHealth policies and strategies, and addressing large eHealth challenges, such as scaling up eHealth interventions.

Dr. Kwankam and other experts’ presentations from the conference are now available.

December 7, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Originally posted on the GBI Portal

CrowdOutAIDS: Engaging Youth to Develop AIDS Policy

CrowdOutAIDS, the online crowdsourcing project that engages young people in developing a UNAIDS strategy on youth and HIV, has wrapped up its fifth week. The project launched in October 2011 and will run for two months, with the final crowdsourced strategy to be produced in January.

Crowdsourcing is a technique used to quickly engage large numbers of people to generate ideas and solve complex problems. CrowdOutAIDS’ target “crowd” is young people, 3,000 of whom become infected with HIV every day and 5 million of whom currently live with the virus.

The project’s approach is to follow a four-step model:

Connect young people online
Share knowledge and prioritize issues
Find solutions
Develop collective actions on HIV

Once the fourth step is completed, the UNAIDS Secretariat will put the youth strategy into action, and the strategy could become an advocacy platform in future UNAIDS work.

Currently the project is in the second stage of sharing knowledge. Youth from all over the world have been connected through eight regional Open Forums that are in Arabic, English, Spanish, French, Russian and Chinese. The moderator of each forum starts each day with a question (such as “What is your description of a healthy relationship?”) and participants respond and interact with one another.

The first week of the project revealed some of the major problems, in the eyes of youth participants, with UN agencies’ current approaches to working with youth. Participants expressed concerns that UN initiatives of working with youth in HIV response lack strategic vision and have no clear plan, and hinder young people from participating in decision-making.

It will be interesting to see what solutions are developed after the knowledge sharing step is completed, as well as what direction the UN youth and HIV strategy takes over the next six weeks. Be sure to check out the CrowdOutAIDS website and Twitter @CrowdOutAIDS for continuous updates.

November 28, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Mobile Health App Launched in Kenya Will Increase Access to Healthcare Information

MedAfrica, the Nairobi-launched mobile health app that makes basic health information more readily available through phones, is generating buzz in mHealth for Africa.

The app was developed by the start-up tech firm, Shimba Technologies, and boasts a sustainable, innovative business model. Shimba CEO Steve Mutinda says the tech company “aims to achieve by creating platforms that facilitate dissemination of information and build communities around the different issues and conditions [in health] while at the same time converging all stakeholders and amplifying their efforts.”

The platform provides information such as doctor and hospital listings, drug authenticators, and lists of symptoms with suggestions for self-diagnosis. This sort of symptom checking could be very useful in countries like Kenya, where as little as 14 physicians exist for every 100,000 people. Members of MedAfrica explain that because the app is providing such valuable information to clients, as well as recommending good doctors and dependable, lab-tested drugs, users are willing to pay for the service.

Originally meant to provide health information solely in Kenya, MedKenya was the overall winner for the East African mobile tech event Pivot25 competition. Changing the name to broaden the app’s potential scope, MedAfrica presented at Demo Fall 2011; in video below, VentureBeat interviews Mutinda and a colleague.

The best news about the launch of the app is its potential scalability. The organization wants to use its launch in Kenya as a road map to scale the product to other African countries. MedAfrica’s mission is to reach every household in Africa.

The content for the app will come from partners such as the Nairobi Hospital and open data from the Kenyan government. During the launch, Kenya’s ICT Board Chairwoman Catherine Ngahu called on other medical institutions, physicians, and health providers to supply content for the app as well.

Given Kenya’s track record in developing some of the most innovative apps in Africa, if not the world, it’s no surprise that MedAfrica has garnered so much attention and holds so much hope for expansion.

November 9, 2011/by actualize

Agriculture, Health, Mobile, Originally posted on the GBI Portal

Is mHealth Taking Off in the Middle East?

A recent report compiled at the United Arab Emirates’ Mobile Show illustrates that citizens overwhelmingly believe that the mobile industry in the Middle East can have a positive effect on the health sector, emphasizing the great potential for mHealth in the region.

Mhealth – or mobile health – is a consistently reported topic in the ICT4D field, with projects popping up in developing countries on a daily basis. While many of these projects are being undertaken in sub-Saharan Africa and Southeast Asia, there is less news on mHealth initiatives in the Middle East.

Photo credit: mHealth Insight

Take Health Unbound (HUB), for example, the mHealth Alliance’s open source database of mHealth projects around the world. Of the 217 projects in the database, only about 8 are located in the Middle East, as opposed to 37 in Southeast Asia and a whopping 109 in sub-Saharan Africa.

But recent reports indicate that more attention is being given to mHealth in the Middle East. One article states that the Middle East has been a “hotbed for mHealth development,” reporting on various mHealth initiatives in the region. Qatar’s Supreme Council of Health announced that it will launch an app that locates clinicians, physicians and other health resources in the country, and two mobile companies in Qatar have partnered up to offer health and wellness education using mobile phones. In addition, the first mplushealth conference will take place at the Arab Health Exhibition and Congress in Dubai in January. The conference will bring together healthcare professionals, insurance providers, government regulators and telecommunications decision-makers to explore mHealth opportunities in the Middle East and hopefully pave the way for the sector to thrive.

The UAE Mobile Show report also revealed challenges that need to be overcome before mHealth can take off in the region. 73 percent of respondents indicated that patient-physician confidentiality was a major concern in implementing a mobile health system, as well as privacy, security, high costs, network infrastructure and technology.

Photo credit: AMEinfo.com

These obstacles may be part of the reason that mHealth initiatives in the region have remained primarily in the hands of independent mobile app developers, without much governmental support. But as attention on mobile health in the Middle East continues to grow, the region could be one to watch for future mHealth innovations.

November 1, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Originally posted on the GBI Portal

Monitoring and Evaluation in mHealth: Opportunities and Challenges

Last week’s mHealth working group meeting laid out the opportunities, challenges, and potential of monitoring and evaluation (M&E) within the mHealth sector.

JhPiego circumcision promotion through texting service

Poster in Swahili promoting male circumcision through SMS service, part of Jhpiego program

Several experts in the field presented their experiences of monitoring and evaluating mHealth projects, emphasizing the considerable potential that mobile projects offer in generating robust and accurate data. Kelly L’Engle, a behavior scientist at FHI 360, discussed the need for M&E in order to gauge the impact of mHealth. She claimed that mHealth technology is not being fully leveraged and that the current mHealth research “doesn’t provide evidence on actual impacts…or answers to critical research questions…”

James BonTempo from Jhpiego presented on evaluating behavior change evidence from a text message project that promotes male circumcision (MC) for HIV prevention in Tanzania. He referred to this evidence extraction as “mining the data exhaust” – that is, the data generated as a byproduct of ICTs, the “trail of clicks” that ICT users leave behind.

The MC program offered a toll-free text-messaging/SMS service. With the service, individuals could request to receive information on the benefits of MC (using key word: TOHARA), where to find MC services (WAPI), as well as receive follow-up care information after undergoing the circumcision (BAADA). While the SMS platform was intended to capture requests to the three keywords and generate access logs for system performance monitoring, Jhpiego has analyzed this data in order to see if there was a relationship between requests for the MC data and actual utilization of MC services.

Jhpiego male circumcision project in Tanzania- behavior change evaluation

Potential link to behavior change in Jhpiego male circumcision project

The data set included 12,056 keyword requests sent by 4,954 users. After performing a Chi Square analysis on the data, the project team found that requests for information on the benefits of MC (TOHARA) was not strongly associated with going to receive the circumcision. However, it was found that those who requested where to find the data (WAPI) did have a statistically significant association with undergoing the circumcision. These results are consistent with pathway models of behavior change, indicating that those who simply wanted to know more about MC were not quite prepared to undergo the procedure, but those looking for service availability were ready to use the services.

The associations found in this particular project imply that providing text or voice messages that tell people where to get a particular service could be more effective in encouraging clients to utilize that service. M&E that finds results such as these could help project leaders design SMS services that generate more useful data.

Like most forms of M&E, there are limitations on findings that use mobile data. There is a lot of information that mobile devices do not provide, such as which phones belong to whom and who actually sends the text messages; this makes it difficult to link messages to specific individuals. In the MC case, data analysts found an association, but did not necessarily know the nature of the association. It can also be challenging to find the time or manpower to rake through the massive amount of data that is produced by mobile devices.

While M&E in mHealth has its limitations, it is difficult to find data that can be collected and analyzed as quickly, cheaply, or easily using other means. Paper, radio, and television simply do not offer the same kind of easily-mined data exhaust that mobile does.

October 25, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

2011 mHealth Summit Q&A

The mHealth Alliance is building on the monumental success of last year’s mHealth Summit, which saw more than 2,600 attendees from nearly 50 countries. This year, the mHealth Alliance joins HIMSS and NIH as organizing partners for the FNIH-presented mHealth Summit. The Summitwill bring together leaders in government, the private sector, industry, academia, providers, and not-for-profit organizations from across the mHealth ecosystem and around the world. It will take place December 5^th-7^th at the Gaylord National Resort & Convention Center located just outside Washington, DC at the National Harbor.

As everyone gears up for the 2011 mHealth Summit, I have received a lot of questions. Some have been logistical, while others have been about the content of the Summit. I thought it might be helpful for those thinking about attending or planning to attend if I post questions as I get them along with answers. Here are a few I have gotten so far:

Q: What is the best airport to fly into and how do I get from the airport to the Gaylord?

A: There are three major airports that serve the Washington, DC metropolitan area, including Washington Dulles International Airport (IAD), Baltimore/Washington International Airport (BWI), and Ronald Reagan Washington National Airport (DCA). Super Shuttles can be taken from all of these locations, and the Gaylord offers hourly shuttle service from Reagan National Airport (DCA). Please visit Shuttle & Metro page of the mHealth Summit site for more information.

Q: Unfortunately, I missed the early registration period. Is there a discount code available?

A: Yes! The mHealth Alliance has a discount codefor the mHealth Summit. If you enter the code mHA11 during the registration process, you will receive $50 off a Full Access Pass. The Full Access Pass will get you into all of the Super Sessions, the Concurrent Sessions, the Exhibit Floor, the Monday Evening Reception, and the Keynote Luncheon on Tuesday. For more information about the different levels of passes available, please visit the registration page.

Q: How much of a focus will there be on maternal health projects?

A: The Maternal-newborn mHealth Initiative (MMI) is an important initiative of the mHealth Alliance. By focusing on maternal-newborn health as a lens to the application of ICTs to health systems, the mHealth Alliance is working toward health systems transformation to improve health outcomes for all populations. As such, maternal health is a very important topic for us, and it can be found throughout the summit program. A few panels and events that may have maternal content include, but are not limited to: mHealth Business Models in Maternal Health, The Intersection of Mobile Health and Public Health – Towards Greater Understanding and Collaboration, Deployment Case Studies for the mHealth Field Worker, and several sessions of the mFinance track. There will also be a Mobile Alliance for Maternal Action (MAMA): An Exchange with Partners side event, which will feature active discussions with its in-country and global partners. Visit the Mobile Alliance for Maternal Action (MAMA) site to learn more about their activities around the world.

Q: How much of a focus will there be on mHealth in the developing world?

A: Making sure that the experiences of people in the developing world are represented at the mHealth Summit is a priority of the mHealth Alliance. Panels and events that focus on this include, but are not limited to: Global Policy and Regulatory Perspectives of mHealth, Global Regulatory Frameworks: Understanding Regulatory Concerns Across Different Markets, Government Role in Scaling mHealth: Collaborations to Launch National mHealth Strategies, Successful mHealth Business Models in Emerging Markets, A New Model for National-level mHealth Planning, and the above mentioned MAMA event. The mHealth Alliance will also host a side event featuring mHealth national stakeholders from around the globe. At the National Stakeholders: Learning from the Global South event, panelists will share the successes and challenges they have faced in bringing a diverse group of stakeholders together to tackle issues like policy and regulation, interoperability, data security, and intersections with other mServices.

If you have any other questions, please feel free to comment below, and I will try to answer you as soon as possible.

Thank you so much for your interest in the mHealth Summit. If you would like to register, please click here. We hope to see you there!

October 25, 2011/by actualize

Agriculture, Health, Health, Health Systems, Originally posted on the GBI Portal

Will Nigeria Turn to mHealth to Achieve its Healthcare Goals?

Nigeria may be joining a number of African countries in prioritizing mHealth as a way to improve the country’s troubled healthcare system. At a recent mobile Health workshop in Nigeria that was put together by the African telecommunications company MTN, stakeholders voted for the nation to adopt a mobile healthcare system.

Omobola Johnson, Nigeria's Minister of Technology and Communications

According to some, Nigeria is among the countries leading the way in using mobile health services. Several mobile companies operate there, with MTN serving the largest population percentage followed by Globacom, Zain and Etisalat. The Nigerian Communications Commission estimates that around 105 million of the country’s 155 million people were subscribed to a mobile service provider in August 2011.

Nigeria faces many challenges in expanding its healthcare system, such as a lack of infrastructure, a shortage of trained healthcare professionals, high illiteracy rates and unreliable power sources. The nation’s government has made some efforts to address these challenges in order to meet the Millennium Development Goals. The National Primary Healthcare Development Agency operates under the Health Ministry to promote and support the development of a high quality primary healthcare system.

Photo credit: eHealth Nigeria

But is the Nigerian government prioritizing mHealth as a means to improve healthcare delivery? Omobola Johnson, Nigeria’s recently appointed Technology and Communications Minister, has been pushing toward nationwide mobile coverage as well as the implementation of emergency call centers and phone lines. However, when Johnson revealed the Ministry’s mandate at the end of August, the use of mobile devices for improved healthcare was not mentioned specifically.

Many individuals, private companies, civil society organizations, and aid agencies feel that Nigeria should embrace mHealth as a mechanism for repositioning the country’s healthcare system. Through fuller adoption of mHealth into the healthcare delivery system, many more people could be reached. But the government will need to place mHealth at the top of the agenda and support mHealth initiatives should the emerging field succeed in improving Nigeria’s healthcare.

October 19, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

How to Disseminate Maternal Health Information to Rural Women

There are numerous ICT projects that focus on maternal health, many designed to reach women in rural areas where there is a severe lack of healthcare services. Mhealth in particular – the use of mobile phones to improve health – has taken off as a tool for providing critical information to pregnant and new mothers. In USAID’s MAMA project, for example, pregnant women in Bangladesh receive weekly information updates via text or voice message.

Photo credit: Open Ideo

But what is the best method for disseminating health information to rural women? How can the women learn and interpret the information in a way in which they can understand its value, making certain behavior changes if needed? Vikram Parmar, a professor at the Delft University of Technology in the Netherlands, attempted to find this out through research conducted in India with 120 women from seven different rural villages. Parmar wanted to know how to motivate users of a Primary Health Information System (PHIS) to adopt positive health practices through designing and developing a Health Information System that maximized information dissemination.

Parmar wanted to explore how to improve information dissemination where health ICT projects had fallen short in three areas. First, he was concerned with the limited impact of Health Information Systems in educating rural users, as well as ICT-based health interventions such as film showings and radio program broadcasts that had not improved the health practices of rural target audiences. Secondly, the typical content and design of Health Information Systems did not encourage regular use due to the “non-persuasive setting of health interventions,” resulting in an information gap between rural women and primary health information. Finally, HIS deployed to rural users were based on content developed for urban users, resulting in a mismatch between the information given to rural women and the information they actually needed. In particular, maternal health and other personal women’s health issues had not been addressed.

Parmar proposed addressing these problems by employing a user-centered design framework to develop ICT interventions (see framework in full below). He tested this framework in the context of the PHIS. The results of his exploratory research indicated that the rural women’s knowledge had improved after interacting with the PHIS, signifying the importance of understanding user needs, taking into account existing social beliefs and practices related to health issues. Using this framework could improve information dissemination, resulting in positive change in rural women’s health-related practices.

October 14, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

Marketing “Mobile Midwife” in Ghana

Can information delivered on a mobile phone affect the outcome of a pregnancy in a developing country? Can communities and healthcare workers use mobile phones to save the lives of newborns? These are some of the questions that the Mobile Technology for Community Health (MOTECH) program in Ghana is trying to address. Grameen Foundation is working with Ghana Health Service and Columbia University in one of the poorest rural districts of Ghana to try to improve the health outcomes for mothers and their newborns using mobile phones. But once a service has been created, how do you generate awareness for it and ensure there is adequate participation?

In July 2010, we launched a service called “Mobile Midwife,” which enablespregnant women and their families to receive SMS or pre-recorded voice messages on personal mobile phones. The messages are tied to the estimated due-date for the woman so the information is time-specific and delivered weekly in their own language. Nurses also use mobile phones to record when a pregnant woman has received prenatal care. If critical care is missed, both the mother and the nurse receive a reminder message on their mobile phones. To date, over 7,000 pregnant women and children under five have been registered in the system. More detail about the program can be found online in our “Lessons Learned in Ghana” report.

One of the challenges we faced in the development of this system was how to generate awareness for the “Mobile Midwife” service in the first place. Unless people register for the service, they cannot receive the important information we are able to provide about pregnancy. As we talked to people in the rural villages where “Mobile Midwife” would be available, it quickly became clear that communities in Ghana, and particularly the Upper East Region, had been inundated with cartoon-like health message campaigns from myriad NGOs and government agencies. People told us that if campaigns were seen as “too slick,” people would not think the messages were relevant to them. The MOTECH team decided to pursue an approach that sought to provide “aspirational” images that were differentiated from the typical “NGO cartoon” campaign, but still were relevant to the UER population. This included using real photographs instead of drawings, and ensuring that the people in the photographs were wearing clothes in the style of those worn in the rural areas where we worked. Part of the aspirational message was dressing the models in new, clean clothing, which proved to be effective. When field testing the marketing styles, many people said they “liked the lady in the pictures and it made them feel good as one day they would like to be dressed well too.” The team also decided to create some messaging that was targeted specifically to men, in an effort to respect their roles as decision makers in the family, get them to listen to the messages with their partners, and be a part of making positive health choices throughout pregnancy, birth and early childhood. As the program evolves, we expect to experiment with broader reach marketing vehicles such as radio and community mobilization.

Initiative:

Maternal Newborn mHealth

Order:

October 5, 2011/by actualize

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