Advancing the use of mobile technologies to improve health outcomes throughout the world.
Over the last two years, the level of interest in mobile for development across World Vision’s (WV) fundraising and programme implementation offices globally has skyrocketed. From a modest start with three funded mobile health projects, WV's mHealth portfolio now exceeds $7.5M in funding obtained across 16 countries in Africa, South & Southeast Asia. In various countries, numerous grants have been obtained and are being strategically timed and geographically positioned so as to leverage rather than duplicate effort. Donors across this growing global portfolio include USAID, DFID, IrishAid, AusAid, CIDA, WHO, African Development Bank, Gates Foundation, and various private funders.
To best support this level of interest and funding, World Vision has intentionally and strategically aligned mobile for health at a global level across a wide range of WV fundraising and implementation offices in order to avoid a fragmented approach. In addition, WV has cultivated and leveraged new and existing collaborations and public-private partnership agreements with Ministries of Health as well as GSMA, Safaricom, Airtel, MTN, Etisalat, BBC Media Action, mHealth Alliance and NORAD.
Notably, WV has been collaborating with the Gates Foundation, Grameen Foundation, and Dimagi in a public-private partnership arrangement and has developed and deployed a global, scalable mobile health solution (Motech Suite – MTS) for WV across various health and nutrition programming models and disease categories. This allows World Vision’s mHealth projects to utilize a common, yet customizable, field-tested mHealth tool.
The advantages of a shared solution include minimizing software development, operations, and support costs, as well as sharing source code, best practices, learning, and other assets to avoid duplication; and ultimately, contributing to improved health indicators at the rural level. This model has already effected notable reductions in duplication of effort and overall costs at the global level, as well as for each project. However, in some cases where Ministries of Health have already made significant investments in other solutions (Rwanda – RapidSMS; Kenya – JAMII Smart; Cambodia – FrontlineSMS), World Vision supports that direction with their funded projects.
MTS was piloted in World Vision’s Afghanistan mHealth project in 2012 (USAID-funded Child Survival Health program 2008-2013), and the evaluation results are encouraging:
- significant improvement between intervention and control groups in any antenatal attendance (20 percent),
- skilled delivery at a health facility (22.3 percent),
- having a birth plan that included improved coordination with the health facility (12.6 percent),
- saved money and arranged transport (12.9 percent)
- knowledge of two or more pregnancy danger signs (12.9 percent).
In World Vision’s Mozambique mHealth project (Gates-funded Grand Challenges 2010-2012), MTS research results indicated that pregnant women in the project’s intervention area had a higher likelihood of accessing antenatal care, prepare better for birth, and have their births assisted by a skilled provider. They were also more likely than those in the control group to know about signs of pregnancy complications and to seek care at a facility for that complication.
World Vision is currently running mHealth projects in Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia, Kenya (JAMII Smart), Rwanda (RapidSMS), Cambodia (TBD) and is moving forward in late-2013/early-2014 with additional implementations in Afghanistan, Mozambique, Uganda, Zambia, Niger, and Ghana. A standardized, flexible monitoring and evaluation framework is being designed to measure attainment of programmatic goals.
Additionally, analysis of the complexity and economics of a global business model versus other models will be undertaken, including total cost of ownership and sustainability
With funding from the USAID Child Survival Health programme, World Vision, in partnership with Dimagi, is conducting operations research to test whether using CommCare, a mobile phone-based application, will increase uptake of healthy actions, improve knowledge of important information points, and improve communication and coordination between community health workers and higher-trained health workers. Building on the success of this project, WV Afghanistan will next roll out an mHealth application to support nutrition programming in 58 sites as part of a larger DFATD-funded MNCH project.
Indonesia’s current system for community-based child nutrition promotion and data collection, the Posyandu, uses monthly growth monitoring and promotion throughout the country to measure trends in child nutrition and provide nutrition behavior change communication to caregivers. There are more than 260,000 Posyandu in Indonesia, with more than 1.3 million CHWs. This program provides a huge potential to contribute to improving the health and nutrition of women and child.
The Kenyan national health information platform was conceived in 2009 by World Vision and Safaricom, and other organizations were incorporated later to form the current consortium. Jamii Smart design and implementation started in 2012. Jamii Smart’s long-term goal is to enable mHealth initiatives for maternal, newborn, and child health to achieve national scale in Kenya.
This Gates Foundation-funded pilot project uses innovative mobile phone technology to improve the quality of life-saving maternal and postpartum health services by community health volunteers in remote, underdeveloped central Mozambique.
NICe Project (Niger Integrated Child Health Services), in collaboration with the Niger Ministry of Health, is rolling out an integrated Community Case Management (iCCM) program among rural community health workers in Niger, West Africa.
This Irish Aid and DFID funded pilot project is an innovative project that aims to deliver behaviour change communication at the household through Community Health Workers for health promotion, illness prevention and increased access to health facilities. It will also evaluate the potential impact of a mobile ttC solution on MNCH outocmes through the improvement in data collection, monitoring and reporting, strengthened health information systems and human resources for health management.
World Vision Lanka has developed a mobile phone based application using the MOTECH suite platform to support the improvement of health and nutrition status of children and to enhance the maternal and child health and nutrition monitoring services provided by the government. This pilot project has introduced mobile technology to track and monitor the health and nutrition status of children in the first phase, and in the second phase will include pregnant women.
WV is collaborating with D-tree International and the University of Toronto to deploy and evaluate a mobile phone based application for community health workers (CHWs) in Singida Rural, Iramba, and Kilindi districts. The application is based on Tanzania’s community Maternal, Newborn, and Child Health (MNCH) program for CHWs and helps them to provided targeted information to pregnant women and caregivers of young children.
WVU currently has three major MNCH projects: East African MNCH- Kitgum district Northern Uganda, Radio Distance Learning Program for VHTS –Kiboga district Central Uganda, and AIM project – Eastern (Busia District) and south Western Uganda (Kabale district). Most of the projects are in their second year of implementation, excluding EAMNCH which is in its third year. These projects’ main objective is to improve MNCH through improved delivery of health services by strengthening health systems at all levels, community to national, in Uganda.
World Vision’s mHealth programming in Zambia leverages funds from the USAID-funded STEPS OVC project, WVUS private funds and AusAID funds to deploy an mHealth solution that enhances the work of caregivers with vulnerable populations in Zambia. The programme’s goal is that families and children attain improved protection from infection and disease, particularly HIV and AIDS, and malaria; and requisite access to essential prevention and treatment health services through more efficient, effective and higher-quality case management in Chongwe, Monze and Sinazongwe via a mobile health solution.
As of October 2011, World Vision has partnered with ESRI to scale-up the use of GIS across our programmes globally. ESRI is the global leader in GIS software development through their ArcGIS platform. This platform integrates their desktop software, clod based portal, serves and mobile technology. World Vision Canada provided leadership in 2010 by signing the Enterprise License Agreement (ELA) with ESRI, the leading provider of GIS software and services in the world.