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MOTECH Ghana & MOTECH Platform Lessons Learned, Current Work & Future Plans

MOTECH Ghana & MOTECH Platform Lessons Learned, Current Work & Future Plans. Grameen Foundation. Mission: To alleviate poverty for the poorest of the poor Increasingly, this means alleviating information poverty

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MOTECH Ghana & MOTECH Platform Lessons Learned, Current Work & Future Plans

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  1. MOTECH Ghana & MOTECH Platform Lessons Learned, Current Work & Future Plans

  2. Grameen Foundation • Mission: To alleviate poverty for the poorest of the poor • Increasingly, this means alleviating information poverty • GF Technology Center in Seattle is focused on health and agriculture domains • Mix of enabling technology and on the ground interventions

  3. MOTECH Ghana • Partnership with Ghana Health Services, Gates Foundation, and Columbia University • Original goal: Use technology to improve health outcomes

  4. Narrowing the Focus Government • Ghana Health Services Goals Clients • Pregnancy Question Box • Pregnancy Diaries • Focus Groups Nurses • Focus Groups

  5. Ghana Health Service • Focus on Maternal & Child Health • Antenatal visits • Vaccinations • Attended Delivery • Improve Reporting • Target Upper East Region

  6. Upper East Region Population: 1M Infant Mortality Rate: 97/1000

  7. Client Research

  8. Pregnancy Question Box

  9. Focus Groups

  10. Nurse Research

  11. Reducing Information Poverty Clients • Actionable health advice • Facts to dispel myths & folklore • Information to encourage family support • Recommend specific care Nurses • Electronic records • Patient status alerts Government • Ability to flexibly analyze reliable data

  12. Mobile Midwife Service • Messaging service coordinated with a woman’s pregnancy • Covers early pregnancy to baby’s first year • Aimed at the mother and her extended community • Delivered via pre-recorded voice or text message up to three times per week • Customized for the mother • Available when she wants the information • Educational and actionable information

  13. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  14. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  15. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  16. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  17. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  18. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  19. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  20. Audio Samples Week 5: Food for pregnancy Week 24: 2nd checkup, SP for malaria Week 34: Signs of labor Local language Intro prompt Tetanus reminder Missed tetanus vaccination

  21. Nurse Application • Records patient visits using mobile forms or SMS • Reminds nurse of upcoming and overdue patient needs • Generates monthly reports • Query the system to get information about patients

  22. Hey, this might be useful… • Build a Platform for mobile health applications • Open Source • Funded through implementations and platform-specific grants

  23. How is MOTECH Ghana Doing? Registrants: 13, 598 Mobile Midwife enrollees: 7, 395 (3,950 active) Health Facilities: 34 Nurses: 110 Encounter uploads: 75,000

  24. How is MOTECH Ghana Doing? “I liked the messages especially on the nutritionas I was able to share with my husbandso he could hear it and now I am allowedto get these things such as beans, vegetables, small ground fish for the soup and sometimes meat” “Now with MOTECH I don’t feel alone during my pregnancy, it makes me feel that there are people that care for me and are concerned about me while I am pregnant. ” “MOTECH helps a lot with the preparation for birth and I felt like I had a good idea of what would happen and how to prepare practically and financially. I went to Paga Health facility and had a safe delivery. ”

  25. How is MOTECH Ghana Doing? Dr Nyonator, PPME Director, GHS “When patients receive those messagesthey come here [to the clinic] early and on time so when they come we look at the services they are due for and we render those services to them and because of thatthe defaulters that we used to have previously has been reduced.” “Some months ago I used to get two or three, but last month I had ten deliveries [at the facility] because the clients get the messages and they come. For postnatal they come. Even if they deliver at home they get the messages [from MOTECH] which make them come for postnatal. So I have benefited from MOTECH a lot.” GHS Midwife CHPS Nurse “This is the age where we transmit data which is efficiently collected and accurate for managers to make informed decisions at district, regional and national levels. That is what MOTECH is all about”

  26. What we’ve learned in Ghana • Technology IS disruptive • Mobile penetration is high, access not so much • Design for scale • Voice trumps text – but higher cost mandates strong business model • Iterate, Iterate, Iterate (e.g. getting voice and content right) • Lessons learned document: (http://www.grameenfoundation.org/sites/default/files/MOTECH-Early-Lessons-Learned-March-2011-FINAL.pdf)

  27. What’s next for MOTECH Ghana • Two year plan to expand to three new districts • Immediate plan to explore long-term business models • Launching impact assessment program • Transition to scale • Ghana Health Service ownership of key services • Infrastructure to support national deployment

  28. What’s next for the Platform

  29. Partnering MOTECH’s strength • Rules-based Messaging • Pill & Appointment Reminders • Message campaigns • Connecting disparate health system components

  30. Platform Components Today • CommCare (Dimagi) • Point of Care Tools Supervisory Tools Data Entry Forms • Video Training Content MOTECH (Grameen) Patient DB IVR Engine Rules Engine Nurse DB IVR & SMS Content Alert/Reminder Engine Connections to external systems • Nuntium& Verboise (InSTEDD) • IVR and SMS Integration with Telcos

  31. 2012 Platform Implementations • Ghana • Treatment Advice for Mobile Alerts (TAMA) • HIV/ART compliance • Bihar, India • CARE • Mobile messaging • BBC World Service Trust • World Health Partners • TB diagnosis and treament adherence • Zambia / World Vision • Referrals, Patient outreach

  32. Questions?

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