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Mobile technology for community health. Dominic Atweam K Health Information Systems Analyst Policy Planning Monitoring and Evaluation Division- Ghana Health Service. Overview. What is MoTeCH? Pregnant Parents Application (MOBILE MIDWIFE) Tools for Community Health Workers(HIMS).

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Presentation Transcript
slide1

Mobile technology for community health

Dominic Atweam K

Health Information Systems Analyst

Policy Planning Monitoring and Evaluation Division- Ghana Health Service

overview
Overview
  • What is MoTeCH?
  • Pregnant Parents Application (MOBILE MIDWIFE)
  • Tools for Community Health Workers(HIMS)
slide3

What is MOTECH?

Using mobile phones to increase the quantity and qualityof maternal and child health services in Ghana

Focus on frontline community health facilities (CHPS zone, Health Centre's)

overview1
Overview
  • What is MoTeCH?
  • Pregnant Parents Application (Mobile Midwife)
  • Tools for Community Health Workers (HIMS)
  • Social Impact Assessment
challenges
Challenges

Challenges in Communities

  • ANC visits start late
  • Incomplete ANC coverage
  • Delay until newborns seen
  • Unattended births
  • Patchy immunization coverage
  • Low IPT uptake
  • Local myths
slide6

MOTECH Component 1: Mobile Midwife

Messages provide key MCH information for “pregnant parents” and reminders to seek timely care:

  • Personal care during pregnancy
  • Newborn care
  • Recognition of danger signs
  • Developmental milestones
  • Nutrition and breastfeeding
  • Malaria
  • Immunization
  • Postpartum family planning
  • Diarrheal diseases
  • Pneumonia
pregnant parents service
Pregnant Parents’ Service

Engage Both Parents

  • Relevant, actionable and fun information by SMS and/or voice
  • Encourage health seeking behavior
  • Available in local languages

Product Development

  • Consultation with GHS stakeholders at all levels, midwives, lactating and expectant mothers, fathers, mothers-in-law, village chiefs.
  • Field testing of messages to ascertain appropriate messaging, voice, accent, dialect.
slide8

Why do we need injections for both mother & baby?

What do we do about body swelling during pregnancy?

Why do I need IPT?

Why should we practice exclusive breast feeding?

Why should

I attend clinic at first

signs of pregnancy?

Why do I vomit when I’m pregnant?

overview2
Overview
  • What is MoTeCH?
  • Pregnant Parents Application (mobile Midwife)
  • Tools for Community Health Workers(HIMS)
slide10

HIMS Challenges

ForNurses

  • Volume of paper: up to 20 different patient registers for each facility
  • Onerous data reporting: nurses spend 4-6 days per month aggregating data
  • Little information flows back to the nurse: difficult to identify defaulters or high risk patients
  • Nurse attitudes sometimes discourage clients from seeking health information
slide11

PROBLEM:

Too much paper,

too little useful information

SOLUTION:

Using the mobile phone for data entry and management

slide12

MOTECH Component #2: Nurses’ Application

  • Data collection & Reporting
  • Simplified paper registers
  • Nurses record patient data onto mForms
  • Upload data to central database
  • Data validation ensures high data integrity
  • Generates monthly reports for nurses and district officials
  • Alerts & Reminders
  • Sends alerts and reminders to nurses and clients about patient care
system effect
System effect
  • Improved supervision and feedback

MOBILIZE SUPPLY

  • Simplified Register
  • Capture and store data more efficiently
  • +
  • Health worker focused mobile intervention
  • information to support service delivery and continuity of care
  • Increase quantity and improve quality of interactions between clients and health system
  • Improve work routine and time for service delivery

MOBILIZE DEMAND

  • Phone-based health education
  • to pregnant women and new mothers to increase knowledge and awareness
  • Phone based alerts and reminders
  • at “critical” times to promote and encourage utilization of essential health services
slide14

MOTECH Pilot-to-Scale

& Transition to GHS

To date

Full implementation in 2 districts in 2 regions – Upper East, Central

Began expansion to 3 new districts in 2 new regions – Volta, Greater Accra

Approximately 23,783 clients currently enrolled (2 districts)

` 100 facilities reporting (automated or enroute to automation)

469 nurses trained and using MOTECH

slide15

(Sustainable) Scale-up Status

  • National steering committee formed and chaired by Director General of GHS, similar platforms at Regional & District level actively leading the program
  • Proposed joint initiative to scale to an entire Region, led by GHS with TA from Grameen
  • Possible MTN partnership: fee-based Mobile Midwife service that will cross-subsidize the free service for those who cannot aford.
  • There are other similar programme running on different plat forms performing the HIMS COMPONENTS of MOTECH
    • GHS community eRegister
    • GHS - Sene Smart Phone Project
  • The Pregnant Parent Components(messaging ) to be integrated into the GHS Community eRegister
slide16

Challenges Ahead

  • Need for full implementation of national ehealth strategy to:
    • ensure alignment and interoperability between MOTECH and other mhealth/ICT solutions in Ghana
    • integration of the Nurses Application into DHIMS2 and GHS community eRegistersystems
  • Costing/packaging MOTECH model for full integration into GHS workplans and budgets
    • Cost of airtime remains high, need for negotiation with Telcos to bring rates down and increase network coverage
    • Securing mobile phones in high volumes at low prices for nurses
  • GHS resource availability to support roll out – health sector budget already strained,
    • Need to demonstrate the cost-efficiency of MOTECH vs. non-mhealth approaches for frontline data management/reporting and getting health information to women