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

Questions & Answers