1. ITU Experts Group Meeting on m-Health: Towards Better Care, Cure and Prevention in Europe
Geneva, Switzerland, September 2012
Narrowing the ‘Evidence gap’ for informed policy and regulations in mHealth
Dr. Shariq Khoja MD. PhD (eHealth)
Technical Advisor –
Evidence, Financing and Policy
mHealth Alliance
Geneva, Switzerland, September 2012

2. Understanding mHealth Ecosystem What are the needs and gaps
Roadmap
Understanding mHealth Ecosystem
What are the needs and gaps
Importance of strengthening Evidence base for mHealth
Role of mHealth Alliance
Building Partnerships
Geneva, Switzerland, September 2012

3. mHealth Ecosystem
Geneva, Switzerland, September 2012

4. Intervention Points across H/system
Health System
Data Collection / Disease surveillance
Inputs
Health Work force
Medicines, Vaccines, Supplies
Facilities/Infrastructure
HIS and Support tools for Health Providers
Emergency Medical Response System
Information Management
Treatment Adherence / Appointment reminders
Service Delivery
Disease Prevention and Health Promotion
Communication and Education
Procurement and Supply chain
Supply Chain Management
Financing
Health Financing
Leadership and Governance
Research and Development
Enablers
Geneva, Switzerland, September 2012

5. Framework for mHealth Impact
Geneva, Switzerland, September 2012

6. Gaps in Evidence Examples of Operational Effectiveness
Examples of Improved health Outcomes
Emergency Response in Haiti
1000% Increase in number of people reached through sms
Benefits:
Expanded geographic reach to remote areas
HIV Testing, Kenya
97% decrease in processing time
Benefits:
Increased speed of Information delivery & Efficient supply chain
Patient Registration, India
300% Increase in volume of data captured
Benefits:
Promotion of healthy behaviour
Increased accuracy of information
Patient Reminders, Kenya
Significant Increase in adherence to care plans
Benefits:
Improved quality of care
Improved capacity of health Providers
Geneva, Switzerland, September 2012

7. Gaps constraining mHealth Ecosystem
Impact Areas
Gaps and Barriers
Lack of rigorous evaluations to demonstrate health impact and learn about what works
Low end-user and health worker technology literacy
Siloed relationship with other mServices (mMoney etc)
Lack of effective dissemination platform for knowledge
Weak technology support markets
Lack of second-phase funding to scale projects
Limited understanding of full cost of implementation
Low engagement of major health funders (GAVI, GF etc)
Limited willingness and capacity to pay among end-users
Lack of Inter-operability with enabling systems & tech
Challenges of delivering services in rural areas
Lack of evidence-based studies to support business case
Lack of mHealth Policy or alignment with the eHealth policy at National level
Limited connection between global North and South
Lack of standards to enable interoperability
Low level of coordination between players at national level
Low level of cross-sectoral understanding b/w communities
Geneva, Switzerland, September 2012

8. mHealth Alliance Mission:
Catalyze the power of mobile technologies to advance health and well-being throughout the world, with a focus on low income countries
Goal:
Mobilize the effective integration of mHealth into global health practices, programs, and policies by building the mobile health commons
Strategic priorities:
Evidence base linking mHealth to operational benefits and improved health
Increased technology integration and interoperability
Sustainable sources of financing for mHealth
Global & national policies support the use of mobile for health
Health community with capacity to design and deploy
Catalyze the Alliance’s partners and members to build “the commons”
In our last meeting, the board approved the strategy.
We have edited and finalized the mission and goal statements, based on a final vote from board members
We have also elevated interoperability and added advocacy to the second activity bucket
Set the agenda to build the commons
Build the mHealth knowledge base & communicate/ advocate
Connect, convene, and facilitate the community
Provide catalytic funding to accelerate building of the commons
Alliance’s activities:

9. Results Framework: mHealth community long term targets
Strategy
Target
Indicator
Measurement method
Catalyze the power of mobile technologies to advance health and well-being throughout the world, with a focus on low income countries
Measurable progress made against MDGs 4,5,6 (DHS/ MDG indicators)
UN MDG indicators for MDG 4, 5, & 6
Refer to publically available research and data
Notes: 1. Community refers to the broader mHealth community that the Alliance targets. Source: Dalberg analysis

10. Results Framework: mHealth community long term targets
Strategy
Target
Indicator
Measurement method
Mobilize the effective integration of mHealth into global health practices, programs, and policies by building the mobile health commons
Health community is aware of mHealth and effectively use
mHealth uses commonly accepted health & technology standards; policies apply to and account for mHealth
Programming and funding of health initiatives & services include mobile component
mHealth is scaled and sustainable due to common challenges addressed
# of Ministries with mHealth incorporated in national programming
# of global health funders with explicit mHealth programming or strategic priority
# of health practitioners and individuals who report using mHealth
Refer to publically available research and data
Partner feedback survey
Member survey

11. Results Framework: mHealth community1 intermediate targets
Strategy
Target
Indicator
Measurement method
Evidence base
Larger and higher quality evidence base linking mHealth to operational benefits and improved health
# and proliferation of comparative studies across countries
# of scaled projects producing rigorous M&E results
# and proliferation of comparative costs/benefit studies
Refer to publically available data
HUB surveys2
Policy
Global & national policies support the use of mobile for health
# of countries adopting mobile policies in national health programs (policies explicitly mention “mHealth”)
Member survey
Refer to publically available research and data
Capacity
Health community with capacity to design and deploy
# of health practitioners using mobile,
# of readers of M&E reports (i.e. # of downloads, distribution)
Website / social media tracking tools

12. Results Framework: mHealth Alliance1 intermediate targets
Strategy
Target
Indicator
Measurement method
Evidence base
2-3 key research questions answered in one use case at national level by 2014
# of studies conducted on key research gaps – either commissioned or brokered by the Alliance and its WG
# of existing studies which have integrated key questions in line with those identified by the WG
Refer to publically available data
Working group performance measurement process (TBD by working group)
Policy
TBD when working group is formed
# of countries adopting mobile policies in national health programs (policies explicitly mention “mHealth”)
Member survey
Refer to publically available research and data
Capacity
% positive responses of target cohort in member survey
# of readers of mHealth reports & tools (# of downloads)
Website / social media tracking tools

13. Membership model: Single actor focus Cross-sectoral GSMA GBC Health
ANDE
CGAP
Stop TB
Roll Back Malaria
Organization Role
Member services
Member services
Member services
Research, policy building
Movement building
Movement building
Private sector mobile companies
Private sector
~250 members
Intermediaries (investors, tech assistance)
~60 members
Funding institutions
~50
Multi-sector institutions
Light screening
1000+
Open
700+
Membership
Implementing actors
We have brought back the discussion membership model to close our discussion on the 11/29.
In order to design the optimal model for the Alliance, we conducted a benchmarking analysis of six comparable sector building organizations.
We conducted interviews and researched the organizations, focusing on their membership and partner models, as well as other best practices for effective sector-building
We found that these organizations employ a range of models, which largely depend on their strategic role and mission.
Some organizations such as GSMA, GBC Health, and ANDE have very specific target sectors that they aim to catalyze, enable, or grow (largely private sector focused). These organizations focus on member services and products. These organizations use a fee model, often have many membership tiers attached to different funding commitments.
Others such as Stop TB and Roll Back Malaria have a very general target audience and aim to build the movement more broadly, through advocacy, convening, and knowledge sharing.
The primary difference across the spectrum is the strategic goals – to provide collaboration across sectors / build a movement versus provide specific services to promote a specific industry or sector.
Implementing actors / general supporters
Funders
Implementers, technical support
Implementers, technical support
Same as members
Partners
Members dues
Occasional fee-for-service
Members dues
Occasional fee-for-service
Grants
Membership fees
Grants
Membership fees
Donations from large funders
Members dues
Funding
Source: Dalberg benchmarking analysis (six sector-building organizations) 2011; Vital Wave “mHealth Alliance Operating Plan” 2009

14. Conclusions
mHealth ecosystem needs evidence on successful business models and health related outcomes
mHealth Alliance is playing an important role in creating enabling environment for mHealth
mHealth Alliance is looking to engage partners at different levels to engage in each of the priority areas
Geneva, Switzerland, September 2012

15. Thank you Dr. Shariq Khoja skhoja@mhealthalliance.org
Geneva, Switzerland, September 2012