mobile technology

 {Photo credit: Samy Rakotoniaina, MSH}Community health volunteers use a mobile phone app to guide their patient interaction in rural Madagascar.Photo credit: Samy Rakotoniaina, MSH

How community health volunteers are using mobile technology to provide better care in remote areas of Madagascar

In remote villages of Madagascar, people who live miles away from a health center largely depend on community health volunteers for basic health care, such as family planning services, or the diagnosis and treatment of simple childhood infections. These volunteers are identified and elected by the community, and are then trained and supervised by the head of the nearest health center. The country's national Community Health Policy places them at the foundation of the health pyramid, as they are serving the most isolated communities. However, ensuring the quality care provided by these volunteers can be challenging: one study reported that only 49% of health volunteers offer family planning in accordance with national standards, and only 53% of children under the age of five are correctly treated for diarrhea, malaria, and pneumonia by health volunteers.

Being a community health volunteer is a tricky job. Among the many difficulties they already face, they are expected to report their activities by completing paper registers on a daily basis. But these paper tools, which are long and time-consuming, often result in delays and errors in the reporting process.

African Strategies for Health (ASH) launches the mHealth database (screenshot, April 20, 2015).

It’s nearly impossible to find someone who doesn’t own or have access to a mobile phone these days. According to International Telecommunication Union (ITU) 2014 estimates, there are nearly seven billion mobile sub­scriptions worldwide, five billion of which are in low- and middle-income countries.

With mobile technologies accessible to 95.5 percent of the world population, a new platform for promoting and delivering health services has emerged. 

Mobile phones are increasingly being used by various cadres of health workers for tasks such as collecting health data; monitoring implementation of health interventions; or informing local communities about potential outbreaks of disease, as was done during the recent Ebola epidemic in West Africa.

These new, innovative ways to make use of mobile technologies to improve health outcomes are known as mobile health or mHealth.  

 {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Mafia Island, Tanzania, learn to use the mobile applications developed by SDSI. The applications allow ADDO personnel to access an SMS-based Pharmacy Council helpline, send service utilization reports to the Pharmacy Council, and to pay annual licensing fees via mobile money.Photo credit: Rachel Lieber/MSH.

Cross-posted with permission from mHealthKnowledge.org.

In the private sector, Tanzania has more than 1,000 pharmacies, 2,500 pharmaceutical personnel, 6,000 accredited drug dispensing outlets (ADDOs), and more than 18,000 ADDO dispensers. The Pharmacy Council of Tanzania has overseen these facilities and personnel since 2011, but lacked a comprehensive system to manage regulatory information. Without such a system, basic facility and personnel information was inaccessible, the locations of rural ADDO facilities were unclear, and tracking business and professional licensing status, including fees collection, was difficult. Furthermore, the Pharmacy Council had no way to efficiently communicate directly with the outlets.

A group of young men in Mwene Ditu discuss using a cell phone to access health information. {Photo credit: Overseas Strategic Consulting, Ltd.}Photo credit: Overseas Strategic Consulting, Ltd.

Mobile phones are being used increasingly throughout Africa to improve health. The USAID-funded Democratic Republic of Congo-Integrated Health Project (DRC-IHP) is using mobile phone technology to increase the number of people referred to health centers in the project’s 80 targeted health zones. In Mwene Ditu, project staff observed that low numbers of referrals to health centers would be improved by increasing communication—within the community, between the community and health service providers, and among provincial health officials.

Cross-posted from the K4Health Blog.

The overhead lights dim and in the dark, the high-spirited rhythm and melodic line of a Malawian song rises and overtakes the quiet buzz of conversation. We are seated in a large auditorium at the International Conference on Family Planning in Dakar, Senegal and watching the first film focused on the K4Health Malawi project in a festival hosted by Population Services International (PSI).

The film festival is a rich visual and audio break in an intense day filled with technical presentations and serious conversations about what works in programs that promote reproductive health and family planning.

Cross-posted from the K4Health Blog.

As the mHealth Summit gets underway this week in the Washington D.C. area amid thousands of mHealth projects taking shape around the world, one particular mobile activity is saving lives by helping to ensure that the contents of medicines match their labels.

The Problem:

According to a  2010 World Health Organization Fact Sheet, it is difficult to estimate the percentage of counterfeit medicines in circulation—WHO cites estimates in industrialized countries at about 1%, and adds that “many African countries, and in parts of Asia, Latin America, and countries in transition, a much higher percentage” of the medicines on sale may be falsely labeled or counterfeit.

This blog post originally appeared on K4Health's blog.

The most important item in Amon Chimphepo’s medical kit is a small cell phone. This single piece of technology has proved to be a lifeline for people living in one of the most remote regions of Malawi. Its power to reach and initiate help immediately from the closest hospital is saving lives and improving health outcomes. In fact, I met a woman, alive today, because Mr. Chimphepo and his cell phone were there to make an emergency call to the district hospital and get an ambulance.

There have been a collection of high-profile and well attended mobile health (mHealth) “summits” held around the world in the past few years, including last month’s second annual mHealth Summit in Washington, D.C. (headlined by Bill Gates and Ted Turner), but the really interesting conversations are happening on the African continent. While large providers in the “developed world” are talking about the need for business plans and analysis, the debate in Kenya and Nigeria and Ghana is on how country-based leadership can scale up proven programs, develop sustainability, and provide practical and integrated models for cooperation between the government, mobile service providers, the medical community and the private sector.

Last year, the mHealth Alliance and the National Institute of Health (NIH) sponsored their first mobile health (mHealth) “Summit,” at the Ronald Reagan building in Washington, DC. The location was telling: it is the home of the US Agency for International Development (USAID). This year’s mHealth Summit has nearly doubled in size, moved its location to the Convention Center, and is being keynoted by Bill Gates and Ted Turner. It is safe to say that mHealth is certainly a topic de jour. The problem is that the big names---the global mobile phone network providers, manufacturers, pharma companies, and global consulting firms---are all jumping on the bandwagon, but they are late to the game. And the conversations in the plenary sessions highlight the fact that there’s a huge disconnect between the global companies and the on-the-ground implementers.

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