Over the last week, there’s been a cascade of communication. A few examples, of many:
- A man missed his appointment with a TB officer. A CHW was texted, who reported the man had gone to Zambia for a funeral. The hospital will be notified upon his return.
- An HIV support group met, and decided on new member guidelines. Via SMS, the group leader asked the hospital to print copies for the lot.
- A CHW asked about ferrous sulfate dosages, so he could administer the proper amount to an anemic child.
I’m at the halfway point of my trip, and after five weeks on the ground, a discussion of the tools is in order. Ken Banks, the creator of FrontlineSMS, recently wrote an article about the emerging social power of mobiles for BBC News:
Ken is building a community of implementers. Interested parties should visit two of the group’s sites: www.kiwanja.net and www.frontlinesms.com.
It is precisely due to FrontlineSMS’s smart simplicity that the project has developed organically – first and foremost, to meet the hospital’s needs as it serves its catchment area. The quick uptake of the project was fueled, in no small part, by how user-friendly FrontlineSMS is, as a central communications hub.
It also has provided solutions to some potentially tricky questions. A quick example:
Text messages cost 10 cents. Units can be sent from one phone to another via Celtel’s Me2U service, but managing the units of 100+ phones manually is near impossible. So, I had to find a way to both monitor each phone’s unit level and top up (replenish depleted reserves) automatically.
Before leaving Stanford, I engraved each phone’s faceplate with a two-digit ID number. Using FrontlineSMS’s auto-forward function, I’ve set up a system to automatically top CHWs up. When they are running low on units, CHWs can text “(ID number) Units” to FrontlineSMS. Subsequently, a message is sent to Celtel, with instructions to top up that particular CHW. System abuse is unlikely and avoidable – the volunteers know that FrontlineSMS records every message received, sandwiched by unit requests.
We’re starting to explore additional functionalities of FrontlineSMS. Each CHW is given a kit of basic medications – a portion of the questions we’re fielding involve those drugs. We’ll set up an auto-reply system so that any message containing a given drug name returns a summary – function, dosages, etc. – for that drug.
Posted: July 14th, 2008
Categories: CHW Training
, HIV/AIDS Care
, Home-Based Care
, Tuberculosis Management
, HIV/AIDS Care
, Tuberculosis Management
Comments: 2 Comments
I was excited to hear that PC World picked up an article that Ken Banks (founder of kiwanja.net, and the man behind FrontlineSMS) wrote, titled, “Witnessing the Human Face of Mobile in Malawi.” If you’re interested, you can read it here.
We’re ready to expand a bit. We heard from every one of the CHWs in our pilot group (some, many times). In just a few days, we saw some tangible results. Here’s one example:
- Verona Kapagawani, who lives in TA Mavwere, alerted the hospital that a patient had run out of his meds.
- A nurse at the hospital, familiar with the patient, responded that he should fill his prescription (he has chronic congestive heart failure) as soon as possible.
- Verona responded, noting that she counseled the patient. He wasn’t feeling well enough to travel, so she came to the hospital to pick up his drugs.
- While chatting with the nurse, Verona charged her cell phone.
I ran into another CHW, Benedict Mgabe, at the hospital today. He’s the chairman of the Community AIDS Committee, and he’s texted me every day. With a smile on his face, he shook my hand and said, “This is a very good program! It is really helping us a lot.” Those short sentences confirmed that I want to have longer conversations with the CHWs, to gather their reactions.
We’re using the pilot group to contact the next wave of CHWs, another 10 volunteers, to be trained and given phones Monday morning. Above, you’ll see Alex (a nurse, who does most of the Home-Based Care community work) and Grace (who coordinates the ART program) using FrontlineSMS to text the group.
I had a long discussion with Dr. Mbeya, the medical director at St. Gabriel’s, about making very definitive links between the hospital and the CHWs’ activities. As the project grows over the next weeks, we’ll create guidelines for reporting and follow-up, based on the specific program. For example, the hospital has a lively prevention of mother-to-child transmission (PMTCT) program, aimed at reducing vertical transmission of HIV. We’ll develop a protocol for utilizing the CHW network to follow up on mothers who’ve missed their appointments, and the CHWs will provide a link to the communities’ pregnant population.
I’d love to get some other perspectives on this.
Sending good wishes from Namitete.