Part 2 of 2 of a short “Bringing mHealth back to earth” series
From the start of our projects to the finish, it’s people who determine what FrontlineSMS:Medic does, when we do it, and why. The tech tools we use exist to serve patients, community health workers, and healthcare professionals – not the other way around. This mindset is critical for a number of reasons. I’ll explain.
We strongly believe that projects should start when clinics ‘pull’ them to a site, as opposed to having projects ‘pushed’ onto healthcare providers. Ken Banks included the (very important) push/pull differentiation in his “Development best practices for beginners” series. Clinics are not just convenient places to pilot technology innovations. Healthcare providers should demand programs they need, and we should be ready to respond. Local staff should determine how the tech will be used, and we should be flexible and helpful in working through use cases and functionality.
Andre Blackman posted this video of our SMS training at Pulse + Signal:
You’ll notice that I’m not in any of the shots. It wasn’t my place to train the community health workers – (1) I don’t lead their other training sessions, and (2) I don’t speak Chichewa well. I’ll work one-on-one with those who need individual attention – although, the CHWs do self-organize into pairs, and those who need help will find it from others. We made it clear that local staff were running the show.
A quick and straightforward example of being responsive: On the first day of training, one of the CHWs was struggling to see the small letters on the cell phone…
So, we created handouts of blown-up number pads, which everyone ended up using.
Our work involves technology, but the focus is on the people. A bag full of cell phones without community health workers using them to serve patients is… just… heavy.
“mHealth” is intimidating. I’ve written about this before – most of FrontlineSMS:Medic‘s partners cautiously approach us. After we work together to get projects up and running, I consistently hear, “We never thought this technology would be – much less work – here.”
With this post, I’m hoping to dispel some mHealth myths and start to dissolve the perception of mHealth programs as unattainable for small and large clinics (with or without technical know-how). Below, you’ll find pictures and prices for all the technology we’re using for the Partners in Health project in Malawi. Here’s the key: except for FrontlineSMS, all of the following tools were already being used locally.
Left: FrontlineSMS running on an Acer netbook with modem attached Right: with Motorola V3 RAZR attached
FrontlineSMS is free software, and incredibly easy to use. The Acer netbook cost $200, and the modem was $150. You can get the phone and data cable for $20 or less.
We needed mobile phones. This is how Hope Phones and the generosity of phone donors helped out, in a big way. We got these RAZRs for $15 each, and we’ve used models that cost as little as $6.50, which work just fine.
Solar panels are useful if electricity’s scarce, and we almost always implement sharing systems. We’ve found that 3-4 community health workers can share a panel, given efficient charging rates. The product pictured cost $20, and we’re testing $7 panels right now. Of course, we’re buying local SIM cards (cost less than $2 each). The last piece of the puzzle is cell network coverage. Luckily, we’re not building any towers; coverage is good and always improving.
That’s it. Really. As Home Depot used to say, “You can do it. We can help.”
Of course, people make this work and give the tools value. My next post (part 2 of 2) will focus on implementation and training (both FrontlineSMS training and SMS workshops with the community health workers) and I’ll include videos.
Henry leading SMS training
I’m happy to answer any questions – just leave a comment.
Hello from Neno! Here, I’ve drawn out the use case we’ll be focusing on for the Partners in Health pilot at Neno District Hospital. There is a lot of potential for the FrontlineSMS:Medic system to be used to track patients in a number of programs: e.g. ART, pre-ART (HIV-positive patients not yet on antiretroviral therapy), TB, PMTCT, Kaposi’s sarcoma, chronic care.
So, we have: touchscreens in the hospital for patient registration and clinical data entry, electronic medical records following patients and creating alerts, and cellphone-wielding village health workers tracking remote patients. I think it’s exciting, and we’ll be structuring the outcomes assessment this week.
We’re training 130-150 village health workers next week. In the picture above, the VHWs had gathered for a training session on multi-drug-resistant TB. You can see me in the back, watching intently.