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Mobile Learning for Primary Health Workers

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Final Workshop presentation 1 - from UK Aid Direct project in Ethiopia

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Mobile Learning for Primary Health Workers

  1. 1. http://digital-campus.org © 2013 Improving Health Extension Workers' training and effectiveness through continuous skills improvement, knowledge assessment and patient management processes GPAF Innovation Project July 2013 - October 2016 Mobile Learning for Primary Health Workers
  2. 2. http://digital-campus.org © 2013 Asia Bangladesh India Indonesia Mongolia Myanmar Nepal Pakistan Qatar GPAF project Technical & Content development Worldwide project partners R&D
  3. 3. http://digital-campus.org © 2013  Inadequate training and very text-heavy.  Little follow up on how the skills and knowledge learned are applied.  Low skilled birth attendance and PNC rate  Need for a professional career development program BMC Human Resources for Health http://www.ncbi.nlm.nih.gov/pubmed/23171076 Primary health care system challenges in Ethiopia
  4. 4. http://digital-campus.org © 2013 Digital-Campus theory of change Strategies Outputs Outcomes Impact Increase ANC/PNC knowledge retention Bridge the digital gap among women Improve quality of ANC/PNC care Achieve MDG goals Quality education Gender Equality Develop a M-learning Platform Mobile-adapt official training content Good health & Well-being Resources to scale innovative local solutions Invest in innovation Mhealth Open source technologies Creative Commons content support
  5. 5. http://digital-campus.org © 2013 • A cohort of 157 HEWs at Mekelle TVET (promotion 2015-16. • Supplementing 1-year face-to- face training with additional multimedia and quiz activities. • HEWs Level IV training content – 13 modules – all mobile adapted to run offline – but focus on ANC & PNC. • We supported HEWs whilst in training centre. • We followed up ongoing usage and knowledge retention once in health post for up to 11 months.
  6. 6. http://digital-campus.org © 2013 Mean Age (29 yo) Married (> 80%) Children (1.6 avg)
  7. 7. http://digital-campus.org © 2013 Phase I: m-learning platform development and content adaptation  First 12 months.  Development and testing the OppiaMobile platform.  Adapting the HEWs level IV official training content to be used in mobiles.
  8. 8. http://digital-campus.org © 2013 What is OppiaMobile? OppiaMobile is the first rich- content open source mobile learning platform specifically designed for users in low bandwidth/connectivity environments.
  9. 9. http://digital-campus.org © 2013 OppiaMobile learning platform  Supports video, quizzes and other activities.  Works when completely offline – all activities stored on device.  Specially designed for slow broadband networks (2G).
  10. 10. http://digital-campus.org © 2013 OppiaMobile learning platform  Currently designed for Android, but can be extended to other mobile operating systems.  Designed to support existing or new training and teaching programmes in all professional areas.  Supports multilingual content.  Text to Speech – the client app can “read aloud” text pages.
  11. 11. http://digital-campus.org © 2013 How it works  No need for programmers to maintain and update learning content.  Course content can be collaboratively edited and produced in Moodle.
  12. 12. http://digital-campus.org © 2013 How it works  Activity tracking, quiz results, video views all submitted to server – trainers and supervisors can track student progress.  Students gain points and “badges” based on their usage and quiz scores (gamification).
  13. 13. http://digital-campus.org © 2013 Customised OppiaMobile versions All open source - can install your own server and create your own client app  Use your own themes/logos for the client application
  14. 14. http://digital-campus.org © 2013 Official training content for Level IV HEWs
  15. 15. http://digital-campus.org © 2013 HEWs level IV training content  13 Modules to upgrade the theoretical knowledge of the country’s 40,000 Health Extension Workers.  These Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia.
  16. 16. http://digital-campus.org © 2013 OppiaMobile adapted HEWs level IV courses
  17. 17. http://digital-campus.org © 2013 OppiaMobile adapted HEWs level IV courses
  18. 18. http://digital-campus.org © 2013 Student and teachers dashboard: automatic activity tracking
  19. 19. http://digital-campus.org © 2013 We developed a glossary english- tigrinya for medical terms
  20. 20. http://digital-campus.org © 2013 ANC & PNC Checklist app
  21. 21. http://digital-campus.org © 2013 Phase II: testing the application with HEWs at Dr. Tewelde training centre  From April 2015 until August 2015.  Training workshops:  Android phones  ANC/PNC checklists  OppiaMobile
  22. 22. http://digital-campus.org © 2013 Mobile Phone baseline survey  Mobile phone use by HEWs. Findings:  99.5% of the HEWs do have mobile phone (Mostly feature Nokia and Techno phones)  91% did not know how to use Internet.  > 90% did not have an e-mail or social media account.  >90% were not confident using a computer.  >37% of HEWs did not have electricity at home to charge their phones.
  23. 23. http://digital-campus.org © 2013 Mobile Apps pre-installed
  24. 24. http://digital-campus.org © 2013 Training workshops
  25. 25. http://digital-campus.org © 2013 Understanding HEWs challenges
  26. 26. http://digital-campus.org © 2013 How to use smartphones
  27. 27. http://digital-campus.org © 2013
  28. 28. http://digital-campus.org © 2013 HEWs level IV graduation
  29. 29. http://digital-campus.org © 2013 Phase III: testing the application with HEWs at their health posts  From December 2015 to October 2016.  Remote follow-up (OppiaMobile Dashboard, phone calls, SMS)  Regular field visits  Monthly top-up (50 Birr)
  30. 30. http://digital-campus.org © 2013 Electricity HP Network HP No Yes
  31. 31. http://digital-campus.org © 2013 Good network but no electricity in HP
  32. 32. http://digital-campus.org © 2013 Electricity Home Network Home No Yes
  33. 33. http://digital-campus.org © 2013 No Yes
  34. 34. http://digital-campus.org © 2013 OppiaMobile automatic activity tracking
  35. 35. http://digital-campus.org © 2013 Health Posts visits
  36. 36. http://digital-campus.org © 2013
  37. 37. http://digital-campus.org © 2013 Health Post visits and monitoring (video)
  38. 38. http://digital-campus.org © 2013 Group Monitoring
  39. 39. http://digital-campus.org © 2013 Phase II: testing the OppiaMobile platform with HEWs at the training centre RESULTS
  40. 40. http://digital-campus.org © 2013 COC May 2105 Aug 2105 Nov 2105
  41. 41. http://digital-campus.org © 2013  Usage stats for the training period:  1 million activity hits.  80,000 quiz attempts, with responses to 600,000 questions.  16,000 video views. • Very few technical issues, students and college dean/tutors very happy with app and content (from satisfaction survey). OppiaMobile main usage statistics (May 15 - July 15)
  42. 42. http://digital-campus.org © 2013 HEWs looked at all Modules
  43. 43. http://digital-campus.org © 2013 >13 wks 8-11 wks 4-8 wks Students activity (May – July 15)
  44. 44. http://digital-campus.org © 2013 P= 0.001 (Mann-Whitney test) Antenatal Care module test results P= 0.29 (Kruskal-Wallis test) P= 0.001 (Kruskal-Wallis test) Pre-quiz (May 2015) Post-quiz (July 2015)
  45. 45. http://digital-campus.org © 2013 Pre-quiz (May 2015) Post-quiz (July 2015) Pre-quiz ANC Post-quiz ANC
  46. 46. http://digital-campus.org © 2013 P= 0.014 (Mann-Whitney test) Postnatal Care module test results P= 0.63 (Kruskal-Wallis test) P= 0.001 (Kruskal-Wallis test) Pre-quiz (May 2015) Post-quiz (July 2015)
  47. 47. http://digital-campus.org © 2013 Pre-quiz (May 2015) Post-quiz (July 2015) Pre-quiz PNC Post-quiz PNC
  48. 48. http://digital-campus.org © 2013 Certificate of Competence national exam results (Nov 2015) 1st time 2nd time
  49. 49. http://digital-campus.org © 2013 Phase III: testing the OppiaMobile platform with HEWs at their health posts RESULTS
  50. 50. http://digital-campus.org © 2013 Less than 6% of phones had any hardware issues in 16 months (lost/stolen, broken or malfunction) Normal Lost/stolen Malfunction Broken
  51. 51. http://digital-campus.org © 2013 Phones were not locked
  52. 52. http://digital-campus.org © 2013 HEWs also installed other apps…  Medical Dictionary  First Aid  English-Amharic Dictionary
  53. 53. http://digital-campus.org © 2013 2615 15935 58165 7414 23080 11551 18972 35850 4142 7753 8085 19335 40272 22120 21058 8673 13325 14525 18883 16502 12092 84134 23761 46173 25988 12472 18640 8863 10910 28672 35542 6032 47112 14711 12455 15237 480 13452 37564 5015 42767 30930 17498 27657 51126 32647 55287 22895 23421 22428 7774 7950 9250 16466 27304 2054 13850 Bizu Tadele: 217.109 ! OppiaMobile activity
  54. 54. http://digital-campus.org © 2013 Post-training evaluation: antenatal care June 2016Test (June 2016) Excellent Good Passed Not passed
  55. 55. http://digital-campus.org © 2013 Antenatal care evaluation Test (June 2016)Test (May 2015) Excellent Good Passed Not passed
  56. 56. http://digital-campus.org © 2013 Post-training evaluation: postnatal care June 2016Test (June 2016) Excellent Good Passed Not passed
  57. 57. http://digital-campus.org © 2013 Postnatal care evaluation Test (June 2016)Test (May 2015) Excellent Good Passed Not passed
  58. 58. http://digital-campus.org © 2013 Postnatal care visits 0-48h (Dec 15 - July 16) Source: eHMIS
  59. 59. http://digital-campus.org © 2013 Antenatal care - at least 4 visits (Dec 15 - July 16) Source: eHMIS data
  60. 60. http://digital-campus.org © 2013 • This project is innovative and relevant. • There are clear results and overall the project scores A+. • The project represents very good value for money. GPAF QAV Visit Report (January 2016)
  61. 61. http://digital-campus.org © 2013 Further info/links • Get the app on Google Play • Documentation: http://oppia-mobile.org
  62. 62. http://digital-campus.org © 2013 Thanks! Contact us at: roman@digital-campus.org

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