Slide 1

MOTECH Ghana& MOTECH PlatformLessons Learned, Current Work & Future Plans

1Grameen FoundationMission: To alleviate poverty for the poorest of the poorIncreasingly, this means alleviating information povertyGF Technology Center in Seattle is focused on health and agriculture domainsMix of enabling technology and on the ground interventionsMOTECH GhanaPartnership with Ghana Health Services, Gates Foundation, and Columbia UniversityOriginal goal: Use technology to improve health outcomesNarrowing the FocusGovernmentGhana Health Services GoalsClientsPregnancy Question BoxPregnancy DiariesFocus GroupsNursesFocus GroupsGhana Health ServiceFocus on Maternal & Child HealthAntenatal visitsVaccinationsAttended DeliveryImprove ReportingTarget Upper East Region

Upper East RegionPopulation: 1MInfant Mortality Rate: 97/10007Client Research

Pregnancy Question Box

Focus GroupsNurse Research

12

13Reducing Information PovertyClientsActionable health adviceFacts to dispel myths & folkloreInformation to encourage family supportRecommend specific careNursesElectronic recordsPatient status alertsGovernmentAbility to flexibly analyze reliable data

Mobile Midwife ServiceMessaging service coordinated with a womans pregnancyCovers early pregnancy to babys first yearAimed at the mother and her extended communityDelivered via pre-recorded voice or text message up to three times per weekCustomized for the motherAvailable when she wants the informationEducational and actionable informationAudio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal language Intro promptTetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal language Intro promptTetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal language Intro promptTetanus reminderMissed tetanus vaccination

Audio Samples

Week 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal language Intro promptTetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal languageIntro prompt Tetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal languageIntro prompt Tetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal languageIntro promptTetanus reminderMissed tetanus vaccination

Audio SamplesWeek 5: Food for pregnancyWeek 24: 2nd checkup, SP for malariaWeek 34: Signs of laborLocal languageIntro promptTetanus reminderMissed tetanus vaccination

Nurse ApplicationRecords patient visits using mobile forms or SMSReminds nurse of upcoming and overdue patient needsGenerates monthly reportsQuery the system to get information about patients

Hey, this might be usefulBuild a Platform for mobile health applicationsOpen SourceFunded through implementations and platform-specific grantsHow is MOTECH Ghana Doing?Registrants: 13, 598Mobile Midwife enrollees: 7, 395 (3,950 active)

Health Facilities: 34Nurses: 110Encounter uploads: 75,000

How is MOTECH Ghana Doing?I liked the messages especially on the nutrition as I was able to share with my husband so he could hear it and now I am allowed to get these things such as beans, vegetables, small ground fish for the soup and sometimes meat

Now with MOTECH I dont feel alone during my pregnancy, it makes me feel that there are people that care for me and are concerned about me while I am pregnant.

MOTECH helps a lot with the preparation for birth and I felt like I had a good idea of what would happen and how to prepare practically and financially. I went to Paga Health facility and had a safe delivery.

How is MOTECH Ghana Doing?This is the age where we transmit data which is efficiently collected and accurate for managers to make informed decisions at district, regional and national levels. That is what MOTECH is all about

Dr Nyonator, PPME Director, GHSWhen patients receive those messages they come here [to the clinic] early and on time so when they come we look at the services they are due for and we render those services to them and because of that the defaulters that we used to have previously has been reduced.

CHPS NurseSome months ago I used to get two or three, but last month I had ten deliveries [at the facility] because the clients get the messages and they come. For postnatal they come. Even if they deliver at home they get the messages [from MOTECH] which make them come for postnatal. So I have benefited from MOTECH a lot.

GHS MidwifeWhat weve learned in GhanaTechnology IS disruptiveMobile penetration is high, access not so muchDesign for scaleVoice trumps text but higher cost mandates strong business modelIterate, Iterate, Iterate (e.g. getting voice and content right)Lessons learned document: (http://www.grameenfoundation.org/sites/default/files/MOTECH-Early-Lessons-Learned-March-2011-FINAL.pdf)Whats next for MOTECH GhanaTwo year plan to expand to three new districtsImmediate plan to explore long-term business modelsLaunching impact assessment programTransition to scaleGhana Health Service ownership of key servicesInfrastructure to support national deployment

Whats next for the PlatformPartneringMOTECHs strengthRules-based MessagingPill & Appointment RemindersMessage campaignsConnecting disparate health system componentsPlatform Components TodayMOTECH (Grameen)Patient DB IVR EngineRules EngineNurse DBIVR & SMS ContentAlert/Reminder Engine Connections to external systemsCommCare (Dimagi)Point of Care ToolsSupervisory ToolsData Entry FormsVideo Training Content

Nuntium & Verboise (InSTEDD)IVR and SMS Integration with Telcos

2012 Platform ImplementationsGhanaTreatment Advice for Mobile Alerts (TAMA)HIV/ART complianceBihar, IndiaCAREMobile messagingBBC World Service TrustWorld Health PartnersTB diagnosis and treament adherenceZambia / World VisionReferrals, Patient outreach

Questions?