informationl briefing feb 2012
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Informational Briefing
Futures Group eHealth and mHealth
Bobby Jefferson, Senior Health Informatics Advisor, Futures Group Manage 36 Programmers India (10) , South Africa (10) , Kenya
(10), Tanzania (2), Nigeria (1), Guatemala (1) , Uganda (2)• U.S. Government President AIDS Relief Program $15 Billion –
10 Countries HIV, Prevention Mother to Child Transmission, TB, OVC
• Principal Investigator– National Health Informatics System (HMIS) Kenya Datawarehouse , National Electronic Medical Records 6,000 hospitals
• Lead IT Project Manager- Community Level Orphans and Vulnerable Children (OVC) electronic data system (World Vision, UNICEF, CRS, Africare) – Zambia, Tanzania
• Health IT Advisor - 5 Central Asia Republics (CAR) Consortium for AIDS Strategic Information in Central Asia (CASICA)
• Kazakhstan, Kyrgyz Republic, Tajikistan,• Turkmenistan, Uzbekistan
Implementing eHealth and mHealth for Implementing eHealth and mHealth for Low Resource Communities Low Resource Communities
502 Staff 30+ countries Multi-disciplinary Majority doctoral and masters-level
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Staff Profile
CHSS Geographic Focus
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Latin America and the Caribbean:GuatemalaGuyanaHaitiHonduras
Africa:KenyaLesotho*MozambiqueNigeriaRwandaTanzaniaSierra LeoneSouth AfricaSwazilandUgandaZambiaZimbabwe*
Asia and the Middle East:AfghanistanChina*IndiaPakistan*
Europe & EurasiaGeorgia*Ukraine
Informatics Solutions • IT Database related to Poverty Reduction
– Social Cash Transfer– Household base assistance, community
empowerment,
• Mobile Surveys • Monitoring and Evaluation system• PPP• Capacity Building, Knowledge Transfer,
– Site Capacity Assessment (SCA) tool
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We are working across 15 Countries, 1,033 Hospital Facilities + Satellites Clinics , Antenatal Care – 535 PMTCT sites
Rural, remote, hospitals “serving poorest of poor” and Ministry of Health (MOH) facilities, Rural health facilities serving BPL, marginalized and most vulnerable populations
• Intermittent power, • Lack IT staff, • Lack internet, • Sparse mobile coverage
•Lack of referrals, or linkage between HIV, PMTCT, TB, •Cost effectiveness and sustainability -- no funds for proprietary licenses, or yearly maintenance fees
Low Resource Environment
Results
• Internet
• Internet
• Mobiles, SMS
Rural, Remote City
# of Facilities
• Sparse Mobile Coverage• No Internet
• Intermittent Power
Online Solutions
MobileSolutions
Offline, DisconnectedSolutions
• Smartphones
Nurses, Clinicians, Adherence Counselors, need health data, M&E program data in knowledge repository
•Lack of referrals, or linkage between HIV, PMTCT, TB, or to existing technology systems • Cost effectiveness and sustainability -- no funds for proprietary licenses, or yearly maintenance fees
Low Resource Environment
Approach
Use of freely available, reusable, tools, “coded in country” Creative commons approach
Reusable software and technology across countries and programs
Offline Solutions, Disconnected modelLocal programmers, all IT staff in country (India,
Kenya, South Africa)- Offer Programmer training SQL, Agile process, Virus Remediation
Low costs, Inexpensive $200-$350 Netbooks , Solar netbooks
Solar mobile phones, SMS instead of Smartphones
-
Rajketu Singh
Amit Kumar
Naveen Sharma
Sanjay Rana
Piyush Khanna,
Jayanta Kr. Das:
Deepika Saini – no photo IT Team in India 2012
Paritosh MishraSeema Verma
Collaborators and Users
ICAP Columbia University 44 sitesIntra Health International 17 sitesElizabeth Glaser EGPAF 16 sitesFamily Health Inter FHI 45 sitesCatholic Relief Services 13 sites
Catholic Relief Services - 32Pathfinder InternationalGertrude Children HospitalDOD Walter Reed - 28 Mount Kenya UniversityMOH Kenya Sites
AIDSReliefJohn Snow InternationalRakai Health Services Vaccine Research
Intra Health International
Mennonite Christian CharitiesAIDSRElief 35 sites
PMTCT , ANC sites 535 sitesElizabeth Glaser EGPAF
Ministry of HealthMinistry of Education
Users
World VisionClinton FoundationColumbia UniversityUNICEFDFID
Health IT SolutionsHealth IT Solutions
Collectively referred to as IQSolutions
1. Electronic medical records
1. IQCare
2. Independent Technical Evaluations Performed
WHO, USAID, CDC Atlanta, CDC in-country, Ministry of Health
2. Mobile Phone solution (IQSMS technology)
3. Visual Dashboards
4. Monitoring & Evaluation Electronic reporting
•
Clinicians able to review individual patient Clinicians able to review individual patient historieshistories
*Clinicians review patient histories, prescribed drugs, ordered tests and results, and progress on care and treatment during the exam
demodemo
http://173.203.65.108/iqcare/frmLogin.aspxUsername: user1Password: 1Facility/Satellite: 001-01-01-Demo Site
Mobile Phone Reporting by Remote Workers
PMTCT Currently consists of 4 types of monthly reports
1. PMTCT Antenatal Clinic (ANC) Monthly Summary Form2. PMTCT Care Register Monthly Summary Form3. PMTCT Maternity (L&D) Monthly Summary Form4. PMTCT Mother - Child followup SummarForm
IQSMS PMTCT ReportsIQSMS PMTCT Reports
Monthly and Quarterly Reports
PMTCT Report
Must Pass All Data Quality Rules,District Office
Data Quality Checks
NUMBER OF CLIENT HAD HIV TEST AT ANC
Excel PMTCT MONTHLY REPORT PMTCT Antenatal Clinic (ANC) Monthly Summary Form
ANC 01. New ANC clients this month
1188
ANC 02. Previously known to be HIV positive 17ANC 03. Total number tasted 574ANC 04. Number of new client had HIV test at ANC 277ANC 05. Tested HIV-Positive 37ANC 06. Post-test counseled for positive and negative 574
ANC 07. Number of partners tested for HIV 16ANC 08. Tested HIV-Positive 4
Orphans Vulnerable Children (OVC), Most At Risk Population (MARPS), Maternal Child Health (MNH)
Ms Access Database
PDA device
Web Internet Desktop
Excel Only
M&E Electronic Reporting SystemSolar Power Cell phones
UNICEF Social Cash Transfer Application
Futures Group International
STEPS OVC
• STEPS OVC = Sustainability Through Economic Strengthening, Prevention and Support for Orphans and Vulnerable Children
• Program provides – Support for HIV prevention and behavior
change initiatives– Reducing HIV transmission– Support for OVC, at-risk youth and adults, and
other vulnerable populations
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STEPS OVC Login
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STEPS OVC Beneficiary Search
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ICT for Development – Best PC Security Practices
District Health Training - Mobile Phone Survey using SMS
Held Training of 600 District Health Officers in KenyaOn New District Health Reporting Tool Ministry of Health NASCOP SMS 1:Have you entered /Imported data into the new tool ? Yes or No SMS 2:Have you run reports using the new district tools ? Yes or No SMS 3:Have you discussed the new district tools and reports with other members of the district health team ? Yes or No
SMS 4:In what district do you work?
Your answers are confidential and a Ksh 20 refund will be given for each valid reply
Mobile Phone Survey Architecture
Assessment Database
(Excel)
Assessment Database
(Excel)
Valid?
SMS Provider service
(Zain/Safaricom)
survey data
sent
via fro
ntline S
MS
SMS archived in
frontlinesms application DB
Survey responses/corrections via SMS
FrontlineSMS
Assessment
Application
Assessment
Application
Survey questions and acknowledgement via SMS
Get SMS data
SaveYes
No
Acknowledge
(Reimburse airtime)
Request for correction
Con
vert
SM
S
cont
ent t
o D
B d
ata
8 provinces involved in the survey, a total of 388 interviewees sent some reply; 101 interviewees completed the survey
Graph 1: N Participated = 165; N completed = 101
Percentage participation/completion in the DHPT text message survey by province
Table 5: Time in minutes to complete the survey
Province N = 131
Minimum
25th Percenti
le
Median 75th Percentile
Maximum Mean
Central 12 11.00 22.00 27.00 59.00 5861.00 999.33
Coast 12 5.00 9.00 27.00 54.50 969.00 106.75
Eastern North 5 15.00 17.00 25.00 30.00 31.00 23.60
Eastern South 20 3.00 9.00 18.00 480.00 9703.00 1202.10
North Rift 17 15.00 34.00 50.00 262.00 17561.00 2512.06
Nyanza 22 9.00 19.00 27.00 152.00 17534.00 1722.05
South Rift 19 2.00 15.00 35.00 1623.00 27553.00 3162.63
Western 24 4.00 768.00 1372.50 19012.50 30063.00 9424.38
Response duration and times
Graph 2: N: 131 interviewees who responded to at least 2 questions
Median times (in minutes) participants used to complete the SMS survey
Response duration and times
• Most of the respondents attended to the SMS after 5pm
• Sending multiple questions drastically reduces the response rate
• Re-sending an answered question does not guarantee a response
• Contact (physical, by mail or otherwise) significantly increases the response rate
• The longer the duration between a response and the next question the lower the chances of getting the next response
www.futuresgroup.comwww.facebook.com/FuturesGroupwww.twitter.com/FuturesGroupGbl
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