Stanford globalm health_p_mechael

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  • Interventions reach over 400,000 people in Sub-Saharan Africa. There is potential for projects to scale-up beyond the MV Sites.
  • These are initiatives that feed into mHealth@MVP. Focus of presentation will be on CC+ and integration into MGV-Net.

Transcript

  • 1. Global mHealth: What Works Patricia Mechael, PhD MHS Director of Strategic Application of Mobile Technology for Public Health and Development 4 May 2011
  • 2. Range of mHealth Programs
    • LOW -------- COMPLEXITY -----HIGH
    • e- and increasingly mHEALTH
    • TELEMEDICINE
    Health-related services delivered remotely with clinical input The delivery of health related services via mobile technology
  • 3. Scale of mHealth
  • 4. mHealth Overview Disease Surveillance Electronic Medical Records Supply Chain Management Decision Support Disaster Response Health Financing eLearning Health Information Systems mHealth Health Policy Health Governance Health Equity FOSS Vertical Trends Horizontal Trends
  • 5.
    • In May 2010, The Earth Institute and mHealth Alliance launched a whitepaper investigating the gaps and barriers to scaling mHealth
    Barriers and gaps affecting mobile health in low and middle income countries: Policy White Paper
    • Methods
    • Searched 6 databases in 3-month time period
    • 2,994 scholarly publications & secondary research reviewed
    • 172 articles analyzed
    • Round-table discussion held with key informants in March 2010
    • Virtual review conducted with key informants in March 2010
  • 6. Review Results
    • 96% of articles reviewed are between 2002 – 2010
    • 85% of studies with sample sizes were between 2 and 927 ; 15% of studies with sample sizes were between 1,140 and 29,000
    • 43% of pilot projects, RCT and qualitative studies took place between 1-3 months, followed by 14% from 4-6 months and 14% from 10-12 months
    • The most prevalent diseases represented were HIV/AIDS (8%), diabetes (8%), and maternal and child health (7%)
    • SMS was the most commonly used functionality ( 25% ), followed by applications on mobile phones or PDA’s ( 23% )
  • 7.  
  • 8.
    • Key Findings
    • Evidence fraught with small-scale implementations focused on usability versus health outcomes
    • Single solutions versus integrated solutions that advance country health systems priorities
    • Cultural chasm between mHealth practitioners and mHealth academics
    • mHealth business model unclear (lack of cost-benefit studies)
    Research gaps to scaling mHealth
    • Call to action
    • Replicable study design (RCT, large sample size, longer time line)
    • Studies that report health outcomes, cost-benefit outcomes, and business model suggestions
    • Cross-country studies
    • Standardized indicators
    • Technology comparison studies
  • 9. Key Findings : 70 project were included in the analysis, representing the contribution of 50 individuals from 29 countries- mostly sexual and reproductive & child health Earth Institute & WHO mHealth Metrics & Evaluation Survey
  • 10.
    • Key Findings
    • Lack of strong mHealth evidence base hinders governments and MOH’s to mobilizing an mHealth policy framework
    • Need policies that minimize entrepreneurial risk and maximize reward
    • Lack of collaboration between MOH, private telecommunications sector academics, practitioners and international community had led to fragmented pilot projects
    • Little coordination between eHealth and mHealth efforts needed
    Policy barriers to scaling mHealth
    • Call to action
    • Develop flexible policies, architectures, and interoperability and data standards to drive additive contribution of multiple stakeholders
    • Mandate the need for pre-implementation studies to align mHealth activities with national health system needs
    • Commit to universal coverage and funding of research needed to provide evidence for policy development
  • 11.
    • Key Findings
    • 112 countries surveyed, 83% responded as having at least one mHealth initiatives and 17% reported that there was no mHealth initiative in-country
    • Most countries reported having 4-6 initiatives
    • Most common types of programs: health call centres, toll-free emergency, and mobile telemedicine
    WHO mHealth Survey Module
  • 12. What we now know…
      • Policy : Start with health priorities and work backwards
      • Strategy : Promote targeted and measurable aims, objectives, and targets & then look for the best tools
      • Architecture : Support the development of interoperability & data standards (convergence on Open Source platforms and integration)
      • Applications : Promote multi-purpose and function support tools with data collection by-products & away from pilots to scale
      • Human resources : Assess demand and develop long and short-term training programs
      • Financing : Links systems to mobile banking and health insurance claims and reimbursement
      • Research and evaluation : Move to cost-benefit (eHealth Value) and health outcomes research and away from usability studies
      • Collaboration and coordination : South-south and south-north engagement (Global, National, PPP)
  • 13. The eHealth/mHealth Ecosystem Technology
    • Social Actors
    • Patients
    • Consumers of Technology
    • Healthy Citizens
    • Workers
    • Managers/Employers
    • Policy Makers
    • Government Officials
    Health Education Economy Governance Infrastructure Environment Society Earth Institute, Columbia University 2009
    • IT
    • Human
    • Resources
    • IT specialists
    • Local Managers
    • Service Providers
    • Hardware/
    • Software
    • Mobile Phones
    • SIM cards, Chargers
    • Computers
    • Servers
    • OpenMRS
    • CommCare
    • mLearning applications
    • Tele-
    • Communications
    • Infrastructure
    • Cell Towers
    • MGV-net
    • Toll-free numbers
    • Internet Connectivity
    • Supplies
    • And Facilities
    • Supply Chain Management
    • Medicines, Vaccines
    • Clinics and Hospitals
    • Pharmacy
    • Health System
    • Processes
    • Disease Surveillance
    • Health Promotion
    • Health Education
    • Emergency Referrals
    • Non-emergent Referrals
    • Health
    • Human
    • Resources
    • Doctors, Nurses
    • Community Health Workers
    • Lab Technicians
    • Ambulance Drivers
  • 14. Millennium Villages Project: A Multi-sectoral Innovation, Testing, and Evaluation Lab Potou, Senegal (Pop. 31,000) Bonsaaso, Ghana (Pop. 30,000) Tiby, Mali (Pop. 55,000) Toya, Mali (Pop. 5,000) Ikaram, Nigeria (Pop. 20,000) Pampaida, Nigeria (Pop. 15,000) Koraro, Ethiopia (Pop. 55,000) Mwandama, Malawi (Pop. 35,000) Gumulira, Malawi (Pop. 5,000) Mbola, Tanzania (Pop. 30,000) Sauri, Kenya (Pop. 55,000) Dertu, Kenya (Pop. 5,000) Ruhiira, Uganda (Pop. 40,000) Mayange, Rwanda (Pop. 20,000)
  • 15.
      • The primary aim of mHealth in MVP is to use mobile technologies to accelerate the achievement of the MDGs, beginning with health. mHealth and eHealth initiatives of MVP are developed and implemented together within a broader MDG Framework with linkages to Community-based Information Systems and other sectors.
    Millennium Villages Project mHealth Activities
  • 16.
    • Provides immed. feedback to CHW
    • Connects CHW and local clinic
    • Provides auto reports to MVP and District HO
    • WHO-standards-based
    • Multilingual
  • 17. Register every child under 5 and Pregnant women Monitor Childhood ailments Immunization Support Supply Chain Management Record Births and Deaths
  • 18.
    • Formatted SMS Text:
    • R45Y7 +T Y N +M 135 Y +R C
    • Other two entries:
    • E54M67 +S VM SF +R B
    • D1E276 +P 8 3 4
    … … … … … … Date HEALTH ID 30/9 E54M67 30/9 D1E276 30/9 R45Y7
  • 19.  
  • 20. Women and mHealth: From Beneficiaries to Partners in Design
    • GSMA mWomen Program
    • Program launched in October 2010- Support from Hillary Rodham Clinton, Cherie Blair Foundation
    • Aims to close mobile phone gender gap by 50% over 3 years
    • PPP between mobile industry and international development community
    • Harness power of private sector to accelerate adoption of mobile services for unconnected while providing life changing services to women
    •  
  • 21. Thank you & Links to Resources
    • http://en.wikipedia.org/wiki/MHealth
    • http://cghed.ei.columbia.edu/?id=projects_mhealth
    • http://www.globalproblems-globalsolutions-files.org/pdfs/mHealth_Barriers_White_Paper.pdf
    • http://www.youtube.com/watch?v=mM-cfcnfEmo&feature=channel
    • www.childcount.org
    • http://www.mhealthalliance.org/
    •