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- 1. Programme Mwana: A Zambian mHealth Initiative
- 2. Programme Mwana • Piloted in Zambia by MoH with support from UNICEF, ZCAHRD, CHAI & ZPCT II • Addresses Early Infant Diagnosis of HIV and post-natal follow-up and care
- 3. Programme Mwana • Piloted in 31 clinics across 13 districts in 6 provinces for over a year, delivering thousands of results • Scale-up approach pre-tested in 30 facilities in Kalomo District in Southern Province • Built on RapidSMS, an open source framework • Designed to be as a MoH owned and operated enterprise mHealth platform
- 4. Locations of Pilot Sites Luapula Province: • 11 Sites • Across 3 Districts • Implementer: UNICEF Southern Province: • 10 sites • Across 2 Districts • Implementer: BU Central Province: • 3 Site • Across 3 Districts • Implementer: CHAI & ZPCTII Copperbelt Province: • 3 Sites • Across 2 Districts • Implementer: CHAI & ZPCT II Northern Province: • 2 Sites • Across 1 District • Implementer: CHAI & ZPCT II North-Western Province: • 2 Sites • Across 2 Districts • Implementer: CHAI & ZPCT II
- 5. Programme Mwana • There is an mHealth Technical Working Group that coordinates Programme Mwana activities and other mHealth initiatives • The TWG is holds meetings every month and has sub committees that look address the day to day activities • The TWG is chaired by MoH
- 7. Locations of PCR Labs Provinces the Labs Serve: • Arthur Davison • Northern • Northwestern • Copperbelt • Luapula • Central • UTH • UTH facility • Southern • Kalingalinga • Lusaka • Eastern • Western
- 8. Early Infant Diagnosis Results Cycle ref - Early Infant Diagnosis: System Summary (2008) – MoH & Clinton H/A Initiative National average of 2008 including rural and urban
- 9. Programme Questions • Can we use mobile technology to significantly speed up getting infants HIV results to their caregivers? • Can we use mobile technology to increase post-natal visits of mothers to health facilities?
- 10. • Delivers infant HIV results from Lab to Facilities via SMS and SMS Printers • Tracks samples through the logistics system • Provides government monitoring tools
- 11. HUB
- 12. From:Results160 Hello Maria, there are 3 DBS results for your clinic. Please reply with your PIN to retrieve these results When results are ready the central SMS System sends a message alerting the clinic workers results are ready. Workflow: Phone: Results Retrieval 1
- 13. Kanyihampa Clinic. Patient ID: XXXXXX- 0001-1. HIV-DNAPCR Result: NotDetected. Approved by ADH DNA-PCR LAB. When a result is ready it is sent by SMS to the printer at the facility it the sample was collected at. Workflow: Printer: Results Retrieval 1
- 14. • Patient tracing by Community Health Workers • SMS Reminders for post-natal visits • Specific traces for DBS results being returned
- 16. Quantitative: Pre-SMS System v Post-SMS System On average results were 56% faster between sample collection and delivery to caregiver
- 17. Quantitative: Pre-SMS System v Post-SMS System 45.5 21 0 5 10 15 20 25 30 35 40 45 50 Pre-SMS Post-SMS TurnaroundTime(days) Pre-SMS and Post-SMS Aggregated Turnaround Time to Facility, Pre- vs. Post-SMS system, Central, Copperbelt, Northern, North-western Provinces
- 18. Quantitative: Hardcopy v SMS Results While urban facilities saw only a 5% improvement rural facilities received results 46% faster between sample collection and delivery facility using SMS
- 19. Quantitative: Hardcopy v SMS Results Luapula Province 60 42 0 10 20 30 40 50 60 70 SMS (N=146) Hard Copy (N=103) Percent Method of Result Receipt SMS vs. Hard Copy, Volume of Results Received, Luapula Province
- 20. Quantitative: Hardcopy v SMS Results On average 30% more results arrived by SMS than by hardcopy
- 21. Triangle of Management Health Facility District Medical Office Provincial Medical Office National IT Management Team Implementing Partner Lab Team Software Develop ment Team Secondary Support Primary Support
- 23. Real-time Alerts
- 24. Way Forward • Scaling Up the system nationally with the help of partners • Each year we set scale up targets • This year we have a target of 300 sites. We are on course to meet this target. •To date we have scaled up Programme Mwana to over 462 sites.
- 25. Way Forward • Scaling the system nationally between now and 2015 • To date we have scaled up Programme Mwana to over 400 sites.
- 26. Thank You
Editor's Notes
- Here is a health worker retrieving EID results on her phone and writing them down into the DBS register
- 3 labs serve the entire country and the transport cycle of EID is a serious problem,
- The system address the last two parts of the results delivery cycle. These times are much more severe in rural areas, as long as 6 months in some cases.
- So what do the actual messages look like that are being sent back and forth?
- The system reminds the RemindMi Agent of a necessary post-natal visit at six days, six weeks, and six months
- The key point here is that there was a much larger volume of results that arrived by SMS rather than by Hard Copy. This trend greatly affected the rural facilities more than the urban ones.
- Level of magnification: topAs the key beneficiaries of Project Mwana, all clinics have threestakeholders providing primary support on an ongoing basis. Two provide immediate support and one provides back-up support. All support teams should have guides outlining roles and responsibilities.“Behind-the-scenes” secondary support is provided by lab teams and software developers.Briefly, the next few slides outline the main duties of each of the key players.
- These web management tools you can sort by districts, facility, time period and view positives, negatives, rejected