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Mobile phone use for integrated health servicesGuinea
experience!
1!
Jacqueline ARIBOT!!GMHC2013, Arusha-Tanzanieq15-17 January
2013!
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Goal and objectives
Describe the implementation strategy of themobile phone
fleet"
Describe results and lessons learned" Discuss problems
encountered"
2!
The goal of this presentation isto share Guineaexperience on the
use of mobile phonetechnology for integrated health services :
"
A head of rural health center with
phone , Kouroussa (12/10/2011)!
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BACKGROUND 1
Country indicators TFR : 5,7 CPR : 9%(6% modernes
methods) MMR : 980/100 000 NV infant mortality : 91/1000
(39/1000 before 1 month) Coverage :! 20 districts (606 healths
facilities and et
1700 CHW villages)"
Family planning (providers, CHW)" Emergency obstetric and
newborn care" Quality improvement through Standards-Based
Management and Recognition"
Child Health: Integrated Management ofNewborn and Childhood
Illness, communitycase management"
Malaria (providers, CHW)" Community outreach and
community-based
service delivery" Pre-service education (doctors ,midwives)"
Infection prevention"
MCHIP/Guinea Majors Activities!
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BACKGROUND2
Almost total absence of means of communicationbetween facilities
of the health system!
Low reference rate of pregnant women (4.6%)! Frequent
Contraceptives stock out! Emerging technology services such as
mobile phone
helped to communicate in various sectors, including
health."
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BACKGROUND3
# Companies: 5 (4 privates)" Two Orange fleets: " WHO/Guinea
& MCHIP/Jhpiego "" Cost: $2-$4/month/line" Unlimited voice
services"
5!
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6!
Deployment of a fleet of 264 Mobile phones : !
Signing of an agreement to use the phone" Provision of
management tools, guidance and
supervision of the staff! Collection of data on utilization of
the fleet!
Keys staff of the health system" Key project personnel"
Health services providers"
INTEGRATION STRATEGIES2 : PROCESS!
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q Data collection & reporting"q Request for "
technical assistance"q Planning & "
Management of "field activities"
7!
Communication between MCHIP staff and field !PURPOSE OF MOBILE
PHONE USE 1!
MH Advisor(MCHIP)!
Midwife(HealthCentre)!
SBMR Advisor(MCHIP)!
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8!
q Referral of cases (FP, MCH, IMNCI)"q Drug/contraceptive
stock
management"q Consulting colleagues"q Coordination of health
activities "q Transmission of epidemiological
surveillance data"
Communication among field staff !PURPOSE OF MOBILE PHONE USE
2!
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KEYS RESULTS 1 : GLOBAL USE OF PHONE
9!
(January to December 2012)
v Use by Region in descending order:Nzrkor, Conakry, Kankan and
Faranah"
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KEYS RESULTS2 : REFERRAL CASES"
10!
v Fever andmalaria are
76% of thereferredchildren"
(January to December 2012)
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11
ACHIEVEMENTS
The phones are used not only for data collection andreferral of
cases!
Fast communication, fewer trips to carry out (andreducing travel
costs) between remote and central
facilities/districts/region! Help providers to timely refer and
to address some
complications of pregnancy and childbirth on site! Sending the
ambulance where available to transfer the
woman quickly! Used for bench marking from successful SBMR
sites
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CHALLENGES / CONSTRAINTS
Loss and recurrent breakdown of phones; Challenge byhealth
providers to replace lost phones!
Low retention capacity of the battery creates frequentand
recurring costs of charging (scarcity of energysources to recharge
phones and poor quality)!
Limitation of services (text messaging services are notincluded
yet)!
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13!
LESSONS LEARNED"
Networking providers and managers of the health system:!
facilitates the information flow! improves the availability of
health services and technical
assistance in remote Geographical locations"
The timeliness and completeness of data collected
greatlyimproved!
Mandatory replacement of lost phone by the holder reducelosses
!
Providing new sturdy phones reduce breakdowns!
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14!
PROVIDERS AND HEALTHSSYSTEM MANAGERS TALK ABOUT !
PROVIDERS:! Fewer trips for medical evacuations;" Easier
reference (the reference center is immediately informed of the
case)" In MH: Support of Pre Eclampsia and Eclampsia management
by
communicating the protocol by telephone;" FP: the management of
side effects of contraceptives is often
discussed"MANAGERS/SUPERVISORS:! Reducing travel from health
centers to districts," Reduced call charges to health facilities in
our area or district" Improving the system of making referrals from
health centers to district hospitals" Faster coordination of an
ambulance in case of referrals from health centers to the
district/regional hospitals" Improved drug/contraceptive stock
management ""
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WAY FORWARD
Use the phone for mentoring ! Evaluate the impact of use of
telephone for
references and data collection! Support the Ministry of Health
for a sustained appropriation
of mobile phones for health system! Expanding the fleet to new
project intervention areas ! Improve the communication system at
all levels in order to
prevent stock-outs! Plan refresher courses for FP providers and
make available
Jobs aids (management of side effects)!
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RECOMMANDATIONS
Improve the management of the phone (mode of use,security) in
health facilities for a better accessibility to allproviders!
Expand the availability of other services to fleets inhealth
facilities (emergency, pharmacy)!
Find more robust/sturdy Phones & Accessories!
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17!
THANK YOU !
MERCI !!ASANTE !!
