Programs Using Mobile Phones toEliminate Pediatric HIV in Africa 1 RapidSMS 2 MAMA 3 R.H.E.A. 4 Young Rwanda MAMA - South Africa, Jembi Health - Rwanda Africa Live UNICEF - Rwanda India, Bangladesh Praekelt Foundation - South Africa 5 Project Mwana 6 Mother Baby 7 HIV-Link 8 Mxit Pair Tracking UNICEF - Zambia, Medic Mobile - Ethiopia Mxit - South Africa mothers2mothers - Malawi South Africa Health 9 M-Trac 10 Connected 11 Ghana 12 Closed User Telemedicine Group UNICEF - Uganda Study Earth Institute, Novartis - Millenium Villages - 10 EGPAF / WHO - Kenya Ghana Countries 7 16 11 19 16 13 The Pamoja 14 LUCAS 15 Wired Mothers 16 Switchboard 9 20 Project ERNECA Ministry of UCLA Switchboard - Liberia, 10 13 EGPAF - Kenya Health and Social Ghana, Tanzania Welfare - Zanzibar 1 3 24 15 17 EpiSurveyor for 18 Philani Mentor 19 mPedigree 20 uReport 16 21 PBF verification Mothers Project mPedigree - Ghana UNICEF, Uganda EPGAF - Mozambique UCLA - South Africa 5 5 21 Improving EID 22 Good Start III 23 MoTECH 24 CommCare TAT 17 EGPAF - Tanzania South African Medical ANC, Grameen Dimagi, 15+ Countries Research Council - Foundation including India, Rwanda South Africa HIV mobile 25 26 Mobenzi appointment Outreach reminders 2 4 6 8 18 22 26 MRC, UCLA, HSRC, Stellenbosch InSTEDD - Cambodia University, University of Washington, SA Department of Health - South Africa
Defining Event Mother & Child shared journeyLenshina, Mother, KENYA Actors & Touchpoints cardsLenshina feels sick and goes tothe clinic. There she finds outto be pregnant and HIVPositive.
MHEALTH FRAMEWORK Mapping Mobile Opportunities MONTHS -9 -6 0 12 LABOR POSTPARTUM/ Mobile Opportunities MOTHER PREGNANCY & BIRTH BREASTFEEDING 1ST TRIMESTER 2ND AND 3 RD BIRTH INFANCY Mobile phones and technology can CHILDHOOD CHILD TRIMESTER address 4 key challenges faced by WHO & UNICEF PMTCT INTERVENTION TIMELINE GUIDELINES expectant and new mothers, their 1. HIV testing 2. CD4 testing 3. Results Early infant care diagnosis (EID) children, and the health care workers Early infant care diagnosis (EID) WEEK 6 MONTH 18 ARVs to mother ARVs to baby who care for them. Ongoing care to mother Ongoing care to HIV-exposed Infant Demand, Tracking & HEALTH TOUCHPOINTS SAMPLE IMPLEMENTATION Awareness Retention & Education of Mothers & Babies 6/ 6/ 6 visit 6/ 6/ 6 visit Mother asked 6/ 6/ 6 visit reminder reminder to visit clinic reminder CHW CHW registers birth • Stigma/fear & isolation • Delayed test results to mother RURAL CLINIC DBS sample registered SMS results received • Adherence to drug results at clinic Mother receives regimens • HIV testing and re-testing of child • Knowledge re: self-care and care • Linkages to on-going treatment for DISTRICT Sample shipped and t racked for her baby mother and pediatric treatment COUNTRY Results registered at national lab EVIDENCE Coordination, EID test result turn-around time improved by over 50%. Supply Chain Supervision & Management Quality of Care MOBILE CHALLENGES RELEVANT TO PMTCT INITIATIVES • Stockouts of test kits, medications, OPPORTUNITIES • Training of CHWs and other commodities • Communication between CHW • Transporting blood samples to lab and nurses Demand, Awareness and Education • Transporting results back to clinic • Updates to new protocols • Delays at clinics. Tracking & Retention of Mother Baby Pairs Coordination, Supervision and Quality of Care Supply Chain Management
Joanne Stevens MAMA South Africa SOUTH AFRICAMAMASouth AfricaMAMA South Africa provides vital health information via mobile phonesto expectant and new mothers and their families, supporting them week-by-week during pregnancy and the first year of baby’s life. Most SouthAfrican moms-to-be learn that they are HIV positive for the first timeduring pregnancy, and lack social support to help them cope with thediagnosis of a life threatening disease while adjusting to the demands ofpregnancy and a new baby.Metrics/Evidence Key Technologies Audience ChallengesMAMA will target 500,000 Mobile Low-income and at-risk Maternal deaths havewomen and household Website/Portal (askmama. expectant and new increased 40% since 1998decision-makers over two mobi), staged SMS mothers, as well as their due to HIV/AIDS. Mothersyears. 100 registered for messages, interactive household decision need caring, accurate,SMS services in first two quizzes via USSD makers. straightforward informationweeks. that is timely and discreet.
Erica Kochi UNICEF Innovation Team ZAMBIA & MALAWIProject MwanaThe Mwana Initiative has improved test result turn-around time by over50%. It delivers early infant diagnosis (HIV) results to rural and under-served communities in Zambia and Malawi via text messages rather thanpaper. Community Health Workers also register births and trace patientsvia SMS to ensure that they receive key childhood interventions.Metrics/Evidence Key Technologies Audience ChallengesEID test result turn-around Basic Mobile Phones, Community Health Logistical challenges intime improved by RapidSMS Workers remote communitiesover 50%. delay EID results and subsequent interventions.
Design Principles PUT THE USERS FIRST GO BEYOND MOBILE THINK SYSTEM-WISE MASH-UP COMPETENCES“ Having data and not knowing what to do with it is as bad “ Mobile has to be part of a multi-pronged approach, that will “ We need to look at the problems both at the national scale and at “ We need to bring designers, health technical leads and as not having any work with and within the level of the single mobile technologist data. other systems. mother. Then solve together more often them in a way that ” ” ” ” works for both.