ITU Experts Group Meeting on m-Health: Towards Better Care, Cure and Prevention in Europe Geneva, Switzerland, 25-26 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, 25-26 September 2012

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, 25-26 September 2012

mHealth Ecosystem Geneva, Switzerland, 25-26 September 2012

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, 25-26 September 2012

Framework for mHealth Impact Geneva, Switzerland, 25-26 September 2012

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, 25-26 September 2012

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, 25-26 September 2012

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:

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

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

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

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

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

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, 25-26 September 2012

Thank you Dr. Shariq Khoja skhoja@mhealthalliance.org Geneva, Switzerland, 25-26 September 2012