Dominic Atweam KHealth Information Systems AnalystPolicy Planning Monitoring and Evaluation Division- Ghana Health Service
MOBILE TECHNOLOGY FOR COMMUNITY HEALTH
Overview
• What is MoTeCH?
• Pregnant Parents Application (MOBILE MIDWIFE)
• Tools for Community Health Workers(HIMS)
Using mobile phones to increase the quantity and quality of maternal and child health services in Ghana
Focus on frontline community health facilities (CHPS zone, Health Centre's)
What is MOTECH?
Overview
• What is MoTeCH?
• Pregnant Parents Application (Mobile Midwife)
• Tools for Community Health Workers (HIMS)
• Social Impact Assessment
ChallengesChallenges in
Communities
ANC visits start late
Incomplete ANC coverage
Delay until newborns seen
Unattended births
Patchy immunization coverage
Low IPT uptake
Local myths
MOTECH Component 1: Mobile Midwife
• Personal care during pregnancy
• Newborn care• Recognition of danger
signs• Developmental milestones • Nutrition and
breastfeeding• Malaria• Immunization • Postpartum family
planning • Diarrheal diseases• Pneumonia
Messages provide key MCH information for “pregnant parents” and reminders to seek timely care:
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.
Why do we need
injections for both mother
& baby?
Why do I need IPT?
Why should I attend clinic at
first signs of
pregnancy?
Why do I vomit when I’m pregnant?
Why should we practice exclusive
breast feeding?
What do we do about body
swelling during pregnancy?
Overview
• What is MoTeCH?
• Pregnant Parents Application (mobile Midwife)
• Tools for Community Health Workers(HIMS)
• 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
HIMS Challenges
For Nurses
PROBLEM:Too much paper,
too little useful information
SOLUTION:Using the mobile phone for
data entry and management
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
MOTECH Component #2: Nurses’ Application
Simplified Register Capture and store data more
efficiently +
Health worker focused mobile intervention
information to support service delivery and continuity of care
Improve work routine and
time for service delivery
Increase quantity and
improve quality of interactions
between clients and health
system
Phone based alerts and reminders
at “critical” times to promote and encourage utilization of essential
health services
Improved supervision and
feedback
MO
BILI
ZE S
UPP
LYM
OBI
LIZE
DEM
AND Phone-based health education
to pregnant women and new mothers to increase knowledge
and awareness
System effect
MOTECH Pilot-to-Scale & Transition to GHS
Aug 2010: Pilot in KNW District, Upper East
Region Sept 2011: Replication in Awutu
Senya District, Central RegionMarch 2012: Phase II: Scale &
Transition
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
(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
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 eRegister systems
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
GHS HIMS STRATEGY
DHIMS2
Integration Tools
Clinical Information Systems
Community eRegister/Motech messaging
Other Systems
Data Warehousing and Reporting
Data Integration
Transactional Data