World Bank Day @ mHealth Summit – Part 2
Notes from the eDevelopment Thematic Group event World Bank Day @ mHealth Summit – mHealth from policy to implementation.
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Session 2: Global Overview, Country Cases and Perspectives
According to a recent UNF-Vodafone Foundation study, the use of mHealth is being implemented in several developing countries with using a number of applications such as data collection and analysis; education and awareness; and monitoring and surveillance. The panelists in this session will provide an overview of the mHealth movement and describe actual project implementations in the field followed by an interactive comment and Q&A video conference session from several country representatives.
- Panel Discussion
Chair: Deepak Bhatia, Lead eGovernment Specialist, Global ICT, World Bank
Global Overview: Mitul Shah, Senior Director, the UN Foundation
What’s being done currently around the world concerning mHealth?
We need a cross cutting tool which can address different challenges
- This tool is the mobile phone
mHealth: delivery of health care services via mobile
communication devices
how does it fit in the whole eHealth sector?
We don’t need train the individuals to use their mobile, it’s also becoming ubiquitous
What can be done specifically to leverage the potential of this tool which is already in the peoples’ hands?
Two client sets:
- patients
- ministry of health
key application
- education and awareness – campaigns
- data collection – health data which is critical
- monitoring and medication compliance
- disease emergency tracking
- health administration systems
- diagnostic tool – most interesting application, maybe in a few more years we’ll see
where is it currently being used?
- Africa is on the forefront
What has the impact been?
- mobile health reaches out to very different audiences
- health care providers, mobile providers, individuals, …
Where do we go from here?
- there is a growing momentum
- we need to focus on solid research, proving the impact
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Mexico Case: Rodrigo Saucedo, mHealth Lead Researcher, Carso Institute
What are the things crucial to mHealth projects?
empowering individuals, focusing on the patient
Technologies are increasingly becoming a part of people’s daily lives
Four solutions
- CardioNet – assessing health indicators and giving advice to change the lifestyle
- Diabediario – reminders on medications and dates, monitoring it on the website to see how users react to various measures
- VidaNet for people with HIV/AIDS – they receive medication, appointments; monitoring, also the ministry of health
- A solution on H1N1 flu
Standardized methodology
- Strategic Planning
- Operation
- Scaling
None of the projects have been scaled so far
Field workers have to be trained
How to take the most of technologies – even without too much knowledge about technologies
- partners
Governments are open to initiatives but they are very risk-averse
Technology is seen as an expensive intervention
Conclusion and outlook – what’ important:
- Training
- Social marketing
- integration into national health system
- funding in the long term
Need for evidence of success
- Networking
- Evaluation
- Best practices
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Kenya Case: Yusuf Ibrahim, Training and Support Manager, DataDyne and Kenyan Ministry of Health
mHealth as a solution to fight polio
EpiSurveyor is used in the ministry
traditional life cycle
- data collection
- data entry
- data analysis
- data reporting
- action
mHealth can drastically decrease the time from data collection to action
February 2009:
- polio outbreaks
- vaccination campaigns
- mHealth was used to support this campaign – making paper work more efficient
- daily information review with EpiSurveyor
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Cambodia/Mekong Region Case: Romdoul Kim, Director of Government Affairs, Mekong Region, InSTEDD iLab (via VC from Phnom Penh) and Eric Rassmussen, CEO, InSTEDD
InSTEDD is an NGO from California
Provides health related tools to actors in the public health sector
Cambodia facts
- 30% mobile phone
- health situation not too good
- but all public health workers have access to mobile phones
Tool: GeoChat
- Open Source
- Vertical Communication
- Used for disease surveillance
- Also horizontal communication – server-independent
Mekong Basin Disease Surveillance
- Six countries
- Instedd helping the countries in ICT adoption
- Keeping whole team updated by using GeoChat
HIV Clinical Management
- mHealth system connecting to current patient database
- using SMS
- purpose: HIV healthcare delivery, not losing the HIV patients
One health – animal health
- working with ministry of agriculture
- telephone hotline to report sick animals
- veterinary in the village receives advice via SMS
GeoChat is also conncted with other tools to maximise impace
In Cambodia there is no reliable way of communication except mobile phones
What we are learning:
- even though almost 100% of health workers for the health centre staff have mobile phones, using English mobile phone technology has proven difficult
- we are working on other ways – e.g. machine-driven way to deliver the correct information
Innovation Lab
- live and work in the field
- training local staff & partner staff
- it’s an open source technology, can be expanded also when Instedd leaves
Instedd does also web synchronisation of data in various countries
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Uganda Case Study: Fiona Lee, Project Lead, Google Africa & Grameen Foundation
Vision for Applab initiative
- Bring accurate, relevant, localized information to the poor
- Partner: Google
Process
- working with users – look at the demand, where are the gaps, how is information consumed
- partnering with local organizations
- piloting and testing lots of applications
- iterate & fail fast
- building sustainable models
- you have to have incentives for all involved
information that is timely, trusted, and specific is important, there are also local customs which have to be
People want specific answers
SMS works on any phones
We tried ten pilots, reaching a lot of peopl
Google SMS service in Uganda was launched
- Google Trader – supporting traders
- Google Seach – for news, sport results, …
- Google SMS tips – agriculture tips, health tips
Providing information to the most vulnerable in a community
- women
- youth
- farmers
SMS Tips has gotten 1.5 million queries in the first months
There is a huge demand – even at the bottom of the pyramid, if there’s value in the services
We want to extend Google Tips to other regions
- We need more content
- there were a lot of queries on health which we didn’t cover
- We need a lot more health information
Google will build a platform for everybody to add relevant health information
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Questions & Remarks by Participating countries: Armenia, Russia, Moldova, Ghana, Rwanda, Tanzania, and Kenya
Moldova:
There is a need for a participatory approach in creating mHealth technologies including public health sector, patients, …;
mHealth seem to rely on a quite sophisticated marketing
What about data protection?
It must be made sure the data is not monopolized by any of the service providers
Services should be designed before thinking about technology
Russia:
Mobile systems should be based on a developed informatio infrastructure;
We try to gather data on every citizen with all disease data – database which is open to the entire country
Mobile technology is important means to support other services
Ghana:
Ghana has an ICT policy, but it needs to be reviewed in the light of developments in the health sector
Different stakeholders which emerged on the screen need to be included
Currently developing an eHealth strategic plan
We need to reach the targets of the MDGs, we need to strategically deploy mHealth for that purpose
Kenya:
We tend to prescribe solutions to the poor – is there any suprising innovation the poor have come up with using the mHealth systems?
Rwanda:
Whatever program you have, you need to have a national plan to introduce it
Instedd in Cambodia – what is the cost of ownership? What is the cost of scalability?
Google Uganda – did you assess the willingness of poor people to pay? Is the SMS cost a barrier for people to access the service?
Tanzania:
We have an initiative of eGovernment & eHealth – mHealth is a subdivision of that and is currently being coordinated – there is a recent project on that
New project using mobile phones tackling the transport costs to the hospitals
Ethiopia:
Ethiopia is going through a business process reengineering process currently
One achievement – free broadband for health institutions
D.C audience:
Are there any policies that were already in place in the countries the organizations the presenters worked in?
Language: is anyone looking at none text-based mHealth solutions?
Twitter:
What is the strategy for Goggle sms health tips beyond the ‘free’ period? Still plans for charging premium SMS rates?
Google/grameen sms health mentioned 1.5 million queries. How are they promoting the service to public?
Instead of prescribing ICT for the poor, what are the local “killer apps” that we should note?
what are the poor actually using these mhealth apps for? and do they think that this is useful for their lives?
Answers:
Language? Software used for end-users: French, Spanisch, Swaheli
- Killer-app? Facebook; there’s no magic killer app, we are continuing to experiment
- Google tips Costs? We offer the service for free for a while, since the launch we started charging for some services – still very cheaply
- How were Google SMS services promoted to the public? Our carriers – e.g. short message by checking their balance
- Language? Uganda: very difficult to provide Google service in other languages
- When you make a service free you devalue it in the eyes of the user
Grameen
- Always looking for sustainability – that’s why we don’t provide them for free
- Langauge? Often it comes down to the kids – they tend to speak English and often translate for their parents
Instedd
- everything we do is free, open standards
- Language: Instedd – we are translating everything in various languages, but we also do
- we try to work with the ministries
October 30th, 2009 at 10:21
[…] World Bank Day @ mHealth Summit – Part 2 […]
November 5th, 2009 at 06:58
Greetings
where? can you find presentations of the mHealth event which I attended via video conferencing?
Regards, Dr. Lawrence
November 8th, 2009 at 23:09
Hi, you can find the presentations at http://go.worldbank.org/MP5IY2CJA0
Best, Florian
November 24th, 2009 at 00:04
Great material.
I really enjoyed the presentations.