This document summarizes a project by Jhpiego to introduce electronic learning materials in limited-resource settings in Ethiopia. It describes assessing IT infrastructure at 3 universities, developing sample e-learning courses, and partnering with a firm to create a distributed learning management system. Immediate solutions included training local IT staff and setting up an e-learning lab. Recommendations focused on managing expectations, leveraging local expertise, obtaining stakeholder buy-in, and allowing mistakes to support long-term sustainability. Next steps included integrating e-learning into classrooms and clinical settings and expanding the program.

1. Bridging the Divide: High Technology in Low-resource Settings James BonTempo, Peter Johnson, Chandrakant Ruparelia, Girmay Abirham SALT Interactive Technologies Conference August 2008

2. Presentation organization About Jhpiego About the project Assessment methodology Assessment findings Project plan Immediate solutions Recommendations Next steps

3. About Jhpiego International health organization affiliated w/Johns Hopkins University Build sustainable, local capacity in limited-resource settings Advocacy & policy development Preservice education & inservice training Performance & quality improvement approaches Founded in 1973 HQ in Baltimore, 30 country offices & representations

4. About Jhpiego

5. About Jhpiego 68 68 52

6. About the project Production of HIV Care, Treatment and Prevention-related Electronic Materials U.S. Government funding (CDC/PEPFAR) Strengthen & expand HIV/AIDS-related services: PICT, PMTCT & IP Three cadres (medical, nursing & midwifery students) @ 3 universities (Addis Ababa, Gondar & Jimma) Modify MoH-approved training materials for electronic delivery Implement LMS

7. About the project

8. Assessment methodology x x IT Director, Server Administrator Server x x Desktop Support, Network Administrator Client(s) x x IT Director, Network Administrator, Users Network Technology x x Desktop Support, IT Director, Users Technology Training x IT Director, Server Administrator Server Management x Desktop Support, IT Director, Users Help Desk x IT Director, Network Administrator Network Management Process x IT Director, Server Administrator LMS Administrator x Desktop Support, Users Desktop Support x Network Administrator, Users Network Support x Faculty Facilitators w/ICT experience x x Users Inservice Providers x Executive Stakeholders, Faculty LMS Leadership & Champion(s) People Observation Interview Focus Group Data Collection Methods Key Informants Criteria

9. Assessment findings

10. Assessment findings Large variation in site readiness Specific challenges Poor network infrastructure, maintenance & support Low confidence using & limited access to computers Slow & unreliable Internet connectivity

11. Assessment findings Common opportunities Interest in & need for learning technologies Ample up-to-date servers & workstations Competency using mobile devices “ e-Learning may be seen as a luxury but it is not, it is a necessity.” “ Don’t give up on us.” “ [We] get tired of reading all of the time.”

12. Project plan Strengthen IT staff competencies Develop sample e-Learning materials Build faculty e-Learning capacity Maximize use of m-Learning Package e-Learning toolkits for instructors Integrate skills labs & e-Learning

13. Immediate solutions Partnered w/technology firm to develop distributed, disconnected LMS VMware-based Hosted & offline instances Custom synchronization tool Strong mobile integration

14. Immediate solutions

15. Immediate solutions Set up e-Learning lab and mentored ICT staff Networked, updated and outfitted 30 PCs Installed Windows Server 2003 on server (IIS, DHCP) Installed VMware-based LMS Created test accounts Loaded draft LOs Demo-ed for faculty stakeholders

16. Immediate solutions

17. Immediate solutions Worked w/local vendor to train 11 ICT staff – 3 10-day courses Managing & Maintaining a Windows Server 2003 Environment Implementing, Managing & Maintaining a Microsoft Windows Server 2003 Network Infrastructure A+ Hardware & Operating System Support Skills Enabled networking/experience sharing Secured buy-in & resources Made use of idle equipment

18. Immediate solutions Developed LOs (PICT, PMTCT, IP) in collaboration w/faculty members Mapped content (ID) Incorporated governement-approved material Recorded narrations & video role-plays Developed assessments Packaged materials using Articulate Studio

19. Recommendations Understand limitations & manage expectations – but don’t underestimate potential Identify & leverage local expertise while also developing capacity where necessary Have a standard goal but don’t expect to be able to take a standard approach Obtain & maintain buy-in @ all levels Engage stakeholders early & keep them involved Communicate often and effectively Provide incentives

20. Recommendations Localize content (“Ethiopian English”) Don’t underestimate time requirements Stakeholders had expectation of simplicity Building capacity and ensuring long-term sustainability Learning vs. training Allow mistakes, learn from them & move on Develop a solid “traditional” e-Learning foundation before implementing m-Learning Competency + Tools + Desire = Performance

21. Next steps Create integrated educational experience classroom, skills labs, clinical & e-Learning Integrate m-Learning (PDAs & MP3 players) Strengthen existing implementations & expand into teaching hospitals Expand to additional universities & hospitals Evaluate impact on student performance

23. Contact information James BonTempo [email_address] jbontempo.jhpiego.net (Skype) 410.537.1849 Peter Johnson [email_address] peterjohnsonmidwife (Skype) 410.537.1800 Chandrakant Ruparelia [email_address] rupa_rupa_99 (Skype) 410.537.1921 Girmay Abirham [email_address] gabirham (Skype) 251.11.618.7821 http://www.jhpiego.org