Tuesday 18 October 2011

#ICT4d Using #mHealth to improve access to family planning and child health services in #Malawi by Limbanazo Kapindula


Limbanazo Kapindula (Twitter: @Limkapin) has come to ITM to help us out in setting up a mobile diabetic project (will report on this later) in Cambodia, the Philippines and the Democratic Republic of Congo. He comes all the way from Malawi where he was involved in three 5 year projects with Management Sciences for Health, they all came to an end in September 2011 (5 year projects). This is a short synopsis of his presentation.
Limbanazo is an IT expert, and he gave the mobile phone training to people who had never used mobile phones before.

Challenges in Malawi
Challenging infant mortality rates (69/1000 children die in the first year) and only 40% of women in Malawi had access to family planning services.
So how can the access to care be increased? How can community workers be helped?

Targeted people:
Health surveillance agents,
Community based distribution agents providing oral contraceptives HIV/AIDS.
13 of the 28 Malawi districts were targeted.

Innovation: community health care using mobile technology
Use of simple mobile phones for electronic reporting and other important communication
To help 2000 CHW (Community Health Workers) what was needed was:
Report in timely way
Get support during emergencies
Request and receive remote technical support
Refer clients/patients for secondary care

Key issues to make it successful
Training to all the users
Technical support to all
Involve the stakeholders (telecom, ministry of health…)
Planning the backup (data backup for future support).

How this mHealth project was set-up
A network between central computers that are connected via USB modems for data transfer, connected with Frontline Medic sms (enables bulk message interactions between a central location and people across any region, setting up forms, connect to patient database).
It was a simple application, so simple that it could be learned from a manual. It took three months to fit the project to the scientific demands of the researchers (java reader, specified forms), but the actual use was really easy thanks to this pre-project input, nevertheless there were some people who simply were not able to cope with the technology and they dropped out due to the pressure to keep reporting (those were mainly part of the community based distribution agents, which are volunteers).
Over 12000 text messages captured using the system within 8 months (WAW!!!).
50% of the messages was on technical information, 35% on patient reports (this division was connected to the startup of the project, dialogues between health care workers). These distinctions in the mobile communication could be recorded because they used keywords for specific communications.
Cost was a main concern for the government, after taking into account all the data, the project showed that with only 10 cents a child’s life could be saved.

If you are interested in setting up a mobile project in any region that is based on simple phones, contact Limbanazo who has all this expertise. Or take a look at the program that was used and check it out yourself.