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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, 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

USAID MAMA initiative leading the way in mobile for maternal health projects

The USAID-initiated MAMA (Mobile Alliance for Maternal Action) project that utilizes cell phones to improve maternal health in developing countries gave an in-depth update at the latest mHealth Working Group meeting.

The pilot initiative, announced in May by Secretary of State Hillary Clinton and co-sponsored by Johnson & Johnson, has begun work in Bangladesh. MAMA seeks to achieve “scale, sustainability and impact” by creating a replicable model of reaching low-income mothers and household decision-makers (husbands, mothers-in-law) through increasing the impact of current mHealth programs, providing technical assistance to new mHealth models, and improving methods of applying mobile technology to improving maternal health.

At the working group meeting, Sandhya Rao of USAID and Pamela Riley of USAID’s SHOPS (Strengthening Health Outcomes through the Private Sector) program discussed the status of Aponjon, the MAMA project in Bangladesh. Aponjon provides vital health information through mobile phones two times a week to expecting and new mothers, reminding them of when to receive checkups and how to stay healthy during the pregnancy. Bangladesh was chosen to pilot the project because the country’s government has been a leader in promoting and expanding access to ICTs and is very active in mHealth.

Photo credit: Council on Foreign Relations

In order to bring it to a national scale, the burgeoning MAMA initiative has established private, public, and NGO partnerships to help implement its activities, and is carefully monitoring its methods and practices to ensure that the project is reaching its target goals. For example, Aponjon is constantly tweaking the content of its phone messages so that mothers and decision-makers understand, retain and relate to the information given.

Photo credit: Highmark Medicare Services

Another aspect of the project that MAMA will be monitoring is its business models to determine which are the most sustainable and effective. Currently, customers pay service providers to retrieve the phone messages. Text messaging is the cheapest method for remitting information in most developing countries, but many of the poorest clients are unable to read the texts. The alternative is interactive voice response (IVR) through which customers can hear recorded messages at a much lower cost than call centers but more than texting. MAMA and its partners are experimenting with different pay schemes, such as subsidizing rates, working with service providers to offer low rates or donate funds to the project, and charging fees based on usage.

It will take the new initiative years before sustainable, reliable, and replicable models are in place. What is clear is that the potential for improving maternal and newborn health through the use of mobile phones is being tapped.

September 29, 2011/by actualize

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

Scalable and Replicable: ICT4Health is Chosen Theme for UN South-South Awards

Digital Health 4 Digital Development was the theme of choice for the 2011 South-South awards that took place earlier this week. The United Nations-supported awards ceremony, held September 19th, honors governments, organizations and individuals accelerating progress toward the Millennium Development Goals (MDGs), and this year awards were given for utilizing ICTs for the advancement of the MDG health goals.

Prime Minister of Bangladesh receives South South award from

Photo Credit: thefinancialexpress-bd.com

The awards were organized by South South News, a digital media platform launched by the United Nations General Assembly High-level Committee in 2010. The platform disseminates development news and allows countries in the global South to share best practices in advancing implementation of the MDGs. As health remains a high priority within the international development field, with three of the eight MDGs calling for health improvements by 2015, this year South South chose the “catalytic and unifying force of ‘digital health’” as its focus.

Awardees were recognized for policies, programs and projects that address global health using ICTs as a mechanism for “scalability and replicability of the broad development agenda.” Awards were given on health categories such as Women and Children’s Health and HIV/AIDS, TB and Malaria with special consideration given to achievements in the fields of mobile, broadband, Internet, medical, and pharmaceutical applications.

Among the winners was Bangladesh’s prime minister Sheikh Hasina who received recognition for the use of ICTs in addressing women and children’s healthcare. The government of Bangladesh has made increasing the use and availability of ICTs a priority over the past decade, declaring IT a “thrust” sector and implementing a national ICT policy in 2002. The prime minister has been a catalyst for ICT development in Bangladesh, launching the Digital Bangladesh 2021 program, reducing taxes to make computers and other electronics more affordable, and giving free internet services to schools. This is not the first time she has been recognized for her ICT work in the country. The PM noted during the ceremony that most of Bangladesh’s 11,000 community health clinics have been digitized, allowing for free treatment of diseases like malaria and AIDS and reducing maternal and infant mortality rates.

Use of PDA by the nurses at ICDDRB hospital in Dhaka, Bangladesh

Photo credit: Bytesforall "ICT4Health" Network

Other development agencies and UN-affiliated organizations are also choosing to give awards to those using ICTs to advance public health initiatives. The Elena Pinchuk ANTIAIDS Foundation, rising from the work of UNAIDS High Level Commission on HIV Prevention, has launched a competition to find innovative start up projects that use social media and mobile phones for HIV prevention. The competition is taking applications until October 1^st and the winners will receive up to $10,000 to implement one-year projects.

As global health becomes a pressing priority, it is essential to utilize, innovate, and increase access to ICTs within the healthcare sector. The South South awards have set a precedent by recognizing the success of ICT4Health in accelerating the Millennium Development Goals and could encourage Global South countries to follow in the footsteps of nations like Bangladesh.

September 22, 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

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

Text to Change: SMS reminders double HIV testing

Short text messages can be used to increase HIV awareness and double the number of people who go for HIV testing, a survey has stated. According to the results of a survey conducted by Text to change, an SMS quiz and reminder sent to respondents led to an increase in the number of people who went for HIV testing.

The SMS campaign was conducted in February 2010 in Lira (Northern part of Uganda). The survey documents that after sending SMS questions and reminders in the second week of February, 398 HIV tests were carried out at the Lira AIDS Information Centre, twice the number compared with 185 in the first week of February.

The survey was conducted among 7,000 people in Lira with an average age of 28.Among those surveyed majority had sufficient knowledge on issues surrounding HIV and family planning. However, only 44 percent had been tested of HIV in the past year.

During the survey conducted by Text to Change, in partnership with Deutscher Entwicklungsdients (DED), more than 145,000 people in the North Western region of Uganda were asked via radio broadcasts to subscribe to the Text to Change HIV/AIDS SMS Quiz. A record 96% of participants in the survey stated that the survey helped them gain new knowledge on HIV and related issues. Ralf Westhageman from DED Lira, stated:

“Both AIC and DED were surprised with the excellent results in terms of program participation and uptake of HCT services. People in Lira liked this programme so much. Even until today we get an enquiry to continue with it. Together with the Town Council, we never expected such a high number (7,000) of subscribers to take part and get involved. In short, it is without doubt, that we can call it “the most successful HIV Programme in Lira to date”.

Participants received seven questions on HIV/AIDS issues and three on family planning. One of the questions asked was: Would you think of getting an HIV test? YES or NO to improve participants’ knowledge, an SMS confirming whether their responses were correct was sent. Participants, who replied an incorrect answer, received additional information on HIV.

The survey indicates that on average, 74% of all questions sent via SMS were answered correctly a clear sign that majority of participants are somewhat knowledgeable in regard to HIV and related issues.

This marked an increased level of awareness compared to the 2006 Domestic Household Survey where only 28% of women and 36% of men had any comprehensive awareness of HIV/AIDS. Men formed the majority of the respondents -81%. Generally women were much more likely to answer correctly on questions regarding their higher chances of becoming infected with HIV whereas men answered correctly on the issue of a woman transmitting HIV to her baby during pregnancy or breastfeeding.

The objective of the study was to improve HIV/AIDS awareness and to increase the number of people going for testing services in Lira in order to increase the awareness of one’s HIV status and to encourage people to seek early treatment and care in order to decrease further HIV transmission. Lira-town has an estimated 80,000 inhabitants according to the results of the 2002 census and approximately 145,000 people living in the wider district. The high mobile penetration in East Africa has placed the use of SMS as an appropriate means of disseminating information due to easy access and simplicity in use.

Click on this link to the Text to Change website for the full research paper.

January 18, 2011/by actualize