MobileActive.org

Uganda suffers from a severe shortage of professional healthcare workers. Thus, programs aimed at prevention of disease are an important complement to the limited healthcare delivery system.

We analyze two deployments of an SMS-based HIV/AIDS education system that uses a quiz format to assess people’s knowledge of the disease, including its causes and methods of prevention. The deployments were to two groups in Uganda, one a sample of mobile phone users who live in a town in northwest Uganda; the other, workers at three factories in central and southeastern Uganda. The two samples had accuracy rates above chance levels and workers at the three factories had higher rates of participation (more individuals and more questions) than the sample selected from the cell tower service area. An analysis of incorrect answers suggested that while participants had some difficulty in matching the formatting required by the quiz, literacy did not appear to be a significant problem.

We discuss the results in terms of implications for using SMS as a user interface mechanism and explore the possibility of using social ties among participants as a way to promote the scalability and sustainability of this quiz-based education method.

Featherweight multimedia devices combine audio with non-electronic visual displays (e.g., paper). Because of their low cost, customizability, durability, storage capacity, and energy efficiency, they are well-suited for education and information dissemination among illiterate and semi-literate people.

We present a taxonomy of featherweight multimedia devices and also derive design recommendations from our experiences deploying featherweight multimedia in the agriculture and health domains in India. We found that with some initial guidance, illiterate users can quickly learn to use and enjoy the device, especially if they are taught by peers.

Mobile Phone ownership in low and middle-income countries has skyrocketed in the past several years. But a woman is still 21% less likely to own a mobile phone than a man. This figure increases to 23% if she lives in Africa, and 37% if she lives in South Asia. Closing this gender gap would bring the benefit of mobile phones to an additional 300 million women. By extending the benefits of mobile phone ownership to women, a host of social and economic goals can be advanced.

Mobile phone ownership provides distinct benefits to women, including improved access to educational, health, business and employment opportunities. Women surveyed across low and middle-incoome countries on three continents believe that a mobile phone helps them lead a more secure, connected and productive life.

Rural health workers in India do not always have the training, credibility or motivation to effectively convince clients to adopt healthy practices. To help build their efficacy, we provided them with messages on mobile phones to present to clients. We present a study which compared three presentations of persuasive health messages by health workers using a phonebased lecture-style message, a phone-based dialogic message that elicits user responses, or no additional aids.

We found that dialogic messages significantly improve the quality of counseling sessions and increase discussion between health workers and clients; however, we did not statistically measure an effect of either phone-based message on health behavioral outcomes. We analyze these results in light of the challenges we faced and compromises we made through the research process due to the interplay of social, cultural and environmental realities, and discuss how these factors affect ICTD projects at large.

A new technology has crept onto the African scene that has enabled a step change in the way that the poor can access and share information. This concept paper outlines why we believe that Instant Messaging (IM) through services such as Mxit and JamiiX can make a significant difference, not only to the provision and impact of information services, but more importantly to the ongoing coaching and mentoring of individuals and communities. This technology offers benefits in terms of lower cost and greater ease of use, whereby users can enter into a “conversation” with a service provider. It is this ability to establish a relationship through the multiple exchange of texts that distinguishes the system from SMS based information services, and it is relationships that hold the key to translating information into practice and thus lasting transformation.

In November 2009, the USAID | DELIVER PROJECT office in Zambia, with technical assistance from the home office, conducted the End-Use Verification activity to assess the performance of the logistics management and supply chain systems for selected essential drugs, malaria and family planning commodities.

The survey was used in conjunction with the ongoing Essential Drugs Logistics System Pilot in Zambia, and overall objective was to assess how the logistics systems managed selected commodities at public health institutions, as well as provide a snapshot of how malaria was being diagnosed and treated at lower level facilities. This report presents the findings of the assessment as well as the short- and long-term recommendations to successfully implement the End-Use process, as well as the use of EpiSurveyor for regular data collection purposes.

In the context of the rapid growth of mobile phone penetration in developing countries, mobile telephony is currently considered to be particularly important for development. Yet, until recently, very little systematic evidence was available that shed light on the developmental impacts of mobile telecommunication. The Information and Communication Technology for Development (ICT4D) program of the International Development Research Centre (IDRC), Canada, has played a critical role in filling some of the research gaps through its partnerships with several key actors in this area.

The objective of this paper is to evaluate the case of mobile phones as a tool in solving development problems drawing from the evidence of IDRC supported projects. IDRC has supported around 20 projects that cut across several themes such as livelihoods, poverty reduction, health, education, the environment and disasters. The projects will be analyzed by theme in order to provide a thematic overview as well as a comparative analysis of the development role of mobile phones. In exploring the evidence from completed projects as well as the foci of new projects, the paper summarizes and critically assesses the key findings and suggests possible avenues for future research.

Mobile phones are currently used by millions of people around the world. In Africa, mobile phone ownership and use has dispersed at a surprisingly rapid rate across the continent. Recently, there have been multiple and diverse efforts to exploit mobile technologies for purposes of health communication, including collection of health data and provision of health information. Using mobile phones to provide family planning information, however, is a new area that has received almost no attention from health workers.

Recognizing this as a gap and an opportunity, the Mobile for Reproductive Health (m4RH) project was born. The m4RH project is conceptualized as an automated, text-based system that is compatible with any and every mobile phone to maximize reach and access to family planning information via mobile phone. Since this is a new project and mobile phones are a novel method of delivering family planning information, formative research to obtain feedback on the project was carried out in countries where the m4RH project will be piloted in 2010.

Background: The objectives are to compare the effectiveness of cell phone-supported SMS messaging to standard care on adherence, quality of life, retention, and mortality in a population receiving antiretroviral therapy (ART) in Nairobi, Kenya.

Methods and Design: A multi-site randomized controlled open-label trial. A central randomization centre provided opaque envelopes to allocate treatments. Patients initiating ART at three comprehensive care clinics in Kenya will be randomized to receive either a structured weekly SMS (’short message system’ or text message) slogan (the intervention) or current standard of care support mechanisms alone (the control). Our hypothesis is that using a structured mobile phone protocol to keep in touch with patients will improve adherence to ART and other patient outcomes. Participants are evaluated at baseline, and then at six and twelve months after initiating ART. The care providers keep a weekly study log of all phone based communications with study participants. Primary outcomes are self-reported adherence to ART and suppression of HIV viral load at twelve months scheduled follow-up. Secondary outcomes are improvements in health, quality of life, social and economic factors, and retention on ART. Primary analysis is by ‘intention-to-treat’. Sensitivity analysis will be used to assess per-protocol effects. Analysis of covariates will be undertaken to determine factors that contribute or deter from expected and determined outcomes.

Discussion: This study protocol tests whether a novel structured mobile phone intervention can positively contribute to ART management in a resource-limited setting.

Two challenges to successful antiretroviral therapy (ART) scale-up in resource-limited settings (RLS) are human resource and healthcare infrastructure limitations. 

We read with interest the modeling study by Bärnighausen et al. which describes the complexities of ensuring adequate human resources to treat HIV/AIDS (HRHA). The authors suggest that factors needed to achieve universal ART coverage include “changes in the nature or organization of care,” training health workers with skills specific to the developing world to reduce emigration, and developing systems that decrease the number of traditional HRHA required to treat a fixed number of patients.

The Rakai Health Sciences Program (RHSP) PEPFAR-funded ART program has been actively pursuing innovative HIV care strategies that directly address these important points. In 2006, we piloted a novel program utilizing peer health workers (PHW) and mobile phones to monitor patients in a rural ART program in Rakai, Uganda.

This guide provides an inexpensive way to create an SMS communications network to enable healthcare field workers as they serve communities and their patients. The steps are purposefully simple – the system is easy to set up, use and maintain.

Answers to Frequently Asked Questions:

1. Who might benefit from a text-based communications network?
2. What are the benefits for my hospital, clinic or organization and the people it serves?
3. What technology do I need?
4. Do I need an internet connection?
5. How expensive is an SMS network?
6. How do I distribute communication credit?
7. How much staff training is required?
8. How much time does it take, per day, to manage the SMS network?
9. How do I conduct SMS training?
10. What is the best power source for the cell phones?
11. Do the CHWs communicate with each other?
12. Where can I find more information on FrontlineSMS?