Up Close and Personal with TulaSalud's m-Health work in Guatemala

Posted by MohiniBhavsar on Mar 09, 2011
Up Close and Personal with TulaSalud's m-Health work in Guatemala data sheet 3010 Views

Mohini Bhavsar was a summer 2010 research intern at MobileActive.org. Shortly after, she volunteered with TulaSalud in Guatemala to observe what it takes to implement and scale a mobile health program.

Innovation in mobile health is not quite as widespread in Latin America as it is in Africa and Asia. Of the m-health programs in Latin America, little sharing of region-specific strategies has taken place.

TulaSalud is an organization based in Guatemala that is leveraging ICT -- specifically mobile phones -- to improve the delivery of health care services for indigenous communities. Through this case study, we hope to share some of what TulaSalud has learned over the years. 

TulaSalud partners with the Ministry of Health and the Cobán School of Nursing and receives support from the Tula Foundation based in Canada. The organization's vision is to use ICT and mobile technology to reduce maternal and infant mortality and to monitor disease outbreaks in the remote highlands of Alta Verapaz. Using mobile phones, TulaSalud has been able to improve the flow of information between health professionals based in hospitals and community health workers (CHWs) in remote villages.

Alta Verapaz has the largest rural and poor indigenous population in the region with limited access to health care services. In an area with one million inhabitants, 93% are indigenous and share the highest burden of maternal mortality.

TulaSalud's community health workers, known as tele-facilitadores, use mobile phones to:

Basic Information
Organization involved in the project?: 
Project goals: 

In partnership with the Ministry of Health and the Coban School of Nursing and with support from the Tula Foundation in Canada, TulaSalud leverages ICT and mobile technology to reduce maternal and infant mortality and monitor disease outbreaks in the remote highlands of Alta Verapaz, Guatemala. 

Brief description of the project: 

Using mobile phones, TulaSalud has been able to improve the flow of information between health professionals in hospitals and community health workers attending to patients in remote villages.

Community health workers are using the mobiles provided by TulaSalud in the following ways:

  1. To seek remote decision-making support from physicians and specialists in urban centers
  2. To receive calls from people seeking care
  3. To organize logistics and transportation for emergencies with other tele-facilitadoras and Tula attendants at the hospitals
  4. To follow-up with Tula attendants at hospitals to ensure their referred patients received care

The NGO takes advantage of the mobile phone in these ways:

  1. Monitors disease outbreaks in real-time based on data aggregated from patient consultations using EpiSurveyor
  2. Sends text message alerts and reminders using FrontlineSMS to community workers
  3. Delivers remote health trainings via mobile phone-based audio conferencing
Target audience: 

Rural indigenous communities in Alta Verapaz, Guatemala.

Detailed Information
Length of Project (in months) : 
What worked well? : 
  • Having strong local IT capacity.
  • Working closely with Ministry of Health, Guatemala.
  • Simple and easy-to-use forms, based on paper-forms that CHWs are already familiar with.
  • Many telefacilitators already have knowledge of community level health issues (previously trained as midwives or community health workers).
  • Telefacilitators use the calling capability of the phone to consult doctors at the TulaSalud office for diagnostic support. The mobile phone plans have 1000 minutes and network to network calling is free. This reduces costs substantially.
  • Digitizing data at the community level through the mobile phone reduced reporting time from 40 days to 4 days. 
  • Distance health training delivered by linking mobile phone to audio conferencing device.
What did not work? What were the challenges?: 
  • Signal issues in some areas required telefacilitators to walk 20-25 minutes from homes. This could be a demotivator.
  • Currently, only one physician has access to the data aggregated in EpiSurveyor. For expansion, the organization needs to develop an organized system of sharing.
  • With Episurveyor, data is downloaded manually into Excel, then to Access, where it is analyzed. This is a slow process with too many steps and is not ideal for expansion.
  • With EpiSurveyor, web-based analysis tools are weak and only for fixed form entries. All analysis is done in internal Access database.
  • There is a need to strengthen the referral processes; it is call-based and does not yet integrate with data coming through EpiSurveyor or directly with Tula's web-based records system.

Zambia: Implementing The End Use Verification Survey Using Mobile Phone Technology

Posted by MohiniBhavsar on Oct 14, 2010
Zambia: Implementing The End Use Verification Survey Using Mobile Phone Technology data sheet 1992 Views
Publication Date: 
Nov 2009
Publication Type: 
Report/White paper

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.

New Releases of Mobile Data Tools: ODK and EpiSurveyor

Posted by KatrinVerclas on Dec 04, 2009

Two of the fastest-growing and popular mobile data collection tools have recently seen some exciting upgrades in newly released versions. 

Open Data Kit recently released v1.1 of ODK Collect. Open Data Kit (ODK) is a suite of tools to help organizations collect, aggregate and visualize their data. ODK Collect is powerful phone-based replacement for paper forms. Collect is built on the Android platform and can collect a variety of form data types: text, location, photos, video, audio, and barcodes. ODK Collect can be downloaded in the Android marketplace or here. The developers also have a demo video that describes the new features of the release. Open Data Kit is a member of the Open Mobile Consortium of which MobileAtive.org is a founding member.

Some of the new features of ODK Collect include barcode scanning, image/audio/video capture and playback, editing of saved forms, and device metadata (phone number, IMEI, IMSI) support. GPS acquisition and form processing is a faster, and the developers added review data entry. The user interface has been field tested and reworked to make training and use much easier. ODK Collect also supports question grouping, repeats, constraints, complex logic, and multiple languages.

ODK is currently deployed for HIV counseling with AMPATH in Kenya, user feedback gathering for Grameen's AppLab in Uganda, war crime documentation with the Berkeley Human Rights Center in the Central African Republic, and forest monitoring with the Brazilian Forest Service.

Meanwhile, our friends over at Datadyne have released version 2.0 of their popular mobile data collection platform EpiSurveyor.  For some of the very cool GPS features of that, see the video below. EpiSurveyor is a free, user-friendly mobile-phone-and-web-based data collection system.  Version 2.0 has many new features such as GPS (users with GPS-enabled phones (like the Nokia E71) can automatically create a "GPS stamp" for every record collected AND automatically see the results on a Google map, all within EpiSurveyor.org), advanced logic, including skip logic; numeric range limits for data entry; and a much better user interface for the web-backend. 

EpiSurveyor is used by organizations around the world.  One organization, TulaSalud in Guatemala, uses EpiSurveyor for maternal health. The video below (en Espanol) explains how the organization is using the tool.

Video informativo de TulaSalud, sobre la aplicación del sistema de monitoreo epidemiológico aplicado con la tecnología de EpiSurveyor, el cual pretende tener a tiempo real el reporte epidemiológico de las comlunidades.


New Releases of Mobile Data Tools: ODK and EpiSurveyor data sheet 3749 Views
Countries: Guatemala