Chipatala Cha Pa Foni (CCPF) Health center by phone: Designing for scale Zachariah Jezman, mHealth Program Manager Malawi With partners

Health Challenges in Malawi 2 HEALTHCARE ACCESSIBILITY INFORMATION AVAILABILITY LACK OF INFRASTRUCTURE HUMAN RESOURCE CONSTRAINTS 2 doctors and 28 nurses/100,000 population Midwives to pregnant women is 1:245 (as compared to WHO recommended 1:7) Poor access to and use of health facilities; almost half of Malawians live over 5 km from the nearest health facility Limited availability of timely and reliable health information for decision-making Delays in care seeking/frequents unnecessary visits to the health centre

One way of addressing the problem 3 Provides timely, reliable, personalized and relevant health information to pregnant women, women of child bearing age and caregivers of under-5 children Improves health seeking behaviors and appropriate use of health services Chipatala Cha Pa Foni (Health center by phone)

Chipatala Cha Pa Foni background 4 In Malawi, CWW Innovations for MNCH ran a nationwide campaign, “Share an Idea, Save a Life”. Over 6000 ideas generated-- CCPF one of them. Best 2 ideas--hotline in addition to face to face interaction with the health system and Tips and Reminders Toll-free line launched in 2011 VillageReach was the lead implementer Supported by Ministry of health in Malawi, Baobab Health trust and IKI- a research organization

CCPF over the past 4 years Results show that CCPF:  Increases positive health behaviors for women and caregivers of young children  Increases health knowledge  Decreased burden on rural health centers and health workers Over 75% of calls to CCPF’s hotline are resolved without a referral to a health facility. Who uses CCPF?  75% are young women or caregivers of young children  55% register for tips and reminders without a personal phone

CCPF over the past 4 years Why do people use CCPF? To get answers for simple health questions To get help for an acute health problem 60% of children & 30% of adults call for symptoms they are experiencing (such as fever, pain, or diarrhea) To receive ongoing relevant health information 65% of callers register for weekly tips & reminders message service

Engaging users 7 Hotline 94% of users satisfied 67% “very satisfied” Tips & Reminders 98% of users satisfied 77% “very satisfied” Indicators Visits to the health centers o 69% of CCPF users hotline advice sufficient o Less than ¼ were referred

8 After proven success, what is next?

Wide brand recognition Capacity to reach a large audience of Malawians countrywide Network of doctors to support service Airtel’s Chipatala cha pa Foni Together, CCPF and Dial-a-Doc can provide easy-to-access, reliable & impactful health information to Malawians nationwide. Chipatala cha pa Foni Airtel’s Dial-a-Doc Has Ministry of Health endorsement and support Has been merged with Airtel dial-a-doc service Scaled up to 7 districts through partner organizations Has expanded scope of service to all medical issues Will expand nationally by 2017 Nationwide expansion-partner collaboration & MoH

Market size Currently in 7 of 28 districts in Malawi reaching:  ~400,000 women of reproductive age  300,000 children under-5  30,000 calls per Year  20,000 unique users  18,000 clients subscribed to “Tips and Reminders” mobile messaging service At national scale, CCPF market would reach  > 3 million women of reproductive age  > 2 million children under-5 10 Dedza Mchinji Salima

The vision of national expansion Integration into MOH plans Engage partners to expand district reach Leverage public- private partnerships to address costs of telecom Plan for MoH to manage operations Testing new functionalities Offer more generalized health advice )))))

Contacts: Zachariah Jezman Carla Blauvelt Visit us at to learn more

Thank You! 13