Over the last two years, the level of interest in mobile for

development across World Vision’s fundraising and program implementation offices has increased greatly. From a modest start with three funded mobile health projects, World Vision's mHealth portfolio now reaches 16 countries in Africa, South & Southeast Asia.

In various countries, grants are being strategically timed and geographically positioned to leverage rather than duplicate effort. Donors across this growing global portfolio include USAID, DFID, IrishAid, AusAid, CIDA, WHO, African Development Bank, Bill and Melinda Gates Foundation, and various private funders. To best support this work, World Vision has intentionally and strategically aligned mobile for health at a global level across a wide range of World Vision fundraising and implementation offices, based on an

agreed Vision Statement and Principles for its mHealth work.

Principles for our work

Coherence and quality of approach and program/project management ALWAYS in partnership with others and building on global learning Designed to meet the needs to community users but also provide the

basis for maturing the evidence base

mHealth: Global Overview

MHEALTH VISION STATEMENT

Empower the most vulnerable households and community health workers/volunteers through the use of common, shared, multi-

functional and collaboratively designed mobile health solutions to deliver community –based health interventions.

Initially affordable yet based on sustainable costing models and scalable technology

Considers data governance issues Uses and strengthens government partners’ information systems Favors open-source solutions and emerging global standards

Public-private partnerships

World Vision is cultivating new and leveraging existing collaborations with Ministries of Health, donors, solution providers and mobile network operators. Notably, World Vision has been collaborating with the Bill and Melinda Gates Foundation, Grameen Foundation, and Dimagi in a public-private partnership arrangement to deploy a global, scalable mobile health solution (Motech Suite) to support various health and nutrition programming approaches. This allows World Vision’s mHealth projects to use a common, yet customizable, field-tested mHealth tool.

The advantages of a shared solution include minimizing software development, operations, and support costs, as well as sharing source codes, best practices, learning, and other assets to avoid duplication; and ultimately, contributing to improved maternal and child health . This model has already streamlined effort and overall costs at the global level, as well as for each project. In some cases where Ministries of Health have already made significant investments in alternative solutions (for example RapidSMS in Rwanda and JAMII Smart in Kenya), World Vision supports that direction with their funded projects.

Initial project results

Dimagi’s CommCare solution, a key component of the MoTECH Suite, was first piloted in World Vision’s USAID-funded Child Survival Health program in

Mobile Operators

Funders

Technology Providers

Ministries of HealthiNGOs

Afghanistan (2008-2013), and the evaluation results comparing intervention and comparison groups were encouraging:

Increase of 20 percentage points in antenatal care visits (P-value = 0.0038),

Increase of 12.6 percentage points in both families with a birth plan and families with improved coordination with the health facility (P-value = 0.04 and P-value = 0.004 respectively),

Increase of 12.9 percentage points in knowledge of two or more pregnancy danger signs (P-value = 0.05).

Evaluation of World Vision’s Mozambique mHealth project (Gates-funded Grand Challenges 2010-2012 again using the CommCare solution) suggested that pregnant women in the project’s intervention area more frequently accessed antenatal care, were better prepared for birth, and gave birth more often with the assistance of a skilled provider. They also appeared to be more familiar with signs of pregnancy complications and to seek care at a facility following danger sign recognition.These evaluations have informed an mHealth Theory of Change that provides a flexible yet systematic framework for measuring program results over time.

An Emerging Social Enterprise

World Vision and its MoTECH Suite collaborators have endeavored to create governance, operating and business models based on a social enterprise approach, which comprises a consortium of technology providers, donors and NGOs, together with negotiated agreements with Ministries of Health and mobile network operators. A social enterprise is an organization or consortium that applies a business strategy to maximize improvements in human and socio-economic well-being through a low-profit offering that is affordable even in challenging economic contexts, rather than maximizing profits for external shareholders.

This model aligns well with the objective of developing a sustainable business model which allows for an open source product to be provided to partners and collaborators at a lower cost, yet is configured for use by governments, general population, NGOs and other stakeholders.

As negotiations with mobile network operators and other potential private sector partners develop, this model is expected to evolve toward an increasingly financially sustainable approach. Additionally, analysis of this

business model is under way, with an eye to maximize economies of scale and sustainability.

World Vision’s Global mHealth Portfolio

World Vision is currently implementing mHealth projects in Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia, Kenya (JAMII Smart), and Rwanda (RapidSMS) and is moving forward in 2014 with additional implementations in Afghanistan, Cambodia, Mozambique, Uganda, Zambia, Niger, and Ghana. For more information on each country project including local contact information, please visit http://wvi.org/mhealth.

Green - Countries with current MoTECH Suite deployments: Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia.

Blue - Other mHealth deployments: Kenya, Rwanda,

Orange – MoTECH Suite or other deployments

Green - Countries with current MoTECH Suite deployments: Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia.

Blue - Other mHealth deployments: Kenya, Rwanda,

Orange – MoTECH Suite or other deployments

Green - Countries with current MoTECH Suite deployments: Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia.

Blue - Other mHealth deployments: Kenya, Rwanda,

Orange – MoTECH Suite or other deployments

Green - Countries with current MoTECH Suite deployments: Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia.

Blue - Other mHealth deployments: Kenya, Rwanda,

Orange – MoTECH Suite or other deployments