ACA is an alliance of 37 member institutions in 12 African countries established in 1997 to provide sustainable capacity solutions in Africa. It implemented a project in collaboration with AMREF to strengthen the capacity of community health workers in Migori County, Kenya to diagnose and manage HIV/AIDS. A mobile phone application was developed and installed on the phones of 32 health workers to provide remote access to expertise. Evaluation found the application reduced remote consultations and increased health worker knowledge. While useful, connectivity and device issues need addressing to optimize the mobile learning approach.

1. Ombonyo P (ACA); Matiang’i M (AMREF)
pombonyo@africacapacityalliance.org
www.africacapacityalliance.org

2. ACA (formerly RATN) is an alliance of 37
Member Institutions working in 12 countries in
Africa.
 Established in 1997 as a Project between UoN
and UoM,
 ACA’s mission :Through partnerships, provide
sustainable capacity solutions to improve lives in
Africa.
 ACA’s strategic pillars :HSS, CSS & PPP.
 ACA’s areas of focus:SIDS, NCDs and HER
 ACA implemented this project in collaboration
with its member AMREF as the lead.
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Problem Statement
The Opportunity
Objectives of the intervention
The Process
Findings
Challenges
Recommendations and Conclusions
Acknowledgement
Partner with Us
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4. The constant flow of new evidence demands that
HCWs receive CME in order to deliver quality care.
Unfortunately, this does not effectively happen
because it requires frequent & expensive out-of-workstation training.
 Instead, outdated methods or remote consultation
with experts on HIV & AIDs management is used; which
has very little effect on improving the capabilities of
HCWs (Farmer et al, 2008; cf. Haines et al., 2007).
 The severe shortage of HCWs further compounds the
situation, especially for underserved settings.
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5. 
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The extensive accessibility &use of mobile
phones presents a significant opportunity to
surmount development challenges in health
and other sectors.
As at March 2012, the mobile phone
penetration in Kenya was 74% & is expected
to surpass 80% due to cheaper gadget prices
& calling costs.
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To strengthen the Capacity of CHWs in Migori
county Nyanza province to diagnose &
manage HIV & AIDs related conditions
through Mobile Learning (m-learning).
To design, develop, implement & evaluate
the role of mobile technology in assisting
health workers to diagnose & manage
HIV/AIDs related conditions in Migori county
Nyanza province.
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7. 1. Capacity gaps assessment - determined the
gaps that resulted in remote consultation by
service providers in lower level health
facilities .
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8. Step 2 • Development of a mobile phone application/algorithm
Step 3
• Installation of the system to mobile phones of 32 HCWs and
linkage to online AMREF ART Hub
Monitoring and Evaluation
• Capacity gaps assessment ( Thematic areas
included: Choice of ARVs, Discerning of clinical
presentations, Diagnosis of opportunistic
Step 1
infections, Identification of and management of
drug toxicity and pictorial illustrations of the
common HIV and AIDS associated lesions)
Step 4 • Training of end-users (HCWs) and Commissioning of the usage of
the application (Users advised to use expert only when in need)
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Participant gender: 19 (59.4%) M & 13 (40.6%) F.
Cadres of HCWs: Nurses 18 (56.3%) & Clinical medical
officers 14/32 (43.7%).
Ranking of usefulness of the application: choice of ARV
(35.0%), followed by pictorial illustrations.
Majority (90.6% )agreed that Access to mobile phone
assisted applications can transform rural facilities
HIV/AIDS Management
75.0% did consult the HIV/AIDS expert to make
decisions (but to a lower degree) while remaining
(25.0%) never consulted at all during this period
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11. frequency of consultation also reduced from weekly (at baseline)
to occasionally; out of 24 participants who sought experts’
opinion, only one par ticipant did it daily.
 There was a significant increase in knowledge when compared
with the baseline study, One respondent said “... I no longer
worried as long as I had the phone, I will quickly scroll through just to
be sure of my decision, and after some time I mastered what to
do....”
 When the DASCO officer was asked if there was a reduction, he
replied that, “… they no longer receive the obvious calls……. Of late
we only receive real cases that are challenging of which some we
have to research before we reply…” He concluded that “…the mhealth has empowered our health providers; they are now
knowledgeable on HIV/AIDS management….”
 88% of participants rated the application as good and excellent.
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12. 
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Most common challenge was operational
difficulty (37%) such as connectivity when
accessing the online hub.
This was followed by mechanical/gadget
challenge (17%); of which phone battery was
the main gadget challenge (57.1%)
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13. 
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The use of mobile phones to build the capacity of health
service providers (m-Learning) has shown a potential
worth scaling up. The mHealth solution reduced remote
consultation, however the following needs to be
considered: thematic features were created based on the need of
Migori County after a needs assessment; this may vary
from region to region.
There is also a need to continuously update the
algorithm created with new evidence on HIV/AIDS
management
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14. 
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AMREF
Sida and CIDA for funding ACA’s INSTANT
program through which this intervention was
implemented.
Ministry of Health (MoH) in Migori County
and former Nyanza Province
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15. Africa Capacity Alliance (ACA)
P.O Box 16035 -00100
Email: phylliso@africacapacityalliance.org
Website: www.africacapacityalliance.org
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