, Program Manager, Mobile Health at UniversalDoctor | Project Coordinator at Zero Mothers Die | Consultant at Advanced Development for Africa
at UniversalDoctor Project, Zero Mothers Die, Advanced Development for Africa
1) Which represents about 73% of mobile subscriptions worldwide – that’s nearly three times the amount in developed countries! 80 percent of rural communities across the globe have access to a mobile network. 3) from randomized scientific trials and studies - Recent evidence from randomized scientific trials and studies has demonstrated that the capabilities of mobile phone technology, particularly SMS messaging, can positively impact treatment outcomes. Results of the WelTel Kenya1 clinical trial, the first study of its kind in Africa, were published in the Lancet in November of 2010. The trial focused on the impact of SMS messaging on remotely located HIV patients’ adherence to antiretroviral therapy (ART). The study showed that patients who received SMS support had significantly higher adherence to ART and higher rates of viral suppression when compared with patients in the control group. A scale up of such an HIV treatment adherence initiative in Kenya could suppress viral loads in 26,000 extra people at the cost of less than USD 8 per person per year Lester R et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. The Lancet Online, 12 June 2011, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61997-6/fulltext Also mention Cell-Life SMS for HIV testing trial….
mHealth represents a cost-effective technology solution to many of these challenges if implemented correctly and brought to scale.
1) Sustainability and scalability factors must be built into the program from the beginning. And a project must be designed to last beyond initial funding. 2) Perform assessments to identify real needs and demand of target beneficiaries, local health priorities and to understand the local landscape (existing players and solutions, policies, local settings and practices, etc.) in the area of implementation. Do not duplicate efforts; collaborate for stronger impact. Take into account the local conditions, environment, stakeholders and barriers identified during the assessment during the design and planning phase. 3) Align the mHealth program (including objectives and target outcomes) with the local and national health priorities and any existing health information systems.
4) Make significant efforts to meet with as many government players, local collectivities and community organizations as possible from the outset to really understand where and how decision-making takes place, particularly on funding. Design a partnership agreement that can be validated by the MOH and various local stakeholders as a tool to support the deployment and adoption of the mHealth intervention across wider areas. 5) Bring knowledge of local landscape necessary to ensure success of pilot and scale up 6) Finding and engaging strategic partners in a meaningful way is a critical success factor. They can can provide their technical know-how and core competencies, resources and network to contribute to the scale up of the project. Common mHealth strategic partners strongly agree that partnerships with various players in the value chain are necessary if mHealth is to grow beyond the pilot phase.
7) One of the main drivers of the scale up of mHealth will be the evaluation of initiatives and collection of data to prove the efficacy and efficiency of mHealth projects in achieving target outcomes and meeting local/national healthcare priorities. It is important to maintain flexibility in project implementation to adapt to the changing needs and priorities of beneficiary populations and avoid failures. M&E should not only be used to indicate success, but also to guide adjustments along the way.
2) Use incentives to promote effective use ; adjust program accordingly.
Through more accurate and timely data, disease surveillance, decision support and health information management, mHealth can effectively inform policy-making and planning within healthcare systems and improve the health of local communities, particularly remote populations.
Scaling Up mHealth in Developing Countries - White Paper Commissioned by Advanced Development for Africa
Scaling Up Mobile Health Elements Necessary for the Successful Scale up of mHealth in Developing Countries Jeannine Lemaire
mHealth is able to address a wide variety of healthcare challenges, including:
Map of mHealth pilots in Uganda by Sean Blaschke, UNICEF Uganda
<ul><li>Critical success factors necessary for the scale up of mHealth </li></ul><ul><ul><li>Global assessment of mHealth </li></ul></ul><ul><ul><li>projects </li></ul></ul><ul><ul><li>Interview of mHealth experts </li></ul></ul><ul><li>Case Studies </li></ul><ul><li>Best Practices </li></ul><ul><li>Recommendations </li></ul>
Senior Advisor, Global Health and Technology at Ashoka Former Executive Director of the mHealth Alliance David Aylward Patricia Mechael Brooke Partridge Anne Roos Weil Executive Director of the mHealth Alliance mHealth and Telemedicine Advisor at The Earth Institute President and CEO of Vital Wave Consulting Co-Founder and CEO of Pesinet
eHealth expert and Program Manager at the World Health Organization (WHO) Getachew Sahlu
<ul><li>Plan for scale up and sustainability on a large scale. </li></ul><ul><li>Perform local assessments and take into account local factors in the design and planning phase. </li></ul><ul><li>Align with local and national health priorities. </li></ul>
<ul><li>Secure buy-in from the government, communities and local healthcare structures as soon as possible. </li></ul><ul><li>Collaborate with local implementation partners. </li></ul><ul><li>Establish strategic partnerships. </li></ul>
<ul><li>Perform monitoring and evaluation (M&E) and assessments of impact </li></ul><ul><ul><li>Use meaningful, measureable metrics </li></ul></ul><ul><ul><li>Collect data to prove cost-efficiency/cost-effectiveness of mHealth solutions </li></ul></ul><ul><ul><li>Use M&E to guide adjustments to the program, maintain flexibility to ensure locally appropriate and effective </li></ul></ul>
<ul><li>Integrate the program within existing healthcare structures </li></ul><ul><li>Employ an integrated solution, cross-sectoral and/or holistic approach </li></ul><ul><li>Identify a sustainable and scalable business model </li></ul><ul><li>Build partnerships with the public and private sectors. </li></ul>
<ul><li>Build local capacity </li></ul><ul><li>Ensure the software is geared towards objectives, suitable for local conditions & designed for the end-user </li></ul><ul><li>Perform social marketing </li></ul><ul><li>Link with other programs </li></ul><ul><li>Seek to empower users, particularly women </li></ul><ul><li>If an aspect of the project is failing, fail quickly and publicly. </li></ul>
<ul><li>Mainstream mHealth in the MOH and other relevant government bodies </li></ul><ul><li>Establish an e/mHealth structure to support mainstreaming of mHealth </li></ul><ul><li>Create an inter-ministerial working group and collective agreement involving various stakeholders </li></ul><ul><li>Identify specific data, technology and interoperability standards </li></ul><ul><li>Advocate for the integration of mHealth within local healthcare initiatives. </li></ul>
<ul><li>Establish global network of key players to inform global approach to support scale up </li></ul><ul><li>Establish global repository of mHealth applications, tools, best practices, recommendations and data </li></ul><ul><li>Advocacy by institutional players for integrating mHealth </li></ul><ul><li>Donors and institutional players need to support the evaluation of initiatives in developing countries and creation of common metrics & indicators. </li></ul>