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15h32 gakuba


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15h32 gakuba

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