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mHealth Intro - Alain Labrique
1. ICMNH Seminar, JHSPH February 22, 2015
mInnovations
Mobile Technology to Bridge Health Systems Gaps
and Improve RMNCH Outcomes
Alain B. Labrique, PhD, MHS, MS
Director
JHU Global mHealth Initiative
Associate Professor
Dept. of International Health & Dept. of Epidemiology
Johns Hopkins Bloomberg School of Public Health
JHU School of Nursing
JHU School of Medicine (Health Informatics)
Chair
WHO mHealth Technical Evidence Review Group
8. A future where:
• Every family has access to
information, services and
medicine
• Every health worker has the
skills, training and support to
do his/her job consistently
well
• A health system counts and is
accountable for every life.
11. 0
.2.4.6.8
1
2008 2009 2010 2011 2012
Year
Lowest Quartile WI (n=17,176) Low Quartile WI (n=19,789)
High Quartile WI (n=6,472) Highest Quartile WI (n=1,032)
Mobile Phone Ownership by WI over Time
Household Mobile Phone Ownership over time in rural
Bangladesh, by “Wealth Index” (n=44,469)
Labrique, Tran et al, 2013 (JMIR, in press)
ProportionofHHreporting“MobilePhoneOwnership”
14. mHealth:The Four C’s
Harnessing ubiquitous information
and communication technology to
collect data, connect individuals,
compress time and create novel
opportunities to improve
individual and public health.
15. Labrique, Vasudevan, Kochi et al, mHealth Innovations as Health
System Strengthening Tools. Global Hlth Sci Prac 2013
*Most downloaded / cited mHealth article 2013-14.
17. mHealth is not a single THING.
Mobile tools can be used to strengthen
different parts of the health system.
18.
19. mHealth Technical Evidence
Review Group for RMNCH
http://bit.ly/who-mterg
“Providing governments and implementing agencies
objective, evidence-based guidance for the
selection and scale of mHealth strategies
across the reproductive, maternal,
newborn and child health continuum”
-mTERG Mission Statement 2012
20. Health System
Adequacy
Provider
Competency and
Accountability
Patient
Knowledge and
Self-Efficacy
ARTICULATING
mHEALTH
STRATEGIES
AS
HEALTH
SYSTEMS
INNOVATION
• INFORMATION
• DEMAND CREATION
• SUPPORT SYSTEMS
• WORK MANAGEMENT
• DECISION SUPPORT
• ENUMERATION
• SURVEILLANCE
• SUPPLY CHAIN
• STAFF AND FACILITY
PERFORMANCE
MONITORING
• REFERRAL SUPPORT
27. Global PPP
Initiative
“If you have any
bleeding during this
month, seek medical
attention right away”
Expectant women/
new mothers sign
up for service
Users receive 2
health-related SMS
or Audio Message
weekly
NGO Partnership and
“Freemium” Model of
Subscription
“Your baby needs an
immunization this week
to stay healthy:
Available free at all
EPI clinics”
US, Bangladesh, South Africa, Russian Federation, India
28.
29.
30. Text Message Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A
Meta-Analysis of Randomized Controlled Trials
David J. Finitsis, Jennifer A. Pellowski, Blair T. Johnson
PLOS ONE 2014
40. Tremendous time and effort is invested in
manual data summarization and reporting.
19 registers contain 473
unique data fields !
Approximately 60 fields
would be required for a
digital system to process the
same information.
53. Project Mwana:
SMS to reduce Infant HIV PCR Turnaround Time
(Median 46% Reduction in DAYS)
54. New frontiers!
Remote, Point-of-care Diagnostic tools
Breslauer D., et al. 2009 Mobile Phone Based Clinical Microscopy for Global Health Applications. PLoS ONE 4(7): e6320
63. Rigorous Process / Outcome / Impact Evaluation
eg. RCTs
mHealth requires BOTH
Engineering and Public Health Approaches
NEED ADEQUATE FUNDING
FOR THIS