MOBILE HEALTH:

WV’s 2014 Global Framework

Vision Statement

Empower the most vulnerable households

and community health workers/volunteers

through use of common, shared, multi-

functional and collaboratively designed

mobile health solutions to deliver

community-based health interventions.

Principles for our Work:

Coherence and quality of approach and

programe/project management

ALWAYS in partnership with others and

building on global learning

Designed to meet the needs of

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

National

LevelDistrict

Level

Community

Level

Framework for mHealth Governance,

Operating & Financial Models

Social Enterprise

Model

WV MOTECH Suite Solution:Social Enterprise Open Source Model

Private

& Public

Donors

Industry

Standards

Organizations

Governments &

Regulatory Bodies

Solution

Providers

Intl &

Local NGOs

Mobile

Operators

WV’s mHEALTH EXPERIENCE

WV mHealth Scope & Reach

CURRENT:

Live Projects in 14

Countries across Africa

& Asia

2,000 Community

Health Workers Using

mHealth

177,000 Community

Members Reached

2016 TARGETS:

CHW: 8,000

Community Members:

700,000

INTEGRATED PROGRAMME &

SOLUTION DELIVERY

MATERNAL & NEWBORN CHILD

HEALTH:

Timed & Targeted Counseling -

CHW-delivered behavior change

program

Community Case Management –

CHW-delivered treatment of acute

illnesses

NUTRITION:

Positive Deviance / Hearth

Growth Monitoring & Promotion

Community Management of

Acute Malnutrition

World Vision’s mHealth Portfolio

Motech Deployments Live in

11 Countries: Sierra Leone,

Uganda, Zambia, Tanzania, India,

Afghanistan, Indonesia, Sri Lanka,

Mozambique, Burundi, Niger

Motech Deployments i n

Planning for 4 Additional

Countries: Ghana, Chad,

Mali, Mauritania,

Supporting Govt

Deployments

In 3 Countries:

Kenya, Rwanda, Cambodia

WV mHealth Forms/Data

Toward Economies of Scale:Goal: Reduce ramp-up time, level of effort & overall costs

GLOBALLY DESIGNED

LOCALLY CONFIGURED & DEPLOYED

Theory of Change Global Specifications Solution Development

Local Configuration Training of Trainers/Users Deployment

Ensure client

expectations

were met

mHealth Theory of Change

Natl & Intl Goals to

which project

contributes

Improved linkages

between facility and

community services

for quality

improvement

Develop

Operating

Plan

Refine business

needs &

requirements

CHW/V

adherence to

behavior change

communications

protocols

CHW/V

adherence to

case

management

protocols*

Foundational

activities

Outputs &

immediate

outcomes

Outcomes to which

project primarily

contribute

Develop M&E

plan and

conduct

baseline

Consolidate

sustainability

plan and

relationships

w partners

Establish

programme

management

team

Training,

curriculum and

partner

development

Improved preventive

health behavior among

pregnant women and

caregivers at the

household level

Access to health

information and

complementary

social services

Build and

sustain user

capacity &

ownership

Communicate

project- roadmap,

benefits, project

management

More timely and effective

use of health services on

the part of pregnant

women and caregivers

Deployment

activities

Develop

solution based

on user needs

Activity

tracking, as

part of M&E

Appropriate

and timely use

of program

monitoring

information

Design

budget &

sustainable

financial

model

Undertake

user

acceptance

testing

Train users

on all

aspects of

solution

• Lower maternal and child U5 mortality rates

• Lowered child U5 morbidity

• Improved maternal and child U5 nutritional status

Millenium

Development

Goals

mHealth Theory of Change

CHW/V

motivation

&

retention

More sustainable,

effective and efficient

CHW/V workforce

Referral

closure rates

between

CHW/V and

facilities

* i.e. ttC visit schedule or CCM clinical case management protocols

ICT System

performance

& scalability

EMPOWER, EQUIP, ADVOCATE

Afghanistan mPhone Project -

USAID-funded Child Survival Health program 2008-2013

• Significant improvement between intervention and control groups in antenatal

attendance (20 percent) and skilled delivery at a health facility (22.3 percent)

• Having a birth plan (12.6 percent) that included improved coordination with the health

facility (12.6 percent),

• Saved money and arranged transport, and knowledge of two or more pregnancy danger

signs (12.9 percent).

Mozambique mHealth Project -

Gates-funded Grand Challenges 2010-2012

• Use of mobile technology by CHWs was associated with high recognition of danger

signs during pregnancy (6%) and postpartum (14%), for an overall complication

identification rate among participants of 20% (global average is 15% according to WHO).

• Prevalence of birth preparedness (64%) in association to danger sign recognition, is

higher than in studies from Uganda (35%), Kenya (7%), two studies in Ethiopia (20%,

22%), and India (48%).

Initial WV mHealth Evaluation ResultsMotech Suite/CommCare Pilots

Current & Emerging

WV Collaborations/Partnerships

Implementers

Ministries of Health & National

Telcom RegulatorsTechnology

Providers

Funders MNOs

Community

Health Workers

Local NGOs

International

NGOs

Community-

Based

Organizations

UN Agencies

DELIVERING MHEALTH AT THE LAST MILE

Fragmentation (pilotitis)

Duplication of effort & reinventing the wheel

Partnering challenges

Capacity gaps

Unsustainable business models

Poor connectivity & coverage

Growing but still incipient evidence base

Reduce ramp up time, learning

curve, duplication of effort

Align & partner toward

common goals

Continuous capacity building

of all stakeholders

Negotiate partnering

agreements to work toward

collective impact

Build capacity to undertake

rigorous operations research

CHALLENGES SOLUTIONS

GUIDING PRINCIPLE: Focus first on needs of community and users