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© 2010 frog design. Confidential and Proprietary.
© 2010 frog design. Confidential and Proprietary.
© 2010 frog design. Confidential and Proprietary.
Programs Using Mobile Phones to
Eliminate Pediatric HIV in Africa                                                 1    RapidSMS             2    MAMA                           3        R.H.E.A.                      4    Young
                                                                                       Rwanda                    MAMA - South Africa,                    Jembi Health - Rwanda
                                                                                                                                                                                            Africa Live
                                                                                       UNICEF - Rwanda           India, Bangladesh                                                          Praekelt Foundation -
                                                                                                                                                                                            South Africa




                                                                                  5    Project Mwana        6    Mother Baby                    7        HIV-Link                      8    Mxit
                                                                                                                 Pair Tracking
                                                                                       UNICEF - Zambia,                                                  Medic Mobile - Ethiopia            Mxit - South Africa
                                                                                                                 mothers2mothers -
                                                                                       Malawi
                                                                                                                 South Africa




                                                                                                                 Health
                                                                                  9    M-Trac               10   Connected
                                                                                                                                                11       Ghana                         12   Closed User
                                                                                                                                                         Telemedicine                       Group
                                                                                       UNICEF - Uganda           Study
                                                                                                                                                         Earth Institute, Novartis -        Millenium Villages - 10
                                                                                                                 EGPAF / WHO - Kenya                     Ghana                              Countries
                                                                         7
  16    11   19   16

                                                                                  13   The Pamoja           14   LUCAS                          15       Wired Mothers                 16   Switchboard
                                                      9   20                           Project                                                           ERNECA Ministry of
                                                                                                                 UCLA                                                                       Switchboard - Liberia,
                                                                        10   13        EGPAF - Kenya                                                     Health and Social                  Ghana, Tanzania
                                                                                                                                                         Welfare - Zanzibar
                                                  1   3   24

                                                                             15   17   EpiSurveyor for      18   Philani Mentor                 19       mPedigree                     20   uReport
                                                                   16   21
                                                                                       PBF verification          Mothers Project
                                                                                                                                                         mPedigree - Ghana                  UNICEF, Uganda
                                                                                       EPGAF - Mozambique        UCLA - South Africa



                                                               5
                                                  5
                                                                                  21   Improving EID        22   Good Start III                 23       MoTECH                        24   CommCare
                                                                                       TAT
                                                           17                          EGPAF - Tanzania
                                                                                                                 South African Medical                   ANC, Grameen                       Dimagi, 15+ Countries
                                                                                                                 Research Council -                      Foundation                         including India, Rwanda
                                                                                                                 South Africa



                                                                                       HIV mobile
                                                                                  25                        26   Mobenzi
                                                                                       appointment
                                                                                                                 Outreach
                                                                                       reminders
                       2   4   6   8   18   22   26                                                              MRC, UCLA, HSRC, Stellenbosch
                                                                                       InSTEDD - Cambodia
                                                                                                                 University, University of Washington,
                                                                                                                 SA Department of Health - South
                                                                                                                 Africa
© 2010 frog design. Confidential and Proprietary.
Defining Event




                                         Mother & Child
                                         shared journey




Lenshina, Mother, KENYA
                                      Actors &
                                  Touchpoints cards
Lenshina feels sick and goes to
the clinic. There she finds out
to be pregnant and HIV
Positive.
MHEALTH FRAMEWORK Mapping Mobile Opportunities
                   MONTHS   -9                               -6                                 0                                                       12



                                                                                                LABOR                                   POSTPARTUM/
                                                                                                                                                                   Mobile Opportunities
    MOTHER                                          PREGNANCY
                                                                                                & BIRTH                                BREASTFEEDING


                                      1ST TRIMESTER
                                                                  2ND AND 3 RD
                                                                                                 BIRTH                             INFANCY
                                                                                                                                                                   Mobile phones and technology can
                                                                                                                                                                    CHILDHOOD
    CHILD                                                         TRIMESTER

                                                                                                                                                                   address 4 key challenges faced by
    WHO & UNICEF                     PMTCT INTERVENTION TIMELINE
    GUIDELINES
                                                                                                                                                                   expectant and new mothers, their
                                 1. HIV testing
                                         2. CD4 testing
                                                3. Results
                                                                                                       Early infant care
                                                                                                        diagnosis (EID)                                            children, and the health care workers
                                                                                                                                                             Early infant care
                                                                                                                                                              diagnosis (EID)
                                                                                                            WEEK 6                                              MONTH 18

                                 ARVs to mother
                                                                                              ARVs to baby
                                                                                                                                                                   who care for them.
                                                                                                                           Ongoing care to mother

                                                                                                                           Ongoing care to HIV-exposed Infant



                                                                                                                                                                    Demand,                                   Tracking &
 HEALTH TOUCHPOINTS                  SAMPLE IMPLEMENTATION
                                                                                                                                                                    Awareness                                 Retention
                                                                                                                                                                    & Education                               of Mothers & Babies
                                                                                                                  6/ 6/ 6 visit        6/ 6/ 6 visit            Mother asked        6/ 6/ 6 visit
                                                                                                                   reminder             reminder                to visit clinic      reminder
    CHW                                                                          CHW registers birth
                                                                                                                                                                      • Stigma/fear & isolation                • Delayed test results to mother
    RURAL CLINIC                                                                       DBS sample registered                           SMS results received           • Adherence to drug results at clinic
                                                                                                                                                                             Mother receives regimens          • HIV testing and re-testing of child
                                                                                                                                                                      • Knowledge re: self-care and care       • Linkages to on-going treatment for
    DISTRICT                                                                                                        Sample shipped and t racked                         for her baby                             mother and pediatric treatment


    COUNTRY
                                                                                                                                            Results registered at national lab




    EVIDENCE
                                                                                                                                                                    Coordination,
                                                                                                                                             EID test result turn-around
                                                                                                                                            time improved by over 50%.
                                                                                                                                                                                                               Supply Chain
                                                                                                                                                                    Supervision &                              Management
                                                                                                                                                                    Quality of Care
    MOBILE                           CHALLENGES RELEVANT TO PMTCT INITIATIVES                                                                                                                                 • Stockouts of test kits, medications,
    OPPORTUNITIES                                                                                                                                                       • Training of CHWs
                                                                                                                                                                                                                and other commodities
                                                                                                                                                                        • Communication between CHW
                                                                                                                                                                                                              • Transporting blood samples to lab
                                                                                                                                                                          and nurses
                                     Demand, Awareness and Education                                                                                                                                          • Transporting results back to clinic
                                                                                                                                                                        • Updates to new protocols
                                                                                                                                                                        • Delays at clinics.
                                     Tracking & Retention of Mother Baby Pairs

                                     Coordination, Supervision and Quality of Care


                                     Supply Chain Management
Joanne Stevens
                                 MAMA South Africa




                                                                                         SOUTH AFRICA




MAMA
South Africa
MAMA South Africa provides vital health information via mobile phones
to expectant and new mothers and their families, supporting them week-
by-week during pregnancy and the first year of baby’s life. Most South
African moms-to-be learn that they are HIV positive for the first time
during pregnancy, and lack social support to help them cope with the
diagnosis of a life threatening disease while adjusting to the demands of
pregnancy and a new baby.

Metrics/Evidence            Key Technologies           Audience                    Challenges


MAMA will target 500,000    Mobile                     Low-income and at-risk      Maternal deaths have
women and household         Website/Portal (askmama.   expectant and new           increased 40% since 1998
decision-makers over two    mobi), staged SMS          mothers, as well as their   due to HIV/AIDS. Mothers
years. 100 registered for   messages, interactive      household decision          need caring, accurate,
SMS services in first two   quizzes via USSD           makers.                     straightforward information
weeks.                                                                             that is timely and discreet.
Erica Kochi
                                   UNICEF Innovation Team




                                                                                       ZAMBIA &
                                                                                        MALAWI



Project Mwana
The Mwana Initiative has improved test result turn-around time by over
50%. It delivers early infant diagnosis (HIV) results to rural and under-
served communities in Zambia and Malawi via text messages rather than
paper. Community Health Workers also register births and trace patients
via SMS to ensure that they receive key childhood interventions.




Metrics/Evidence              Key Technologies              Audience           Challenges


EID test result turn-around   Basic Mobile Phones,          Community Health   Logistical challenges in
time improved by              RapidSMS                      Workers            remote communities
over 50%.                                                                      delay EID results and
                                                                               subsequent interventions.
Design Principles




    PUT THE USERS FIRST           GO BEYOND MOBILE            THINK SYSTEM-WISE             MASH-UP COMPETENCES




“   Having data and
    not knowing what to
    do with it is as bad
                              “   Mobile has to be part
                                  of a multi-pronged
                                  approach, that will
                                                          “   We need to look at the
                                                              problems both at the
                                                              national scale and at
                                                                                        “   We need to bring
                                                                                            designers, health
                                                                                            technical leads and
    as not having any             work with and within        the level of the single       mobile technologist
    data.                         other systems.              mother. Then solve            together more often
                                                              them in a way that



                          ”                           ”                            ”                              ”
                                                              works for both.

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SGS Pediatric AIDS Panel

  • 1. © 2010 frog design. Confidential and Proprietary.
  • 2. © 2010 frog design. Confidential and Proprietary.
  • 3. © 2010 frog design. Confidential and Proprietary.
  • 4. Programs Using Mobile Phones to Eliminate Pediatric HIV in Africa 1 RapidSMS 2 MAMA 3 R.H.E.A. 4 Young Rwanda MAMA - South Africa, Jembi Health - Rwanda Africa Live UNICEF - Rwanda India, Bangladesh Praekelt Foundation - South Africa 5 Project Mwana 6 Mother Baby 7 HIV-Link 8 Mxit Pair Tracking UNICEF - Zambia, Medic Mobile - Ethiopia Mxit - South Africa mothers2mothers - Malawi South Africa Health 9 M-Trac 10 Connected 11 Ghana 12 Closed User Telemedicine Group UNICEF - Uganda Study Earth Institute, Novartis - Millenium Villages - 10 EGPAF / WHO - Kenya Ghana Countries 7 16 11 19 16 13 The Pamoja 14 LUCAS 15 Wired Mothers 16 Switchboard 9 20 Project ERNECA Ministry of UCLA Switchboard - Liberia, 10 13 EGPAF - Kenya Health and Social Ghana, Tanzania Welfare - Zanzibar 1 3 24 15 17 EpiSurveyor for 18 Philani Mentor 19 mPedigree 20 uReport 16 21 PBF verification Mothers Project mPedigree - Ghana UNICEF, Uganda EPGAF - Mozambique UCLA - South Africa 5 5 21 Improving EID 22 Good Start III 23 MoTECH 24 CommCare TAT 17 EGPAF - Tanzania South African Medical ANC, Grameen Dimagi, 15+ Countries Research Council - Foundation including India, Rwanda South Africa HIV mobile 25 26 Mobenzi appointment Outreach reminders 2 4 6 8 18 22 26 MRC, UCLA, HSRC, Stellenbosch InSTEDD - Cambodia University, University of Washington, SA Department of Health - South Africa
  • 5. © 2010 frog design. Confidential and Proprietary.
  • 6. Defining Event Mother & Child shared journey Lenshina, Mother, KENYA Actors & Touchpoints cards Lenshina feels sick and goes to the clinic. There she finds out to be pregnant and HIV Positive.
  • 7. MHEALTH FRAMEWORK Mapping Mobile Opportunities MONTHS -9 -6 0 12 LABOR POSTPARTUM/ Mobile Opportunities MOTHER PREGNANCY & BIRTH BREASTFEEDING 1ST TRIMESTER 2ND AND 3 RD BIRTH INFANCY Mobile phones and technology can CHILDHOOD CHILD TRIMESTER address 4 key challenges faced by WHO & UNICEF PMTCT INTERVENTION TIMELINE GUIDELINES expectant and new mothers, their 1. HIV testing 2. CD4 testing 3. Results Early infant care diagnosis (EID) children, and the health care workers Early infant care diagnosis (EID) WEEK 6 MONTH 18 ARVs to mother ARVs to baby who care for them. Ongoing care to mother Ongoing care to HIV-exposed Infant Demand, Tracking & HEALTH TOUCHPOINTS SAMPLE IMPLEMENTATION Awareness Retention & Education of Mothers & Babies 6/ 6/ 6 visit 6/ 6/ 6 visit Mother asked 6/ 6/ 6 visit reminder reminder to visit clinic reminder CHW CHW registers birth • Stigma/fear & isolation • Delayed test results to mother RURAL CLINIC DBS sample registered SMS results received • Adherence to drug results at clinic Mother receives regimens • HIV testing and re-testing of child • Knowledge re: self-care and care • Linkages to on-going treatment for DISTRICT Sample shipped and t racked for her baby mother and pediatric treatment COUNTRY Results registered at national lab EVIDENCE Coordination, EID test result turn-around time improved by over 50%. Supply Chain Supervision & Management Quality of Care MOBILE CHALLENGES RELEVANT TO PMTCT INITIATIVES • Stockouts of test kits, medications, OPPORTUNITIES • Training of CHWs and other commodities • Communication between CHW • Transporting blood samples to lab and nurses Demand, Awareness and Education • Transporting results back to clinic • Updates to new protocols • Delays at clinics. Tracking & Retention of Mother Baby Pairs Coordination, Supervision and Quality of Care Supply Chain Management
  • 8. Joanne Stevens MAMA South Africa SOUTH AFRICA MAMA South Africa MAMA South Africa provides vital health information via mobile phones to expectant and new mothers and their families, supporting them week- by-week during pregnancy and the first year of baby’s life. Most South African moms-to-be learn that they are HIV positive for the first time during pregnancy, and lack social support to help them cope with the diagnosis of a life threatening disease while adjusting to the demands of pregnancy and a new baby. Metrics/Evidence Key Technologies Audience Challenges MAMA will target 500,000 Mobile Low-income and at-risk Maternal deaths have women and household Website/Portal (askmama. expectant and new increased 40% since 1998 decision-makers over two mobi), staged SMS mothers, as well as their due to HIV/AIDS. Mothers years. 100 registered for messages, interactive household decision need caring, accurate, SMS services in first two quizzes via USSD makers. straightforward information weeks. that is timely and discreet.
  • 9. Erica Kochi UNICEF Innovation Team ZAMBIA & MALAWI Project Mwana The Mwana Initiative has improved test result turn-around time by over 50%. It delivers early infant diagnosis (HIV) results to rural and under- served communities in Zambia and Malawi via text messages rather than paper. Community Health Workers also register births and trace patients via SMS to ensure that they receive key childhood interventions. Metrics/Evidence Key Technologies Audience Challenges EID test result turn-around Basic Mobile Phones, Community Health Logistical challenges in time improved by RapidSMS Workers remote communities over 50%. delay EID results and subsequent interventions.
  • 10. Design Principles PUT THE USERS FIRST GO BEYOND MOBILE THINK SYSTEM-WISE MASH-UP COMPETENCES “ Having data and not knowing what to do with it is as bad “ Mobile has to be part of a multi-pronged approach, that will “ We need to look at the problems both at the national scale and at “ We need to bring designers, health technical leads and as not having any work with and within the level of the single mobile technologist data. other systems. mother. Then solve together more often them in a way that ” ” ” ” works for both.