Presentation on theme: "Health Information Systems Analyst"— Presentation transcript:
1 Health Information Systems Analyst Mobile technology for community healthDominic Atweam KHealth Information Systems AnalystPolicy Planning Monitoring and Evaluation Division- Ghana Health Service
2 Overview What is MoTeCH? Pregnant Parents Application (MOBILE MIDWIFE) Tools for Community Health Workers(HIMS)General intro to presentation
3 What is MOTECH?Using mobile phones to increase the quantity and quality of maternal and child health services in GhanaFocus on frontline community health facilities (CHPS zone, Health Centre's)There are other similar programme running on different plat forms but performing the same functions as MOTCHGHS NMCSSP eREgisterGHS - Sene Smart Phone Project
4 Overview What is MoTeCH? Pregnant Parents Application (Mobile Midwife) Tools for Community Health Workers (HIMS)Social Impact Assessment
5 Challenges in Communities ANC visits start lateIncomplete ANC coverageDelay until newborns seenUnattended birthsPatchy immunization coverageLow IPT uptakeLocal mythsWhen considering communities issues around Maternal and Child Health:pregnant women are often late to report to the CHPS compound, resulting in late uptake of ANCnot all of our mothers are attending for at least 4 antenatal visitspost natal care uptake for newborns is lowvaccination schedules are not followed reliablyIPT uptake is lowand local myths sometimes encourage practices which are damaging to people’s health
6 MOTECH Component 1: Mobile Midwife Messages provide key MCH information for “pregnant parents” and reminders to seek timely care:Personal care during pregnancyNewborn careRecognition of danger signsDevelopmental milestonesNutrition and breastfeedingMalariaImmunizationPostpartum family planningDiarrheal diseasesPneumoniaMoTeCH aims to address some of the community-based issues by offering a mobile health information service for pregnant women, their husbands and families. The woman’s pregnancy is registered in the MoTeCH system along with her Estimated Due Date. MoTeCH then sends the patient’s mobile phone a message each week, containing information specific to that particular week of pregnancy. The information aims to give practical advice on how to deal with some of the challenges of pregnancy; physical, emotional and financial. It provides reminders about what healthcare women should be receiving, and gives users tips about where to deliver, how to breastfeed, how to care for the baby, and explains local myths. It is intended that this service encourages better health seeking behavior, leading to improved health outcomes.Provides weekly, relevant, actionable pregnancy care voice messages in local languages3 messages a week , Tailored to stage of pregnancy, and first year of child’s life, Women use their own or , household/compound phones, Free serviceProvides maternal and child health information and encourages better and timely health-seeking behavior
7 Pregnant Parents’ Service Engage Both ParentsRelevant, actionable and fun information by SMS and/or voiceEncourage health seeking behaviorAvailable in local languagesProduct DevelopmentConsultation 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.MoTeCH aims to address some of the community-based issues by offering a mobile health information service for pregnant women, their husbands and families. The woman’s pregnancy is registered in the MoTeCH system along with her Estimated Due Date. MoTeCH then sends the patient’s mobile phone a message each week, containing information specific to that particular week of pregnancy. The information aims to give practical advice on how to deal with some of the challenges of pregnancy; physical, emotional and financial. It provides reminders about what healthcare women should be receiving, and gives users tips about where to deliver, how to breastfeed, how to care for the baby, and explains local myths. It is intended that this service encourages better health seeking behavior, leading to improved health outcomes.The service has been developed in collaboration with GHS policy makers and Upper East management, midwives, pregnant women and other community members. The content aims to address user’s knowledge gaps and support the work of the CHPS workers. Early and constant consultation with real potential users has helped MoTeCH to ensure they are creating a useful service.
8 Why do we need injections for both mother & baby? What do we do about body swelling during pregnancy?Why do I need IPT?Why should we practice exclusive breast feeding?These are some of the questions that potential users have asked . It is these kinds of questions that we are able to answer through the service.Why shouldI attend clinic at firstsigns of pregnancy?Why do I vomit when I’m pregnant?
9 Overview What is MoTeCH? Pregnant Parents Application (mobile Midwife) Tools for Community Health Workers(HIMS)To address some of the challenges faced by nurses, MoTeCH has developed Simplified Registers and a mobile system to capture some patent data.
10 HIMS Challenges For Nurses Volume of paper: up to 20 different patient registers for each facilityOnerous data reporting: nurses spend 4-6 days per month aggregating dataLittle information flows back to the nurse: difficult to identify defaulters or high risk patientsNurse attitudes sometimes discourage clients from seeking health informationFor the CHPS nurses there are challenges in the reporting systems which rely on cumbersome paper forms, which take days per month to complete, detracting from the time the nurses are spending with their patients. Information which nurses record in their registers does not flow back to the nurse in a way that is useful for reporting or service provision.
11 PROBLEM: SOLUTION: Too much paper, too little useful informationSOLUTION:Using the mobile phone for data entry and managementMoTeCH is enabling nurses to enter some of the information on the simplified registers on to a mobile phone. Doing this enables us to automatically generate some of the nurses’ monthly reporting. It is hoped that this will reduce the amount of time that nurses spend on administrative tasks. By capturing patient data on the mobile phone MoTeCH is also able to send the nurses reminders about patients who are due or overdue for care. For instance we can send nurses’ lists of all antenatal defaulters. It is hoped that this will make it easier for nurses to follow up on patients, resulting in better coverage of care. The phones are simple, low cost handsets which will be provided by MoTeCH.The simplified registers and mobile phone service together aims to reduce the burden of reporting and patient tracking for the nurse – reducing the many different registers that are currently in existence….
12 MOTECH Component #2: Nurses’ Application Data collection & ReportingSimplified paper registersNurses record patient data onto mFormsUpload data to central databaseData validation ensures high data integrityGenerates monthly reports for nurses and district officialsAlerts & RemindersSends alerts and reminders to nurses and clients about patient careWe started with Nokia 1680 and migrated to Nokia 2330 and subsequently to Nokia C1. Currently the program is using Nokia ASHA 200.
13 Phone-based health education Phone based alerts and reminders System effectMOBILIZE SUPPLYSimplified RegisterCapture and store data more efficiently+Health worker focused mobile interventioninformation to support service delivery and continuity of careImproved supervision and feedbackIncrease quantity and improve quality of interactions between clients and health systemImprove work routine and time for service deliveryMOBILIZE DEMANDPhone-based health educationto pregnant women and new mothers to increase knowledge and awarenessPhone based alerts and remindersat “critical” times to promote and encourage utilization of essential health services
14 MOTECH Pilot-to-Scale & Transition to GHSAug 2010:Pilot in KNW District, Upper East RegionSept 2011: Replication in Awutu Senya District, Central RegionMarch 2012: Phase II: Scale & TransitionTo dateFull implementation in 2 districts in 2 regions – Upper East, CentralBegan expansion to 3 new districts in 2 new regions – Volta, Greater AccraApproximately 23,783 clients currently enrolled (2 districts)` 100 facilities reporting (automated or enroute to automation)469 nurses trained and using MOTECH(automated or enroute to automation)
15 (Sustainable) Scale-up Status National steering committee formed and chaired by Director General of GHS, similar platforms at Regional & District level actively leading the programProposed joint initiative to scale to an entire Region, led by GHS with TA from GrameenPossible 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 MOTECHGHS community eRegisterGHS - Sene Smart Phone ProjectThe Pregnant Parent Components(messaging ) to be integrated into the GHS Community eRegister
16 Challenges AheadNeed for full implementation of national ehealth strategy to:ensure alignment and interoperability between MOTECH and other mhealth/ICT solutions in Ghanaintegration of the Nurses Application into DHIMS2 and GHS community eRegister systemsCosting/packaging MOTECH model for full integration into GHS workplans and budgetsCost of airtime remains high, need for negotiation with Telcos to bring rates down and increase network coverageSecuring mobile phones in high volumes at low prices for nursesGHS 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
17 GHS HIMS STRATEGY DHIMS2 Integration Tools Clinical Information SystemsCommunity eRegister/Motech messagingOther SystemsData Warehousing and ReportingData IntegrationTransactional Data