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mHealth and Community Health Workers
 

mHealth and Community Health Workers

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With a worldwide penetration rate of over 85%, the mobile phone has become one of the most transformative tools in human history. As mobile communication technologies become less expensive, faster, ...

With a worldwide penetration rate of over 85%, the mobile phone has become one of the most transformative tools in human history. As mobile communication technologies become less expensive, faster, and more accessible, the ability of people, communities and institutions to share information and knowledge will continue to skyrocket. Specifically for Global Health, the use of mobile communication and network technologies for delivery of health care (mHealth) holds great promise for the future. In low resource settings, community health workers (CHWs) provide a backbone for the delivery of health care services. Often isolated and without significant formal education or training, CHWs can be seen as key connectors between their communities and the formal health care system. In the hands of CHWs, mHealth tools may facilitate effective task shifting; by expanding the pool of human resources, increasing the productivity of health systems, and lowering the cost of services. The reported experience with mHealth suggest a wide range of opportunities exist to improve ease, speed, completeness and accuracy of the work of CHWs. The outcomes associated with these sort of new capabilities can be expected to result in ongoing improvements in performance on key national health indicators. The presentation will examine the state of the art and science-- by describing a systematic review of the literature and citing examples in action -- and provide recommendations focused on the design and development of mHealth tools for use by CHWs to strengthen Global Health interventions.

Speaker Bio:
Dennis M. Israelski, M.D
www.instedd.org/team

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  • The iLab Southeast Asian team member, An Yon show to Kien Chrey Health Center staff to use the reporting wheel to send suspect TB patient to TB system.\n
  • CONTEXT: MOBILE PHONES \nNot long ago, the idea of everyone having a cell phone was a far fetched idea. We believed cell phones were only a reality for the richest, most powerful men in the world. \n\n\n
  • In 1973, the first cell phone reached market. It was more than a foot long, weighed nearly 2 pounds and sold for $3,995 (that’s over $19,300 adjusted for today)!\n
  • http://data.worldbank.org/indicator/IT.CEL.SETS.P2\n\nCONTEXT: MOBILE PHONES\nToday, the idea of mobile phones only reaching elite and wealthy customers has been shattered. Mobile technologies continue to skyrocket worldwide. \n
  • \n
  • CONTEXT: MOBILE PHONES\nOut of the 7 billion people worldwide, 5.9 billion are mobile phone users. That means 87% of the worlds population has a mobile phone. In addition, smartphone sales are up 63% from 2010 *4888.5 million* were sold in 2011. \n
  • Ben Wood, mobile phone analyst at CCS Insight said the mobile phone may be "the most prolific consumer device on the planet" \n\n
  • Time quote of Kurzweil, "A kid in Africa with a smartphone has access to more information than the President of the United States of the U.S. 15 years ago." This quote from page 2 of the Editor's Desk from the Time magazine on March 26th 2012.\n\nRead more: http://business.time.com/2012/03/15/sxsw-top-5-stories-of-2012/slide/ray-kurzweils-vision-of-the-future/#ray-kurzweils-vision-of-the-future#ixzz1wD9ZFQjh\n\nsource: Quote from Futurist, Ray Kurzweil, Time Magazine, March 26, 2012\n
  • Every single one of us in this room has a cell phone. We use it everyday to communicate to our friends, families and progressional networks. And it’s not just us. With a global penetration rate of 87%, the mobile phone has become part of our culture.\n\nhttp://s3.amazonaws.com/estock/fspid9/13/00/71/6/ecomm-ecomm2008-ecommmedia-1300716-o.jpg\n\nWe all know that the internet, global telecommunications, and economic globalization have made the world incredibly interconnected. This has not only helped us all communicate better, but has also empowered each of us to such an extent that the average individual has more power now than at any other time in history. \n
  • CONTEXT: HOW WE USE MOBILE PHONES \nQuote from Ben Wood, mobile phone analyst at CCS Insight\n\nhttp://www.ccsinsight.com/\n\nBen Wood, mobile phone analyst at CCS Insight said the mobile phone may be "the most prolific consumer device on the planet".\n
  • CONTEXT: PROLIFERATION AND SCALE OF MOBILE PHONES\nQuote from Ben Wood, mobile phone analyst at CCS Insight\n\nWith a worldwide penetration rate of over 85%, the mobile phone has become one of the most transformative tools in human history. As mobile communication technologies become less expensive, faster, and more accessible, the ability of people, communities and institutions to share information and knowledge will continue to skyrocket.  Specifically for Global Health, the use of mobile communication and network technologies for delivery of health care ( mHealth) holds great promise for the future.\n
  • CONTEXT: PROLIFERATION AND SCALE OF MOBILE PHONES\n\nMobile phones are quickly becoming the cheapest, easiest, fasted most effective and efficient way to connect people and institutions in a seamless way.\n\nWith a worldwide penetration rate of over 85%, the mobile phone has become one of the most transformative tools in human history. As mobile communication technologies become less expensive, faster, and more accessible, the ability of people, communities and institutions to share information and knowledge will continue to skyrocket.  Specifically for Global Health, the use of mobile communication and network technologies for delivery of health care ( mHealth) holds great promise for the future.\n
  • CONTEXT: PROLIFERATION AND SCALE OF MOBILE PHONES\nWith a worldwide penetration rate of over 85%, the mobile phone has become one of the most transformative tools in human history. As mobile communication technologies become less expensive, faster, and more accessible, the ability of people, communities and institutions to share information and knowledge will continue to skyrocket.  Specifically for Global Health, the use of mobile communication and network technologies for delivery of health care ( mHealth) holds great promise for the future.\n
  • \n
  • In low resource settings, community health workers (CHWs) provide a backbone for delivery of health care services. Often isolated and without significant formal education or training, themselves, CHWs can be seen as key connectors between communities and formal health care system.\n
  • CONTEXT: CHW SHORTAGE\n\nNearly all countries are challenged by shortages of health workers. 57 countries.\n\nsource: Narasimhan V, Brown H, Pablos-Mendez A, et al. Responding to the global human resources crisis. Lancet. 2004;(363):1469–72. | Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human \n
  • CONTEXT: CHW SHORTAGE\n36 of which are in sub-Saharan Africa, have severe shortages of health workers. For the world’s poorest countries, the scarcity of human resources is a crisis fueled by the low absolute numbers of trained health workers, difficulties in recruiting, retaining and managing health workers, the devastation of HIV/AIDS, migration of qualified health workers to richer countries, poor health-worker performance and inadequate investment in a national health system\n
  • http://www.who.int/mediacentre/events/2006/g8summit/healthworkers_large.gif\n\nCONTEXT: CHW SHORTAGE\n\nNearly all countries are challenged by shortages of health workers. For the world’s poorest countries, the scarcity of human resources is a crisis fueled by the low absolute numbers of trained health workers, difficulties in recruiting, retaining and managing health workers, the devastation of HIV/AIDS, migration of qualified health workers to richer countries, poor health-worker performance and inadequate investment in a national health system\n
  • \n
  • By building on existing resources and skills, we have a transformative opportunity to dramatically improve global health\n
  • mHealth also exists at the intersection of two dynamic spaces, making it a natural tool for CHW\n
  • Global Health Evidence Summit \n\nCommunity and Formal Health System Support for\nEnhanced Community Health Worker Performance\n\n
  • \nfor the purpose of this talk, mHealth, is defined as “the delivery of health care services via mobile communication devices”\n\nCHWs are the backbone of health care in developing countries, however they often have little formal education and training and so devices that use a combination of text, audio, images and video can improve their ability to provide high quality patient care\n\n
  • \n
  • As part of our ongoing commitment to research and evaluation, InSTEDD conducted a systematic review of the literature focused on CHWs and mHealth. To capture the multidisciplinary evidence of this field, we searched in the following medical, public health, engineering, and global development database\n
  • \n
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  • BENEFITS:mHealth tools enable CHWs to provide health services far from the clinical setting, in rural areas, and among hard to reach communities. A rigorously designed series of evaluations found that, as compared to paper-based data collection, mHealth tools had fewer errors (15), less data loss (17) and enabled real-time review of quality, CHW supervision, and rapid response to cited health issues (14,17). \nIn the hands of CHWs, mHealth tools may facilitate effective task shifting; by expanding the pool of human resources, increasing the productivity of health systems, and lowering the cost of services. The reported experience with m-Health suggest a wide range of opportunities exist to improve ease, speed, completeness and accuracy of the work of CHWs. The outcomes associated with these sort of new capabilities can be expected to be potential transformative.\n\nServices are more accessible to patients due to reduced time and expense of travel (13) and due to the ability to seek out patients who are the targets of stigma and discrimination (14).\n\nMahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technology and health care : official journal of the European Society for Engineering and Medicine. 2010 Jan;18(2):137-44. \n\nCurioso WH, Karras BT, Campos PE, Buendia C, Holmes KK, Kimball AM. Design and implementation of Cell-PREVEN: a real-time surveillance system for adverse events using cell phones in Peru. AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2005 Jan;:176-80. \n\nBernabe-Ortiz A, Curioso WH, Gonzales MA, Evangelista W, Castagnetto JM, Carcamo CP, et al. Handheld computers for self-administered sensitive data collection: a comparative study in Peru. BMC medical informatics and decision making. 2008 Jan;8:11. \n\nTomlinson M, Solomon W, Singh Y, Doherty T, Chopra M, Ijumba P, et al. The use of mobile phones as a data collection tool: a report from a household survey in South Africa. BMC medical informatics and decision making. 2009 Jan;9:51. \n\n
  • Most articles reported on projects in developing countries particularly Africa (n=9), with several focused on Asia (n=5), a few in South America (n=2), and only one in North America\nThere were more programs in rural (n=18) than urban (n=13) areas.\n
  • address health issues:A broad range of health issues were addressed; the most common included the interrelated set of issues around sexual, reproductive, maternal and child health (n=20), including HIV/AIDS (n=8). Using mHealth technology for data collection (n=11), decision support (n=6), and alerts and reminders (n=5), typical activities included field-based research and direct medical care. \nProvide decentralized servicesmHealth tools enable CHWs to provide health services far from the clinical setting, in rural areas, and among hard to reach communities. A rigorously designed series of evaluations found that, as compared to paper-based data collection, mHealth tools had fewer errors (15), less data loss (17) and enabled real-time review of quality, CHW supervision, and rapid response to cited health issues (14,17). \nProvision of medical services: CHWs commonly provide direct medical services from the field using mobile devices, , most prominently through decision support as well as alerts and reminder tools. The authors argue that CHWs are the backbone of health care in developing countries, however they often have little formal education and training, and so devices that use a combination of text, audio, images, and video can improve their ability to provide high quality patient care. CommCare is a salient example from the literature of an automated quality improvement system. In a small descriptive study of a maternal health intervention in Tanzania, the authors found that their mobile phone system helped CHWs manage their day and report real-time data through checklists, decision support protocols, and reminders that reinforce target activities and outcomes (18). \nLink CHWs to professional support and supervision. Articles describe the creation of professional support networks, both among CHWs and between CHWs and their supervisors, to provide real-time support while working in the field. In his quasi-experimental study, Chib (2010) found that professional networks also created an opportunity for remote monitoring and supervision of CHWs, leading to greater autonomy for CHWs. Svoronos et al (2010) found, similarly, that mobile phone tools facilitated real-time monitoring of job performance by supervisors at the clinic.\n
  • From Paper:\nThe literature indicates that CHWs commonly provide direct medical services from the field using mobile devices, most prominently through decision support as well as alerts and reminder tools. Several studies found that these tools facilitated improvements in the quality of care provided independently by CHWs, far from the clinic. For instance, a simulated experimental study (12) used mobile multimedia devices to facilitate point-of-care clinical decisions among CHWs in Colombia. They found that CHWs had significantly decreased errors and increased compliance with care protocols in a range of clinical care situations. The authors argue that CHWs are the backbone of health care in developing countries, however they often have little formal education and training, and so devices that use a combination of text, audio, images, and video can improve their ability to provide high quality patient care. \n\n
  • From Paper:\nCommCare is another salient example from the literature of an automated quality improvement system. In a small descriptive study of a maternal health intervention in Tanzania, the authors found that their mobile phone system helped CHWs manage their day and report real-time data through checklists, decision support protocols, and reminders that reinforce target activities and outcomes (18). Although lacking in rigor, this study demonstrates the feasibility of using a variety of mobile tools to shift tasks from highly trained physicians and nurses in the clinic, to minimally trained CHWs in the field. \n\n\n
  • Benefits of mHealth include expanding the pool of human resources, increasing the productivity of health systems, and lowering the cost of services. Empowering CHW is one of the cheapest, fastest most efficient ways to improve global health. \n
  • BENEFITS:mHealth tools enable CHWs to provide health services far from the clinical setting, in rural areas, and among hard to reach communities. A rigorously designed series of evaluations found that, as compared to paper-based data collection, mHealth tools had fewer errors (15), less data loss (17) and enabled real-time review of quality, CHW supervision, and rapid response to cited health issues (14,17). \nEvidence suggests a wide range of mHealth opportunities to improve ease, speed, completeness and accuracy of the work of CHWs.\n\n\n14. Curioso WH, Karras BT, Campos PE, Buendia C, Holmes KK, Kimball AM. Design and implementation of Cell-PREVEN: a real-time surveillance system for adverse events using cell phones in Peru. AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2005 Jan;:176-80. \n15. Bernabe-Ortiz A, Curioso WH, Gonzales MA, Evangelista W, Castagnetto JM, Carcamo CP, et al. Handheld computers for self-administered sensitive data collection: a comparative study in Peru. BMC medical informatics and decision making. 2008 Jan;8:11. \n\n17. Tomlinson M, Solomon W, Singh Y, Doherty T, Chopra M, Ijumba P, et al. The use of mobile phones as a data collection tool: a report from a household survey in South Africa. BMC medical informatics and decision making. 2009 Jan;9:51. \n\n
  • www.instedd.org/technologies/verboice\n
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  • www.instedd.org/technologies/reporting-wheel\n
  • www.instedd.org/technologies/resource-map\n
  • \n
  • \n
  • \n
  • \n
  • While the number of evaluations has grown and become increasingly rigorous, more research and evaluation needs to be done in this field. While the number of evaluations has grown and become increasingly rigorous, more research and evaluation needs to be done in this field.\n
  •  There is still a lot of small scale, independent, exploratory pilots that lack consideration for interoperability, reusability, scalability, and therefore sustainability.\n
  •  There is still a lot of small scale, independent, exploratory pilots that lack consideration for interoperability, reusability, scalability, and therefore sustainability.\n
  • The literature indicated a tendency towards external "fly-in and fly-out" approach, rather than a locally driven and sustainable path forward\n
  • In order to maximize the impact of CHWs on Global Health interventions, we need to keep our focus on the collaborative design and development of mHealth tools in order to ensure we've hit the mark.\n\n
  • Evidence suggests promising opportunities to improve the range and quality of services provided by community health workers with mHealth tools.  Following the current trend, there remains a need for more rigorous evaluation of impacts. Future efforts should focus on economic analysis, participatory approaches to program leadership and management, and best practices for sustainable and scalable mHealth initiatives.\n\nPART 5: RECOMMENDATIONS FOR FUTURE\npoint 1: Effective implementation requires:  1) need to develop implementation science agenda for rigorous M&E, operations research, economic assessment & impact evaluation\npoint 2:  Effective implementation requires 2) country and community ownership, human centered design and engaged end users \npoint 3:  Effective implementation requires 3) smart architecture, reusability, interoperability, open source accessibility\n\nTherefore, recalling the Paris Declaration on Aid Effectiveness, the Accra Agenda for Action and other relevant declarations and drawing deeply on the 2010 Greentree Principles, Improving Health Outcomes with Information and Communications Technologies; \nWe, the undersigned representatives, commit to progress on these issues and supporting improved health outcomes and equity via eHealth in LMICs by: \nCoordinating, Harmonizing and Sharing - Agreeing to strategically coordinate and harmonize our eHealth work in low resource settings and planning to use our combined resources and assets in ways that are increasingly shareable, where possible, for increased impact and decreased duplication of effort.\nCountry Leadership and Ownership - Promoting and strengthening the in-country leadership and ownership of eHealth projects by governments and their partner organizations within low-resource countries where eHealth solutions are being developed and implemented.\nCapacity Development - Developing and responding to the capacity development needs of local constituencies by actively working to improve local in-country skills and jobs so as to ensure appropriate support and partnerships, as well as long-term sustainability.\n\nOpenness - Promoting the use of open eHealth architecture, interoperability, industry-based standards, and transparent sharing of technology and its components. \n\nStrategic Reuse - Building considerations of reusability and interoperability into new eHealth projects and initiatives; Extracting reusable components from appropriate projects, and building new, shared tools and platforms as required; Promoting values of reuse, wherever possible.\n\nResearch and Evaluation - Contributing to the body of knowledge that informs future eHealth investment by actively including research and evaluation in the plans and budgets of eHealth projects and initiatives, building the international evidence-base for what works and what does not, particularly in low resources environments.\n\n
  • 1 - technology\n2 - medicine\n3 - rapid responses\n4 - education\n5 - research\n6 - evaluation\n7 - community cohesion \n8 - prevention\n9 - local capacity\n10 - cultural understanding\n\n
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mHealth and Community Health Workers mHealth and Community Health Workers Presentation Transcript

  • Enhancing Community Health Dennis M. Israelski, MD President and CEO, InSTEDDWorkers Performance WithMobile Technology Innovative Support to from PEPfAR with support Emergencies Diseases and Disasters
  • Source: Wall Street, 20th Century Fox, Written by Stanley Weiser and Oliver Stone, Directed by Oliver Stone, Produced by Edward Pressman, 1987
  • source: Motorola, 1973
  • 4b Mobile phone subscriptions (billions) developing countries developed countries* 3b 2b 1b 2000 ‘01 ’02 ’03 ’04 ’05 ’06 ’07 ’08source: World Bank, 2011 http://data.worldbank.org/indicator/IT.CEL.SETS.P2 *OECD members
  • Global Cell Phone Usage Cell Phones Per Person Over 1.20 .901 - 1.20 .601 - .900 .301 - 600 Under .300source: World Bank, 2011 http://data.worldbank.org/indicator/IT.CEL.SETS.P2
  • 87% of the global population is a mobile phone user Cell Phones Per Person Over 1.20 .901 - 1.20 .601 - .900 .301 - 600 Under .300source: World Bank, 2011 http://data.worldbank.org/indicator/IT.CEL.SETS.P2
  • 87% of the global population is a mobile phone user 4.5 billionsource: CIA World Fact book 20010-11 users in the developing world
  • A kid in Africa with a smartphone today has access to more information than the President of the United States had just 15 years ago. Ray Kurswell quote: kid in africa has more info than the pres 15 yrs agosource: Quote from Futurist, Ray Kurzweil, Time Magazine, March 26, 2012
  • “ This device has become part of the fabric of society, whether a teenage girl taking a Blackberry to bed with her, or a farmer in an African village trying to find out the latest crop prices. ”source: Quote from Ben Wood, mobile phone analysis at CCS Insight, 2010, http://www.bbc.co.uk/news/10569081
  • “ The mobile phone just may be the most prolific consumer device ” on the planet.source: Quote from Ben Wood, mobile phone analysis at CCS Insight, 2010, http://www.bbc.co.uk/news/10569081
  • <30 years
  • <20 yearssource: Nokia, 2007
  • small lightweight portable connected inexpensive simple convenient intuitive+ accessibleopportunity
  • 57 countries havesevere shortagesof health workers
  • 36 are in sub-Saharan Africa
  • Countries with a Critical Shortage of Health Service Providers (doctors, nurses and midwives) countries with critical shortage countries without critical shortagesource: WHO, Global Atlas of Health Workforce (http://www.who.int/mediacentre/events/2006/g8summit/healthworkers_large.gif)
  • 53% of the population of Africa owns a mobile phonesource: World Bank, 2011
  • 53% 74% of the population of Asia owns a mobile phone of the population of Africa owns a mobile phonesource: World Bank, 2011
  • mHealth: at the intersection of mobile communication technologies and health + health issues mobile + service delivery communications mHealth + decision support technologies + supervision + moresource: USAID Community Health Worker Evidence Summit Concept Note, 2012
  • The Community Health Worker at the Intersection of Two Dynamic Systemsgraphic: Mobile Tech and Community Case Management , UNICEF & frog design
  • mHealth:the delivery of health care servicesvia mobile communication devices
  • Systematic Review of the Literature initial search strategy n = 5,868 duplicate citations identified & excluded n = 1,201 unique citations n = 4,667 mHealth exclusions based on title, abstract & author key words relevant mHealth n = 2,064 literature obtained n = 2,603 CHW exclusions based on title, abstract & key wordsrelevant CHW & mHealth n = 2,031 literature obtained n = 35 CHW & mHealth inclusions based on citations full text of potentially n=4relevant literature obtained n = 37 studies excused post full-text review literature included in n = 11 analysis n = 26 Catalani, C et. al. ( Manuscript Submitted) supported by HIPPP, PEPfAR
  • medical engineering mHealth research areas global publicdevelopment health databases Catalani, C et. al.
  • Systematic Review of the Literature Catalani, C et. al. ( Manuscript Submitted) supported by HIPPP, PEPfAR
  • Systematic Review of the Literature Catalani, C et. al. ( Manuscript Submitted) supported by HIPPP, PEPfAR
  • - errors- data loss- lack of real-time QA- lack of CHW supervision- lack of rapid response- travel expenses
  • africa asian=9 n=5 mHealth research locations south northamerica america n=2 n=1 Catalani, C et. al.
  • provide address decentralizedhealth issues services mHealth research use cases provision of professional medical support & services supervision Catalani, C et. al.
  • Colombia | multimedia mHealth technologiesA simulated experimental study in + significantly decreased errorsColombia used mobile multimedia + increased compliance with care protocolsdevices to facilitate point-of-care + combination of text, audio, images and video improve patient careclinical decisions among CHW. Florez-Arango JF, Iyengar MS, Dunn K, Zhang J. Performance factors of mobile rich media job aids for community health workers. Journal of the American Medical Informatics Association  : JAMIA. 2011 Mar 1;18(2):131-7.
  • Tanzania | CommCare maternal mHealth technologiesCommCare is a CHW focused automated + improved time managementquality improvement system operating + improved data reportingthrough mobile phones. + helpful decision support Svoronos T, Mjungu D, Dhadialla P, Luk R, Zue C. CommCare  : Automated Quality Improvement To Strengthen Community-Based Health The Need for Quality Improvement for CHWs. New York City: 2010.
  • + health + human systemresources productivity mHealth effective support for task shifting - costs - errors Catalani, C et. al.
  • + fewer errors+ less data loss+ real-time review of quality+ close CHW supervision+ rapid response capabilities+ cost effective
  • mHealth technologies Verboice is a customizable application thatempowers users to build their own interactive voiceresponse systems.
  • mHealth technologies Baby Monitor is anunconventional approach to service delivery along the birth continuum in remote locations by creating an interactive voice response application for mobile phones that is designed for mothers as end-users.
  • mHealth technologies Reporting Wheel is a non-electric device thatsimplified data reporting for the most remote workers, including the illiterate.
  • mHealth technologiesResource Mapping helpspeople to collaboratively track their work, resources and results geographically and through SMS.
  • mHealth technologies GeoChat is enables self- organizing group communications by allowing users to link the field, headquarters, and the local community in a real-time, interactive conversationvisualized on the surface of a map. GeoChat is a tool forgroup communications based on SMS, email, and Twitter.
  • mHealth technologies GeoChat is a flexible open source group communications technology that lets team members interact to maintain sharedgeospatial awareness of who is doing what where — over any device, on any platform, over any network.
  • mHealth technologies Nuntium is a set of services and clients that allow anyone to build SMS-based applicationswith uses that range from simple modem-based needs to countrywide deployments integrated with wireless operators.
  • mHealth technologies Nuntium is used every day in mission-critical applications includingministries of health or in crises such as in Haiti.
  • Research & Evaluation
  • project project A project H B small scaleproject independent project exploratory G non-collaborative C project project F project D E
  • project project A project H B PILOTITIS small scaleproject independent project exploratory G non-collaborative C project project F project D E
  • project project A project H B interoperabilityproject reusability project scalability G sustainability C project project F project D E
  • Recommendations for the Future + country leadership & ownership* + human-centered design + engaged end users + capacity development* + strategic reuse* + interoperability + open source accessibility* + coordinating, harmonizing & sharing* + research & evaluation* + implementation science agenda for M&E, operations research, economic assessment & impact evaluation *Greentree Principles
  • Innovative Support to Emergencies Diseases and Disasterswww.instedd.org
  • Enhancing Community HealthWorkers Performance WithMobile Technology Innovative Support to Emergencies Diseases and Disasters (manuscript in preparation)
  • Health Informatics Public Private Partnership Management TeamPaul Biondich, Regenstrief Institute Mike Gehron, OGACDennis Israelski, InSTEDD John Novak, USAIDChris Seebregts, Jembi, South Africa Xen Santas, CDC Chris Bailey, WHO* A Central OGAC Initiative *former member
  • 1. Narasimhan V, Brown H, Pablos-Mendez A, et al. Responding to the global Enhancing Community HealthREFERENCES human resources crisis. Lancet. 2004;(363):1469–72. 2. Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health: overcoming the crisis. Lancet. 2004;364(9449):1984-90. Workers Performance With 3. Hongoro C, McPake B. How to bridge the gap in human resources for health. Lancet. 2004;364(9443):1451-6. Mobile Technology 4. WHO. Taking stock: Task shifting to tackle health worker shortages. Geneva: 2010. 5. Price N, Walder R. Community-based distribution: Service Sustainability Strategies in Sexual and Reproductive Health Programming. 2010. Caricia Catalani, DrPH, MPH 6. WHO. World Health Report. Geneva: 2006. InSTEDD and University of California, Berkeley* 7. Lipp A. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases: a review synopsis. Public health nursing (Boston, Mass.). 2009;28(3):243-5. 8. Islam MA, Wakai S, Ishikawa N, Chowdhury A, Vaughan JP. Cost-effectiveness Rebecca Braun, DrPH(c), MPH of community health workers in tuberculosis control in Bangladesh. Bulletin of the University of California, Berkeley World Health Organization. 2002 Jan;80(6):445-50. 9. Torgan C. The mHealth Summit: Local & Global Converge. Washington, D.C: 2009. Julian Wimbush, PhD, InSTEDD 10. Rotheram-Borus M-J, Richter L, Van Rooyen H, van Heerden A, Tomlinson M, Stein A, et al. Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV. Trials. 2011 Jan;12:2. Dennis Israelski, MD, InSTEDD** 11. Zurovac D, Sudoi RK, Akhwale WS, Ndiritu M, Hamer DH, Rowe AK, et al. The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial. Lancet. 2011 Brooke Estin, InSTEDD Aug 3;378(9793):795-803. 12. Florez-Arango JF, Iyengar MS, Dunn K, Zhang J. Performance factors of mobile rich media job aids for community health workers. Journal of the American *Contact lead author: Caricia@instedd.org Medical Informatics Association : JAMIA. 2011 Mar 1;18(2):131-7. 13. Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge **Contact senior author: israelski@instedd.org the healthcare communication gap in the rural developing world. Technology and health care : official journal of the European Society for Engineering and Medicine. 2010 Jan;18(2):137-44. 14. Curioso WH, Karras BT, Campos PE, Buendia C, Holmes KK, Kimball AM. Design and implementation of Cell-PREVEN: a real-time surveillance system for Innovative Support to Emergencies adverse events using cell phones in Peru. AMIA ... Annual Symposium Diseases and Disasters proceedings / AMIA Symposium. AMIA Symposium. 2005 Jan;:176-80. 15. Bernabe-Ortiz A, Curioso WH, Gonzales MA, Evangelista W, Castagnetto JM, Carcamo CP, et al. Handheld computers for self-administered sensitive data collection: a comparative study in Peru. BMC medical informatics and decision making. 2008 Jan;8:11. 16. Leach-Lemens C. Using mobile phones in HIV care and prevention. 2009. 17. Tomlinson M, Solomon W, Singh Y, Doherty T, Chopra M, Ijumba P, et al. The use of mobile phones as a data collection tool: a report from a household survey in South Africa. BMC medical (manuscript submitted)