MOBILE HEALTH:
WV’s 2014 Global Framework
Vision Statement
Empower the most vulnerable households
and community health workers/volunteers
through use of common, shared, multi-
functional and collaboratively designed
mobile health solutions to deliver
community-based health interventions.
Principles for our Work:
Coherence and quality of approach and
programe/project management
ALWAYS in partnership with others and
building on global learning
Designed to meet the needs of
community users but also provide the
basis for maturing the evidence base
Initially affordable yet based on
sustainable costing models and scalable
technology
Considers data governance issues
Uses and strengthens government
partners’ information systems
Favors open source solutions and
emerging global standards
National
LevelDistrict
Level
Community
Level
Framework for mHealth Governance,
Operating & Financial Models
Social Enterprise
Model
WV MOTECH Suite Solution:Social Enterprise Open Source Model
Private
& Public
Donors
Industry
Standards
Organizations
Governments &
Regulatory Bodies
Solution
Providers
Intl &
Local NGOs
Mobile
Operators
WV’s mHEALTH EXPERIENCE
WV mHealth Scope & Reach
CURRENT:
Live Projects in 14
Countries across Africa
& Asia
2,000 Community
Health Workers Using
mHealth
177,000 Community
Members Reached
2016 TARGETS:
CHW: 8,000
Community Members:
700,000
INTEGRATED PROGRAMME &
SOLUTION DELIVERY
MATERNAL & NEWBORN CHILD
HEALTH:
Timed & Targeted Counseling -
CHW-delivered behavior change
program
Community Case Management –
CHW-delivered treatment of acute
illnesses
NUTRITION:
Positive Deviance / Hearth
Growth Monitoring & Promotion
Community Management of
Acute Malnutrition
World Vision’s mHealth Portfolio
Motech Deployments Live in
11 Countries: Sierra Leone,
Uganda, Zambia, Tanzania, India,
Afghanistan, Indonesia, Sri Lanka,
Mozambique, Burundi, Niger
Motech Deployments i n
Planning for 4 Additional
Countries: Ghana, Chad,
Mali, Mauritania,
Supporting Govt
Deployments
In 3 Countries:
Kenya, Rwanda, Cambodia
WV mHealth Forms/Data
Toward Economies of Scale:Goal: Reduce ramp-up time, level of effort & overall costs
GLOBALLY DESIGNED
LOCALLY CONFIGURED & DEPLOYED
Theory of Change Global Specifications Solution Development
Local Configuration Training of Trainers/Users Deployment
Ensure client
expectations
were met
mHealth Theory of Change
Natl & Intl Goals to
which project
contributes
Improved linkages
between facility and
community services
for quality
improvement
Develop
Operating
Plan
Refine business
needs &
requirements
CHW/V
adherence to
behavior change
communications
protocols
CHW/V
adherence to
case
management
protocols*
Foundational
activities
Outputs &
immediate
outcomes
Outcomes to which
project primarily
contribute
Develop M&E
plan and
conduct
baseline
Consolidate
sustainability
plan and
relationships
w partners
Establish
programme
management
team
Training,
curriculum and
partner
development
Improved preventive
health behavior among
pregnant women and
caregivers at the
household level
Access to health
information and
complementary
social services
Build and
sustain user
capacity &
ownership
Communicate
project- roadmap,
benefits, project
management
More timely and effective
use of health services on
the part of pregnant
women and caregivers
Deployment
activities
Develop
solution based
on user needs
Activity
tracking, as
part of M&E
Appropriate
and timely use
of program
monitoring
information
Design
budget &
sustainable
financial
model
Undertake
user
acceptance
testing
Train users
on all
aspects of
solution
• Lower maternal and child U5 mortality rates
• Lowered child U5 morbidity
• Improved maternal and child U5 nutritional status
Millenium
Development
Goals
mHealth Theory of Change
CHW/V
motivation
&
retention
More sustainable,
effective and efficient
CHW/V workforce
Referral
closure rates
between
CHW/V and
facilities
* i.e. ttC visit schedule or CCM clinical case management protocols
ICT System
performance
& scalability
EMPOWER, EQUIP, ADVOCATE
Afghanistan mPhone Project -
USAID-funded Child Survival Health program 2008-2013
• Significant improvement between intervention and control groups in antenatal
attendance (20 percent) and skilled delivery at a health facility (22.3 percent)
• Having a birth plan (12.6 percent) that included improved coordination with the health
facility (12.6 percent),
• Saved money and arranged transport, and knowledge of two or more pregnancy danger
signs (12.9 percent).
Mozambique mHealth Project -
Gates-funded Grand Challenges 2010-2012
• Use of mobile technology by CHWs was associated with high recognition of danger
signs during pregnancy (6%) and postpartum (14%), for an overall complication
identification rate among participants of 20% (global average is 15% according to WHO).
• Prevalence of birth preparedness (64%) in association to danger sign recognition, is
higher than in studies from Uganda (35%), Kenya (7%), two studies in Ethiopia (20%,
22%), and India (48%).
Initial WV mHealth Evaluation ResultsMotech Suite/CommCare Pilots
Current & Emerging
WV Collaborations/Partnerships
Implementers
Ministries of Health & National
Telcom RegulatorsTechnology
Providers
Funders MNOs
Community
Health Workers
Local NGOs
International
NGOs
Community-
Based
Organizations
UN Agencies
DELIVERING MHEALTH AT THE LAST MILE
Fragmentation (pilotitis)
Duplication of effort & reinventing the wheel
Partnering challenges
Capacity gaps
Unsustainable business models
Poor connectivity & coverage
Growing but still incipient evidence base
Reduce ramp up time, learning
curve, duplication of effort
Align & partner toward
common goals
Continuous capacity building
of all stakeholders
Negotiate partnering
agreements to work toward
collective impact
Build capacity to undertake
rigorous operations research
CHALLENGES SOLUTIONS
GUIDING PRINCIPLE: Focus first on needs of community and users
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