community health and

mhealth

Agenda

• Thinking about mHealth: Adam Slote, USAID• Mhealth feedback from CORE meeting participants:

Ann H-J, CORE Group• Small Group work: devising an mHealth

checklist/design challenges• Whole group report back• How should the Community Health Network move

mhealth forward?

Mhealth ideas from Working Groups

IMCI

Bottlenecks to fix: Support community case management process by answering specific queries of CHWs as they attend to clients day to day.

• Referral to health facilities in Element 1 of the C-IMCI framework (linking communities with health facilities)

Intervention points: • Implementation: supervision of CHWs• Implementation: Referral to health facilities• M&E: to help collect and transfer data quickly

Mhealth ideas from Working Groups

Nutrition

Bottlenecks to fix: Getting data more quickly to another level (MOH) for useful, timely analysis

Intervention points: • Baseline, endline surveys• Mapping coverage (using GPS in phone)• Monitoring

Mhealth ideas from Working Groups

Tuberculosis

Bottlenecks to fix: Improve adherence through text messaging.Community-based troubleshooting during case management,

e.g. adverse effects, missing patient

Intervention points: • Case detection: link TB and HIV services if not colocated,

contact tracing• Diagnosis: camera on microscope send sputum slide photo• Stigma reduction: text messages• World TB day mass text messaging.

Mhealth ideas from Working Groups

HIV

Bottlenecks to fix: Bridge physical access to remote areas.• Help with adherence• Provide real time data• Coordination with CHWs and TTM—improve coordination, follow up

with referrals

Intervention points: • Baseline• Evaluation• Monitoring• Adherence

Mhealth ideas from Working Groups

Monitoring and Evaluation

Bottlenecks to fix: Minimize data entry errors due to multiple entry points (enumerators hand enter incorrectly, data entry person enters into computer directly without data check capabilities or dropdown/choice menu.

Intervention points: Whenever surveys are done (baseline, monitoring, midterm, final)

Instantly incorporate ongoing monitoring data, and make basic management data easily accessible.

Mhealth ideas from Working Groups

Other suggestions

• Assist in adherence to meds via texting, photo (camera phone) or video…virtual DOT for HIV, TB, malaria, etc.

• Send SMS/text message reminders to keep appts or take meds or get vaccinated

• Provision of price/market info to women entrepreneurs• Provision of info on health/nutrition topics,

date/time/local of health fairs, GMP events, vaccination days.

Concern Worldwide

Malawi competition results

Twowayflow of info

Onewayflow of info

SMS BookingSystem

One sender to one recipient/correspondent

One sender to many recipients

Mass textmsgs

Volunteertreatment supporters

M&E datatransfer

CHW calls facility/dr

Video-based & othertraining tools

Mass text msg contests

hotline

Family in labor calls TBA

Checklist/Design Challenges1. Small Group ideas (choose

one for your group)• Community action for

home-based MCH• PD/Hearth• Care Groups addressing

_____?• Community Case Mgmt• ?

2. Choose a setting, including country.

3. TaskYou are designing a program, and

assessing whether mhealth application(s) should play a role. You have a midsized budget.

Design a checklist/list of questions that should be used to assess whether mhealth should be used, how, why, when, where.

Apply the checklist/questions to your topic/setting.

Be both creative and realistic.