This document discusses several programs that use mobile phones to help eliminate pediatric HIV in Africa. It provides brief descriptions of 16 programs across 10 countries. The programs use text messages and mobile applications to improve demand and awareness, track patients and test results, coordinate care, and manage supply chains. They target challenges such as low testing rates, delayed results, poor adherence, and stockouts. The document suggests mobile can address key issues in prevention of mother-to-child HIV transmission initiatives.

1. © 2010 frog design. Confidential and Proprietary.

2. © 2010 frog design. Confidential and Proprietary.

3. © 2010 frog design. Confidential and Proprietary.

4. Programs Using Mobile Phones to
Eliminate Pediatric HIV in Africa 1 RapidSMS 2 MAMA 3 R.H.E.A. 4 Young
Rwanda MAMA - South Africa, Jembi Health - Rwanda
Africa Live
UNICEF - Rwanda India, Bangladesh Praekelt Foundation -
South Africa
5 Project Mwana 6 Mother Baby 7 HIV-Link 8 Mxit
Pair Tracking
UNICEF - Zambia, Medic Mobile - Ethiopia Mxit - South Africa
mothers2mothers -
Malawi
South Africa
Health
9 M-Trac 10 Connected
11 Ghana 12 Closed User
Telemedicine Group
UNICEF - Uganda Study
Earth Institute, Novartis - Millenium Villages - 10
EGPAF / WHO - Kenya Ghana Countries
7
16 11 19 16
13 The Pamoja 14 LUCAS 15 Wired Mothers 16 Switchboard
9 20 Project ERNECA Ministry of
UCLA Switchboard - Liberia,
10 13 EGPAF - Kenya Health and Social Ghana, Tanzania
Welfare - Zanzibar
1 3 24
15 17 EpiSurveyor for 18 Philani Mentor 19 mPedigree 20 uReport
16 21
PBF verification Mothers Project
mPedigree - Ghana UNICEF, Uganda
EPGAF - Mozambique UCLA - South Africa
5
5
21 Improving EID 22 Good Start III 23 MoTECH 24 CommCare
TAT
17 EGPAF - Tanzania
South African Medical ANC, Grameen Dimagi, 15+ Countries
Research Council - Foundation including India, Rwanda
South Africa
HIV mobile
25 26 Mobenzi
appointment
Outreach
reminders
2 4 6 8 18 22 26 MRC, UCLA, HSRC, Stellenbosch
InSTEDD - Cambodia
University, University of Washington,
SA Department of Health - South
Africa

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6. Defining Event
Mother & Child
shared journey
Lenshina, Mother, KENYA
Actors &
Touchpoints cards
Lenshina feels sick and goes to
the clinic. There she finds out
to be pregnant and HIV
Positive.

7. MHEALTH FRAMEWORK Mapping Mobile Opportunities
MONTHS -9 -6 0 12
LABOR POSTPARTUM/
Mobile Opportunities
MOTHER PREGNANCY
& BIRTH BREASTFEEDING
1ST TRIMESTER
2ND AND 3 RD
BIRTH INFANCY
Mobile phones and technology can
CHILDHOOD
CHILD TRIMESTER
address 4 key challenges faced by
WHO & UNICEF PMTCT INTERVENTION TIMELINE
GUIDELINES
expectant and new mothers, their
1. HIV testing
2. CD4 testing
3. Results
Early infant care
diagnosis (EID) children, and the health care workers
Early infant care
diagnosis (EID)
WEEK 6 MONTH 18
ARVs to mother
ARVs to baby
who care for them.
Ongoing care to mother
Ongoing care to HIV-exposed Infant
Demand, Tracking &
HEALTH TOUCHPOINTS SAMPLE IMPLEMENTATION
Awareness Retention
& Education of Mothers & Babies
6/ 6/ 6 visit 6/ 6/ 6 visit Mother asked 6/ 6/ 6 visit
reminder reminder to visit clinic reminder
CHW CHW registers birth
• Stigma/fear & isolation • Delayed test results to mother
RURAL CLINIC DBS sample registered SMS results received • Adherence to drug results at clinic
Mother receives regimens • HIV testing and re-testing of child
• Knowledge re: self-care and care • Linkages to on-going treatment for
DISTRICT Sample shipped and t racked for her baby mother and pediatric treatment
COUNTRY
Results registered at national lab
EVIDENCE
Coordination,
EID test result turn-around
time improved by over 50%.
Supply Chain
Supervision & Management
Quality of Care
MOBILE CHALLENGES RELEVANT TO PMTCT INITIATIVES • Stockouts of test kits, medications,
OPPORTUNITIES • Training of CHWs
and other commodities
• Communication between CHW
• Transporting blood samples to lab
and nurses
Demand, Awareness and Education • Transporting results back to clinic
• Updates to new protocols
• Delays at clinics.
Tracking & Retention of Mother Baby Pairs
Coordination, Supervision and Quality of Care
Supply Chain Management

8. Joanne Stevens
MAMA South Africa
SOUTH AFRICA
MAMA
South Africa
MAMA South Africa provides vital health information via mobile phones
to expectant and new mothers and their families, supporting them week-
by-week during pregnancy and the first year of baby’s life. Most South
African moms-to-be learn that they are HIV positive for the first time
during pregnancy, and lack social support to help them cope with the
diagnosis of a life threatening disease while adjusting to the demands of
pregnancy and a new baby.
Metrics/Evidence Key Technologies Audience Challenges
MAMA will target 500,000 Mobile Low-income and at-risk Maternal deaths have
women and household Website/Portal (askmama. expectant and new increased 40% since 1998
decision-makers over two mobi), staged SMS mothers, as well as their due to HIV/AIDS. Mothers
years. 100 registered for messages, interactive household decision need caring, accurate,
SMS services in first two quizzes via USSD makers. straightforward information
weeks. that is timely and discreet.

9. Erica Kochi
UNICEF Innovation Team
ZAMBIA &
MALAWI
Project Mwana
The Mwana Initiative has improved test result turn-around time by over
50%. It delivers early infant diagnosis (HIV) results to rural and under-
served communities in Zambia and Malawi via text messages rather than
paper. Community Health Workers also register births and trace patients
via SMS to ensure that they receive key childhood interventions.
Metrics/Evidence Key Technologies Audience Challenges
EID test result turn-around Basic Mobile Phones, Community Health Logistical challenges in
time improved by RapidSMS Workers remote communities
over 50%. delay EID results and
subsequent interventions.

10. Design Principles
PUT THE USERS FIRST GO BEYOND MOBILE THINK SYSTEM-WISE MASH-UP COMPETENCES
“ Having data and
not knowing what to
do with it is as bad
“ Mobile has to be part
of a multi-pronged
approach, that will
“ We need to look at the
problems both at the
national scale and at
“ We need to bring
designers, health
technical leads and
as not having any work with and within the level of the single mobile technologist
data. other systems. mother. Then solve together more often
them in a way that
” ” ” ”
works for both.