MobileActive.org

In Jordan, a new program called SOHITCOM (Social Health and IT for Rural Communities) uses mobile phones and web-based technology to improve access to maternal and early childhood healthcare information.

Developed by the Royal Scientific Society of Jordan in a partnership with Canadian funder IDRC, SOHITCOM is part of a larger program promoting and developing ICT4D in the Middle East. A two-part project, SOHITCOM is both a vaccination adherence service and a health information portal for rural Jordanians.

Information Portal

Scheduled to launch at the end of February, the SOHITCOM information portal is a forum for asking (and finding answers to) health questions. A dual website/mobile forum, it features a question and answer module, which allows users in rural areas to text in questions to partner doctors and receive answers via SMS (currently the project has a maternal and early childhood focus). The questions are posted to an online forum as well so that users with access to the site can see what other members are asking and the responses.

Explains Islam Ahmad, system analyst for the Royal Scientific Society and technical team leader for the SOHITCOM project, "[a user] can simply open her mobile phone and send an SMS to 9444 – which is so very known here in Jordan because it is the government's national gateway number – and send the question that she wants answered." The question gets loaded onto the website and a doctor answers, with users only being charged if they receive an answer via SMS. The SMSs cost 1/3 the price of regular SMSs because the Royal Scientific Society receives a reduced price from the government.

Built as part of an IDRC funded project, the website is currently a proof-of-concept site, which the RSS hopes to have taken over by the Ministry of Health after the launch. Designed in Java using open-source software and code, the website is available only in Arabic and allows users to submit questions anonymously. Watch a video of the Royal Scientific Society's Edward Jaser demonstrating an early prototype of the SOHITCOM mobile portal here

Ahmad explains that an added benefit of the site, in addition to regular medical advice and information, will be the openness SOHITCOM encourages. She says, "We got the people in the rural areas to overcome their difficulty discussing their own medical situations [...] The people of Jordan do have this challenge with speaking about themselves in public. And this is very good for young generations, young mothers, getting to discuss their issues over the Internet."

Vaccination Reminders Through Mobiles

Another aspect of the SOHITCOM project is a reminder service via mobiles for mothers who want to keep track of when their children need vaccinations. According to Ahmad, the vaccination reminder system fulfills a need to streamline the vaccination process. She says that nurses at rural health centers found people weren't coming in to vaccinate their children at the right times, or would miss follow-up appointments. In order to combat this, the service sends enrolled mothers either SMSs or prerecorded voice calls to alert them when it is time for a follow-up vaccination appointment for their children. The initial pilot launched in the Ma’an region of Jordan, and ran from March of 2010 to September 2010 with 16 mothers.

The service works by having nurses at community health centers (two community health workers were involved with the original pilot in Ma’an) log information on vaccination dates via SMS and send the information to a central database. Parents get an SMS alert when they need to take their children in for the next round of vaccinations. Health workers record if mother is literate or illiterate, and the database sends either an SMS or a prerecorded voice call depending on her needs.

Building a system that could connect cheaply with all enrolled participants regardless of service provider proved to be a challenge. Ahmad explains, "There are five [GSM operators in Jordan], so which one will you choose to host your idea in? You will be restricted to a fifth of the users. And between [the operators] they can charge each other for having SMS sent or voicemails sent over GPRS, which is very costly. We don't want the mothers to be charged anything.” To work around this so that the service would be available regardless of users' service providers, the RSS purchased a modem and connected it to a PC, directly calling mothers through the computer. The modem method was chosen for two reasons: to keep costs down, and to avoid being restricted to only one of Jordan's five telecoms.

A second challenge faced by the project was moving from the original pilot to a larger rollout, due to a lack of feedback coming from Ma’an where there was political turmoil. She explains, “…In order to get to the second phase of the pilot, we needed to get feedback from Ma'an. But no feedback was coming, so the approval for the second phase was delayed. We got delayed for almost three months.” After finally getting the data from the original pilot organized, the project is ready to move on to the next phase: the project is now preparing for expansion to five new areas (Ma’an, Al-Karak, Al-Mafraq, Jerash, and rural Amman). Training of community health workers in each areas has been completed, and the new phase will officially launch on March 7th.