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  • 1. mUbuzima/mHealth
    Dr Richard Gakuba
    National e-Health Coordinator
    Rwanda
  • 2. Dispersed population and hilly terrain make access to health facilities difficult
  • 3. Governance
    E-Health Strategic Plan
    E-Health Unit in MoH
    E-Health steering committee
    MoH institutions
    Other Government stakeholders
    MINICT/RDB-IT
    Local Government
    NID
    Development partners
  • 4. E-Health systems
  • 5. mHealth in Rwanda
    First mHealth application: 2004
    HIV/AIDS monitoring system (TRACnet)
    Used by over 400 facilities that offer HIV services (over 80% of total facilities)
    Community Health information system (SISCOM) 2010
    mUbuzima and RapidSMS
    In Pipeline: health insurance authentication
  • 6. Community based applications
    mUbuzima
    MDG indicator monthly reporting
    Localizing MDGs
    mEducation
    RapidSMS
    Maternal Health tracking
    Pregnancy
    Risk events
    Delivery
    Post natal
    mEducation
  • 7. Sustainability challenges
    CHWs organization
    Not full time, have to take care of their families
    Cost of handsets
    Cost for 45k handsets
    Lost phones, phone lifespan
    Communication cost
    Cost of calls/SMS
    Technology: eg: SMS vs IVR
    Negotiation with telecoms: 84% cost reduction for voice and SMS
    Infrastructure
    Electricity
    Software development and support
    In-country development/support
    MoH programmers and Local company support
  • 8. Sustainability challenges
    Phone use penetration
    Per capita affordability
    Network footprint
    Cost effectiveness/Impact on health care
    Proof that outcome is worth the health outcomes
    How many lives per $ is cost effective?
    mHealth as part of an Enterprise (Health) Architecture
    mHealth applications not stand alones
    Interoperability and standards with other applications
    Ownership
    Part of a Government program; planning, funding
    Should make CHW’s work easier
  • 9. SISCom data used for PBF payments
  • 10. SIScom database and eHealth Enterprise Architecture
    Selected eHealth Registries
    Facility Registry
    National Indicator data warehouse
    Provider Registry
    Interoperability layer
    SISCom
    Health facility PBF
    EMR
    HMIS
    RapidSMS
    mUbuzima
    Some of the related eHealth Applications
  • 11. Scalability
  • 12. Lessons learned
    The enormous scale of the roll-out of the system requires careful planning and considerable resources that were not initially anticipated
    Substantial savings can be made by combining training schedules with the delivery of other content (data management + PBF, MCH monitoring, etc..), rather than doing them all in parallel.
    Opportunity for public-private partnership with 45,000 new cell phone users. The MOH was able to negotiate deep discounts for SMS and voice messaging with the mobile-phone operators (bringing costs of air time down 82% from $600k to $116k).
    By combining PBF incentives within the SISCom , reporting compliance risen quickly to 97%
  • 13. Thank you/Merci/Murakoze