Maternal & Child Health – Page 2

Agriculture, Family Planning, Health, Health Systems, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

New app gives Thailand’s healthcare chance to go paperless

A doctor using the Family Folder Collector app on an Android pad, collecting information on a member patient. Photo Credit: bangkokpost.com

Thailand’s public health system has developed a mobile app for Android enabled tablet PC’s to monitor and collect household information on patients. The app, called Family Folder Collector (FFC), was developed by a research team at the National Electronics and Computer Technology Centre (Nectec).

Nectec researcher Watcharakon Noothong said the application comprises three major programs, including a walking map, genogram (a pictorial display of a patient’s health and family relationships) and Java Health Center Information System (JHCIS) synchronization.

FFC is designed to make life easier for public health workers who collect data on patients and for patients who are on time sensitive treatment schedules and cannot travel to health stations at any given moment for treatment.

The app is free. The only cost to utilize the service is paying for the tablet PC’s which is being covered by the province’s public health office.

Here are some of the features and capabilities of the FFC app:

Google maps shows the exact location and number of households in a given area
Genograms can be displayed
Chronic disease frequency can be color coded on a house-to-house basis
The program can collect and store other vital data, such as a patient’s weight, height, blood pressure and pulse rate, and even calculate a patient’s body mass index (BMI) automatically.
The program provides forms for treatment results, initial symptoms, health recommendations, and health behaviors
Doctors can schedule future appointments with patients
In the near future, the program will also be able to send an SMS to alert patients to get treatment at the health station.

All the collected data is updated and stored on the Android device then synchronized to the JHCIS database server. Public health workers were trained on how to properly input data into the tablet PC’s before pilot testing started. Of a total of 25 districts in the province of Ubon Ratchathani, eight are running the pilot trial of the FFC program, which, in its first phase, covers 123 health stations.

Ubon Ratchathani was chosen as the province since its existing IT infrastructure can accommodate sophisticated ICT’s for healthcare. There are over 1.8 million people in the province, all of whom will be accounted for by health workers using the FFC app.

This do-it-all app is a valuable tool for public health officials and physicians in Thailand. FFC can potentially replace the paper based system of collecting data and monitoring patients in Thailand.

The FFC application can display a genogram, monitor chronic diseases with Google Maps, and locate the house coordinates using a GPS system. Photo Credit: bangkokpost.com

The potential benefits of using this service are bountiful. Patient data will be gathered much easier and will be much harder to lose over time. Doctors can schedule appointments and prescribe treatments without physically seeing patients. Also, analysis of patient data will be faster, more efficient and more accurate.

Thailand may experience a revolution in healthcare if this service lives up to its potential. Currently, each health station has one tablet PC equipped with the program. The FFC application is expected to run throughout the province covering all 346 health stations by 2012.

Furthermore, according to Sinchai Tawwuttanakidgul, director of ICT Centre, Office of the Permanent Secretary, Ministry of Public Health, today there are some 45 provinces that are ready to switch from their paper-based system to the FFC mobile application. It sounds like Thailand is ready to experience that revolution soon.

August 11, 2011/by actualize

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

Millions awarded for maternal health innovations

Secretary of State Hillary Clinton and USAID Administrator Rajiv Shah. Photo Credit: USAID

The Saving Lives at Birth program held its DevelopmentXChange event last week in Washington DC. The event was hosted by Secretary of State Hillary Clinton and USAID Administrator Rajiv Shah and was sponsored by USAID, the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and The World Bank.

The program called for scholars, researchers, doctors, and entrepreneurs to develop innovative prevention and treatment approaches for pregnant women and newborns in rural, low resources setting around the time of birth. There were over 600 applications from around the world, and 77 finalists were chosen to attend this 3-day event held in Washington. At the end of the 3-day event, $14 million in grants were awarded to 25 of the 77 finalists.

The 77 ideas and projects fell into two categories: seed grant finalists and transition to scale finalists. The former were completely innovative and fresh ideas while the latter were already existing ideas that were calibrated to fit for maternal health purposes.

The projects and ideas highlighted gadgets, treatment schemes, prevention methods, health centers, strategic plans and a plethora of mobile phone related solutions. Finalists came from all over the United States and from over the world including Bangladesh, Kenya, India, Uganda, Pakistan, Switzerland and Australia.

Some of the 25 award nominees. Photo Credit: USAID

Many of the ideas that had mobile solution components used mobile phones as an ICT. One innovative project was from Kenya called mAfya which aimed to set up health specific kiosks that would offer basic medical services for free for maternal health issues. There was another project from Kenya that aimed to provide pregnant mothers vouchers to use towards health services through mBanking called Changamka.

Among the awardees, one project from Save the Children provided a mobile phone monitoring system for recording maternal and neonatal deaths. This, along with an electricity-free fetal heart rate monitoring component aims to give communities in Uganda better intra-partum response services. Another project originated from Healthpoint services in India that has already set up rural health clinics and provides water, and is looking to expand its maternal health services using an integrated telemedicine and mHealth system.

Saving Lives at Birth, the first program in a series of Grand Challenges for Development led by USAID. The Grand Challenges is an attempt to bring science, technology and innovation to the field of development, lowering the cost of helping the world’s poor and, in the process, saving lives, said USAID administrator Shah.

“Especially in these very difficult economic times … coming up with more innovative, more local and sustainable ways to make it cheaper and easier to help mothers survive child birth and help children survive the first 48 hours of life is what this program is all about,” added Shah.

Maternal and child health issues still need a lot of attention. A woman dies every two minutes in childbirth, and 99% of the deaths are in the developing world, according to the World Health Organization. Also, about 1.6 million neonatal deaths occur each year around the world. Additionally noteworthy is that only a handful of countries are set to meet Millennium Development Goal 5 of reducing maternal mortality by 2/3 by 2015.

August 1, 2011/by actualize

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

Delivering babies in Ghana just got a little easier

Pregnant woman on phone. Photo Credit: MOTECH

A new mobile phone service was recently launched in Ghana that provides free access to health information in ensuring safe pregnancies. The service, aptly named Mobile Midwife, offers text or voice messaging on maternal health to pregnant women.

Mobile Midwife was developed as part of the U.S. based Grameen Foundation’s MOTECH Ghana initiative, funded by the Bill & Melinda Gates Foundation. It is just one more result of rising donor attention to mHealth services. Its creation continues a trend of mHealth initiatives being churned out in Africa.

Educating women and making them aware of the maternal health risks associated with pregnancies are the cornerstone goals of the service. To make it convenient for the user, the service comes in several different languages, and is presented by text or voice via mobile phones. Additionally, the messages are time specific concurring with the woman’s stage of pregnancy.

When a pregnant woman registers for the service, they are asked to give the expected due date for delivery of the unborn child and their location. Then, periodically, the woman receives messages informing when appointments are due or overdue to remind them to visit the health clinic for check-ups.

The users also get reminders for specific treatments, information about milestones in fetal development, nutrition facts, tips on the benefits of breastfeeding and other pregnancy-related and prenatal health information. It also provides information that demystifies local pregnancy myths and helps users overcome the widespread fear of visiting doctors or health clinics.

MOTECH also rolled out a similar mobile health service earlier in the year that enables nurses in rural Ghanaian health facilities to automate much of their record keeping and reporting, which formerly took 4-6 days per month. The service is in the form of a java–based mobile phone application.

Both Mobile Midwife and the application mentioned above have made life easier for everyone involved in the process of delivering a baby.

One Ghanaian mother said to Grameen, “I would like to advise my pregnant friends to go to the hospital to enroll into MOTECH, to listen to the messages and also to practice what is said because it helps a lot…I used to be scared about pregnancy but now with the messages I am no longer scared and it has taken away my worries and that we feel ok and then the pregnancy is ok.”

This service is extremely pertinent since Africa exhibits some of the worst maternal health records in the world. Fourteen of the fifteen countries with the highest rates of maternal mortality in the world are in Africa. Furthermore, African countries are far behind in meeting Millennium Development Goals set for 2015; especially for those associated with maternal health. Perhaps services like this can lend a helping hand.

July 18, 2011/by actualize

Agriculture, Family Planning, Health, Health, Health Systems, Infectious Diseases, Maternal & Child Health, Mobile, Nutrition, Originally posted on the GBI Portal

New mHealth service gives Iraq options for monitoring health

Iraq’s largest private telecommunications company, Asiacell, announced this week the launch of its mobile health content download and SMS service which is now available to its prepaid and postpaid subscribers. Asiacell is the only mobile telecom company providing coverage for all of Iraq.

An Iraqi man holds a cell phone. Photo Credit: Mario Tama, Getty Images

The new service offers information on various health practices which can be discriminately selected by the user. Asiacell offers a weekly and a daily health update service. The daily health updates include information on women’s health, men’s health, children’s health, dieting, mental health, and diabetes. Albeit a little more limited, the weekly updates is a downloadable service which only cover topics such as sports and fitness, mental health, and emergency medicine.

Customers can subscribe to the daily SMS service, by sending a blank SMS message to the toll-free short code “2330”, and then send their preferred health topic, which they can choose from a list that will be automatically sent via SMS, to short code “2331”. This service costs IQD 2,500 ($2.14) per month.

Subscribers can also download content on a weekly basis by sending the number “1” to short code “2332” for sports and fitness information, or to “2333” for mental health information, or to “2334” for emergency medicine information. This service costs IQD 2,000 ($1.71) per month.

A similar service operates in India called mDhil which uses SMS to send health messages on various topics. The service overcame social stigmas regarding certain topics of health such as reproductive health, and became one of the most successful mHealth programs in India. Asiacell’s new service faces identical hurdles in Iraq and hopes to prevail like mDhil did.

Photo Credit: Asiacell

Asiacell is the only telecom provider to cover all of Iraq. They provide services to nearly 8 million of the estimated 31 million living in Iraq. This is remarkable given that just 5 years ago under the reign of Saddam Hussein, less than one million Iraqis had access to land lines and the average civilian did not have access to a mobile phone. Despite that and the war which ruined telecommunication infrastructure, Iraqis now have steady access to telecom services, especially mobile phones.

It is probably due to the increased access to information that has led Iraqis to become more health conscious claims Asiacell. Dr. Mustafa Adil, an Iraqi physician, said that maintaining a healthy lifestyle has become a major concern for communities, as people are more aware of the importance of following the latest health advancements and practices. He explained that Asiacell’s Mobile Health service supports the healthcare sector’s goal to promote sound health habits.

July 6, 2011/by actualize

Agriculture, Health, Health, Health Systems, HIV/AIDS, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Mobile health quizzes get a 2.7 million Euro boost

Text to Change (TTC), an mHealth non-profit organization based in the Netherlands, announced earlier this month that they will receive a €2.7 million grant to expand its services. TTC provides an SMS-based educational service to improve the health of citizens in eight countries in Africa and one in South America.

Already a big contributor in mHealth development, TTC hopes to become a leader in the field with the reception of its multi-million Euro grant from the Dutch Ministry of Foreign Affairs via Connect4Change (C4C), a consortium funded by the Dutch Ministry of Foreign Affairs that develops mobile based solutions on issues of poverty in Africa and Latin America. TTC will partner with C4C to expand its services to 11 more countries in Africa and South America by the end of this year.

Implementing ICT in the 11 countries is a top priority for both TTC and C4C. They are hoping the mutual partnership will make establishing ICT services an easier task as the expansion continues. According to TTC, the game plan calls for TTC to provide “low” technologies like SMS and mobile voice services while C4C provides “high” technologies such as mobile internet and video transfer. Therefore, TTC and C4C will play different roles.

C4C will also invest its time reaching out to local entities on the ground to strengthen ICT networks. TTC will focus on improving health outcomes through their established mobile phone initiatives.

TTC sets up their mobile platform through the recipient country’s mobile service infrastructure already in place. They then subscribe mobile phone users to their programs which use SMS communication to inform people of HIV testing, treatment clinics, and other health related services at no cost to the recipients.

TTC SMS system Photo Credit: TTC

TTC programs offer the information through a free educational quizzing service where participants are quizzed about a specific health topic. As participants answer the questions correctly, they are sent more rounds of questions, again at no cost. If the participant can answer enough questions correctly, he/she receives incentives such as phone credit, t-shirts and health products.

Thus far, TTC has reached thousands of individuals with their programs on HIV/AIDS, malaria, and reproductive health. Furthermore, to assess the impact of ICT in the countries they are currently working in, TTC will even conduct large scale ICT evaluations over the next few years in those countries.

TTC is poised to make an impact in ICT through their mobile services. Their work is just another example of how mobile phones are being used as a medium to educate, inform and save lives. The tag-team partnership with C4C will be expanded to all 11 target countries by the end of this year. However, we will have to wait some time before confirming the outcome of this joint strategic approach.

June 27, 2011/by actualize

Agriculture, Health, Health Systems, Humanitarian Assistance, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

UN calls for increased sustainability of mobile health clinics in Pakistan

Mobile maternal health clinic on the road. Photo Credit: UNFPA

Nearly a year after the devastating floods in Pakistan, calls are being made by UNICEF health officials to expand capacities of mobile health clinics in the country. The clinics were first developed in response to the 2005 earthquakes in the northern region of Pakistan. Although the mobile clinics have touched hundreds of thousands of lives, more will be needed with expanded capabilities to ensure their long term impact.

In October 2005, the UNFPA joined hands with the Pakistani government and created mobile health clinics, whose main focus was on maternal health needs. By 2008, these clinics had treated over 850,000 patients, mostly for maternal and child health related issues. The clinics, still running, are staffed by women and are stocked with equipment and supplies for quality maternal health care. Since 2005, UNICEF has also become a key funder for mobile health clinics in Pakistan.

The UNICEF funded mobile health clinics tackle a variety of health issues, with an emphasis on maternal and child health. These clinics are staffed by three health workers, and treat up to 300 patients on a daily basis. After the emergence of the floods that affected 20 million people in Pakistan in July 2010, these health clinics became pivotal in reaching isolated populations.

Healthcare for women and children is better now than it was before the floods and the earthquake. However, despite the welcomed success of these mobile health clinics, there has been a call to expand the capacities for the mobile health clinics in order to make them more sustainable. This is where the world of ICT can step in and lend a helping hand.

The potential for impact is highest is rural and isolated areas where resources are poor and hardest to reach. According to a UNDP report, “ICT is yet to be widely mainstreamed to assist developing countries in addressing traditional development problems with innovative solutions and approaches that are both effective and more easily scalable and replicable.”

ICT services can complement existing initiatives such as the mobile health clinics in Pakistan to attenuate health burdens such as maternal mortality, which is what the UNFPA funded clinics focused on. This would be crucial in rural areas where ICT services would be invaluable. ICT services can potentially offer live video or audio feeds to health professionals when examining patients as well as educational classes to women from urban based instructors using the mobile clinics already in use.

Once ICT services are in place, NGO’s and government agencies can directly improve citizen access to information and at the same time, immediately strengthen their own capacities to help the citizens. Pakistan and other developing nations will only continue to reap the benefits for years to come.

June 9, 2011/by actualize

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

Using cell phones to improve pregnancy in Herat

A community health worker shows a visual aid

Photo credit: Dimagi

With funding from USAID, World Vision and Dimagi will conduct operations research to test if the use of CommCare will increase the uptake of healthy actions, improve knowledge of important information points, and improve communications and coordination between community health workers (CHWs) and higher trained workers.

CommCare is a phone-based application to strengthen community health programs. CHWs use software running on a phone during each client visit to improve quality of care and data reporting. When the CHW is within range of a cellular network, data is automatically submitted to a central server for use in program management, monitoring and health surveillance.

World Vision’s study will focus on improving the uptake of a list of identified “Healthy Actions” and knowledge of key “Important Information” points. It will also study the improvement that the phone make between the CHWs for coordination with midwives and other health experts. World Vision expects the following:

Utilization – increased percentage of healthy actions taken by pregnant women
Knowledge Access – increased knowledge by pregnant women of the important information points
Access- increased use of midwives and expert services via phone calls

The primary CommCare module the study will focus on promotes essential care during and immediately after pregnancy. The module reinforces the training the CHWs will have received based on the American College of Nurse-Midwives Home Based Life Saving Skills. The module is designed to quickly bring a CHW through key points of identifying and responding to emergency signs including difficulty breathing, low birth weight, and hypothermia. The module then helps the CHW promote simple but effective hygiene and preventive care to reduce infections such as infected cord stumps, pneumonia, and tetanus.

A key challenge World Vision encountered was that the CHWs in the Herat region are low-literate. CommCare was, therefore, adapted for low-literate users by including audio prompts and images. These multimedia prompts have been found to also help engage the client more, as the CHWs play the audio clips and show images to their clients.

The following video demonstrates how the CommCare application works:

CommCare-Sense House Visit 1 from Derek Treatman on Vimeo.

Click here to learn more about this project.

March 8, 2011/by actualize

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

USAID Maternal and Child Health Integrated Program Uses Mobile Technology to Improve Health Care

The Maternal and Child Health Integrated Program (MCHIP) is the USAID Bureau for Global Health’s flagship maternal, neonatal and child health (MNCH) program. Awarded in September 2008, MCHIP focuses on reducing maternal, neonatal and child mortality in 30 priority countries, contributing to Millennium Development Goals (MDGs) 4 and 5.

Designed by USAID as a “Leader with Associate Cooperative Agreement” (LWA), MCHIP can be funded by USAID Missions and Regional Bureaus through traditional field support and other mechanisms. In addition, MCHIP can accept Associate Awards that Missions, Regional Bureaus or Global Offices develop with the Leader organization and oversee directly.

MCHIP takes “what works” to scale by working with USAID Missions, national and local governments, nongovernmental organizations, communities and partner agencies. Based on country context and identified gaps in providing services at the household,community and referral levels, MCHIP designs program strategies to ensure that services reach women and their families.

What MCHIP Is Doing Using Mobile Technology

Nearly half of all births in developing countries occur in facilities, yet the quality of care provided is often unknown. Reported clinical practice may differ greatly from observed practice. MCHIP has developed a Maternal and Newborn Quality of Care (MNH QoC)Toolkit consisting of five mobile, electronic data-entry tools for assessing the quality of services provided in hospitals and health facilities. These are primarily checklist tools for observing health worker performance related to services provided for labor and delivery and essential newborn care. The tools are designed to capture health worker responses to spontaneous complications, such as pre-eclampsia/eclampsia (PE/E) or postpartum hemorrhage (PPH), two of the leading causes of maternal death.

As of November 2010, MCHIP MNH QoC assessments have been conducted in five African countries, providing baseline data for quality improvement activities for maternal and newborn care at facility, regional and national levels.

Maternal and Newborn Health QoC Mobile Toolkit

Obstetricians and nurse-midwives are trained to use mobile phones for capturing observational health worker performance data at hospitals and health facilities;
Data is entered on Windows Smart Phone forms with Range, Logic, Skip and other data quality controls;
Data includes clinical observation checklists on labor and delivery services, antenatal care, facility inventories, health worker maternal and neonatal knowledge tests, register, maternity chart and partograph review;
Quantitative and qualitative data is captured via interviews, simulations and observation checklists including audio noted and pictures of partograph;
Data is backed up to internal SD card and then transmitted via GPRS to in-country servers; and
Results are uploaded to the Web in predefined table, graph and map templates.

A Tool for Improving Quality of Care

The overall goal for MCHIP is to contribute to the reduction of frequent, preventable maternal and newborn deaths through increased quality of known life-saving interventions in countries facing the highest disease burden. Mobile phones have improved the quality of data and expedited the timeliness of results reporting. Specific needs for effective interventions for screening, prevention and treatment of obstetric and newborn complications are being identified as results come in from the MNH QoC Assessments.

Data collected and analyzed provides an opportunity to guide development of program interventions to improve the quality of facility-based maternal and newborn care services. By providing a baseline and end line measures in countries where the survey is part of an evaluation of interventions being implemented, data also provides an opportunity to inform policy change and resource allocation. These indicators and data collection tools can be used in multiple countries to provide information on key screening, prevention and management of interventions of the most frequent direct maternal complications.

Click here to view the poster presented by USAID at the mHealth Summit 2010. Also check out this Youtube Video of MCHIP’s own David Cantor speak as part of the panel discussion at the Summit.

January 20, 2011/by actualize

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