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 fundraising and program implementation offices has increased greatly. From a modest start with three funded mobile health projects, World Vision's mHealth portfolio now reaches 16 countries in Africa, South & Southeast Asia.
In various countries, grants are being strategically timed and geographically positioned to leverage rather than duplicate effort. Donors across this growing global portfolio include USAID, DFID, IrishAid, AusAid, CIDA, WHO, African Development Bank, Bill and Melinda Gates Foundation, and various private funders. To best support this work, World Vision has intentionally and strategically aligned mobile for health at a global level across a wide range of World Vision fundraising and implementation offices, based on an agreed Vision Statement and Principles for its mHealth work.
MHEALTH VISION STATEMENT
Empower the most vulnerable households and community health workers/volunteers through the use of common, shared, multi-functional and collaboratively designed mobile health solutions to deliver community –based health interventions.
mHealth Policy Brief (June 2014)
For the hundreds of millions who remain invisible to and unreached by health services, mHealth solutions provide a platform to improve health information, services and systems to count and reach the most vulnerable with high-quality, equitable, affordable and accessible healthcare. Find out how World Vision is Harnessing mHealth to reach every woman, every child.
This brief further explores the narrative from More Than Numbers, highlighting how World Vision is and all mHealth implementers should leverage this cross-cutting solution to reach the unreached.
PRINCIPLES FOR OUR WORK
- Coherence and quality of approach and program/project management
- ALWAYS in partnership with others and building on global learning
- Designed to meet the needs to community users but also provide the basis for maturing the evidence base
- Initially affordable yet based on sustainable costing models and scalable technology
- Considers data governance issues
- Uses and strengthens government partners’ information systems
- Favors open-source solutions and emerging global standards
World Vision is cultivating new and leveraging existing collaborations with Ministries of Health, donors, solution providers and mobile network operators. Notably, World Vision has been collaborating with the Bill and Melinda Gates Foundation, Grameen Foundation, and Dimagi in a public-private partnership arrangement to deploy a global, scalable mobile health solution (Motech Suite) to support various health and nutrition programming approaches. This allows World Vision’s mHealth projects to use 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 codes, best practices, learning, and other assets to avoid duplication; and ultimately, contributing to improved maternal and child health . This model has already streamlined effort and overall costs at the global level, as well as for each project. In some cases where Ministries of Health have already made significant investments in alternative solutions (for example RapidSMS in Rwanda and JAMII Smart in Kenya), World Vision supports that direction with their funded projects.
Initial Project Results
Dimagi’s CommCare solution, a key component of the MoTECH Suite, was first piloted in World Vision’s USAID-funded Child Survival Health program in Afghanistan (2008-2013), and the evaluation results comparing intervention and comparison groups were encouraging:
- Increase of 20 percentage points in antenatal care visits (P-value = 0.0038),
- Increase of 12.6 percentage points in both families with a birth plan and families with improved coordination with the health facility (P-value = 0.04 and P-value = 0.004 respectively),
- Increase of 12.9 percentage points in knowledge of two or more pregnancy danger signs (P-value = 0.05).
Evaluation of World Vision’s Mozambique mHealth project (Gates-funded Grand Challenges 2010-2012 again using the CommCare solution) suggested that pregnant women in the project’s intervention area more frequently accessed antenatal care, were better prepared for birth, and gave birth more often with the assistance of a skilled provider. They also appeared to be more familiar with signs of pregnancy complications and to seek care at a facility following danger sign recognition.
These evaluations have informed an mHealth Theory of Change that provides a flexible yet systematic framework for measuring program results over time.
An Emerging Social Enterprise
World Vision and its MoTECH Suite collaborators have endeavored to create governance, operating and business models based on a social enterprise approach, which comprises a consortium of technology providers, donors and NGOs, together with negotiated agreements with Ministries of Health and mobile network operators. A social enterprise is an organization or consortium that applies a business strategy to maximize improvements in human and socio-economic well-being through a low-profit offering that is affordable even in challenging economic contexts, rather than maximizing profits for external shareholders.
This model aligns well with the objective of developing a sustainable business model which allows for an open source product to be provided to partners and collaborators at a lower cost, yet is configured for use by governments, general population, NGOs and other stakeholders.
As negotiations with mobile network operators and other potential private sector partners develop, this model is expected to evolve toward an increasingly financially sustainable approach. Additionally, analysis of this business model is under way, with an eye to maximize economies of scale and sustainability.
World Vision's Global mHealth Portfolio
World Vision is currently implementing mHealth projects in Afghanistan, Zambia, Sierra Leone, Uganda, Tanzania, India, Sri Lanka, Indonesia, Kenya (JAMII Smart), and Rwanda (RapidSMS) and is moving forward in 2014 with additional implementations in Afghanistan, Cambodia, Mozambique, Uganda, Zambia, Niger, and Ghana. For more information on each country project including local contact information, please click on the country names in the following section.
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. Read more...
World Vision India started integrating mHealth into its programming in August 2011 in the Melghat Area Development Program (ADP) through a maternal, newborn and child health monitoring system. WV India is solidifying its mHealth experience and outcomes in order to scale up the solution nationally. Read more...
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. Read more...
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. Read more...
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. Read more...
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. Read more...
The goal of the project is to enhance the attainment of strategic health targets in Gicumbi district, Northern province by implementing Rapid SMS as a key health programming tool. It is in this framework that mHealth has conducted a Rapid SMS assessment to identify community needs in 14 health centers operating in Gicumbi. Read more...
WV Sierra Leone has deployed the MOTECH Suite application across three of its area development programs (ADPs) in Bonthe District. As part of a maternal and child health program supported by WV Ireland and WV UK, the application allows community health workers to register pregnant women and children under two years of age, collect health information during their timed and targeted visits to the household, and refer high-risk and emergency cases to the nearest health center for treatment. Read more...
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. Read more...
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. Read more...
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. Read more...
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. Read more...
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. Read more...