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Round 1 (2011)


Mobilizing Innovation for Global Health

Round 1 (2011)

The following 2011 catalytic grant winners were announced in December at the 2011 mHealth Summit in the Washington, D.C. area. 


Cell-Life – Supporting Mothers for Stronger Babies (South Africa)

In South Africa, Cell-Life developed an SMS-based service that provides pregnant and new mothers with health information to reduce under-5 mortality rates and maternal mortality. Topics covered include postpartum clinic attendance, the importance of HIV testing and availability of free prevention of mother to child transmission (PMTCT) services, and other healthy behaviors like breastfeeding. Over the two-year grant period, Cell-Life reached 20,072 unique users with this life-saving content. Due to national policies, Cell-Life was only able to train health workers in one district to sign up users for their service. To reach a larger segment of their target audience, Cell-Life bought advertising space at the bottom of Please Call Me messages (a common tactic used by other products and services). This was found to be more cost-effective and allowed Cell-Life to reach potential users directly and scale their service without relying on the public health system for user sign-ups. At the end of the grant, the SMS service was folded into the larger Mobile Alliance for Maternal Action (MAMA) project in South Africa.

Lead contact:  Tash Sundar, Cell-Life
URL: http://www.cell-life.org/ 
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CHAI - SMART (Nigeria)

The Clinton Health Access Initiative (CHAI), the Federal Ministry of Health (FMOH) of Nigeria, and Hewlett Packard have partnered on the SMS Printers to Accelerate Return of Test Results for Early Infant Diagnosis of HIV/AIDS program (SMART), which seeks to reduce the turnaround time (TAT) for infant HIV test results using SMS printers. The SMART program was implemented to keep pace with the rapid expansion of early infant diagnosis in Nigeria, which has grown from 745 tests in 2007 to over 70,000 tests in 2013. Evaluation of the program has shown that the SMS printer reduced overall TAT by approximately 21 days when compared with the traditional paper method. CHAI and partners have successfully equipped 200 health facilities and 8 PCR labs across all 6 geo-political zones in Nigeria with SMS printer technology. Furthermore, 767 healthcare workers and 49 laboratory personnel were trained on the operation of SMS printers and SMS sending software. The SMART program will continue to scale-up nationally through the FMOH and implementing partners.

Lead contact: Rosemary Archibong, CHAI Nigeria
URL: http://www.clintonhealthaccess.org/
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D-Tree International – Mobile Technology to Support the Diagnosis and Treatment of Malnutrition (Zanzibar)

D-Tree manages a decision-support tool based on national guidelines that helps CHWs diagnose and treat severe acute malnutrition (SAM) amongst children under five in Zanzibar. The project is currently in 12 sites in 3 districts in Zanzibar. CHWs used D-Tree’s application to improve quality of care for approximately 400 children. An external evaluation carried out by UNICEF found a 20%-40% increase in accuracy of diagnosis and comprehensiveness of treatment, as well as a 34% increase in client satisfaction with the care provided. During 2013, D-Tree expanded their relationship with the Ministry of Health (MoH) to include not only the nutrition unit but the Integrated Management of Childhood Illness (IMCI) program. This decision was based on the need to integrate the nutrition program horizontally into general child health in order to achieve scale. To support these efforts, D-Tree developed an application that links national IMCI guidelines with malnutrition, with the idea that this kind of application would be used more regularly by CHWs and thus better integrated into flow of care. Key staff from within the MoH and the IMCI coordinator have been engaged in the development of the application, recognizing it as a potential tool to promote adherence to IMCI guidelines for children under 5, which at the moment is quite low. The application is in the final round of development before field testing and a pilot are conducted in March 2014.

Lead contact: Marc Mitchell, D-Tree

URL: http://www.d-tree.org/
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Dimagi - CommCare (India)

Dimagi is working with key partners in India to scale-up applications that help frontline health workers (FHWs) deliver improved quality of care. The three key partners collaborating with Dimagi are the Real Medicine Foundation (RMF), World Vision (WV), and Catholic Relief Services (CRS). The CRS application focuses on birth preparedness and safe delivery, which is meant to empower FHWs who often struggle to provide timely, comprehensive counseling to women throughout the pregnancy and postpartum periods. CommCare allows FHWs to track and support every pregnant woman and their newborns, while providing key oversight and supportive supervision to project managers to address performance and care-related issues. The WV tool, while similarly monitoring the health of expecting and new mothers, also monitors early childhood health from ages 0-2, directly contributing to MDG 4, reducing both infant and under-five mortality. The RMF tool, like the other two, addresses a number of issues related to maternal and child mortality through a comprehensive antenatal care regime and a complimentary set of counseling messages for new mothers and their children. In addition, this tool tackles MDG 5’s focus on the unmet need for family planning by providing specific counseling and messaging around this difficult subject. Across the three projects, Dimagi is working with 374 health workers that reach an estimated 12,598 women and 23,804 children. While catalytic funding for these projects has come to a close, each of them are continuing to scale, adding new sites, adding additional FHWs, and piloting new features. In addition, Dimagi has been able to leverage IWG catalytic mHealth grant funding to further expand their evidence base as well as their core functionality, benefitting the entirety of their existing partners across the world.


Lead contact: Neal Lesh, Dimagi 
URL: http://www.dimagi.com/
URL: http://www.commcarehq.org/
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Grameen Foundation- MOTECH (Ghana, Nigeria)

In Ghana, Grameen Foundation runs Mobile Midwife, through which pregnant women and their families receive voice messages that provide actionable information about their pregnancy each week of gestation, including alerts and antenatal care reminders. In search of a sustainable way to provide this service at scale to poor, rural women, Grameen developed a fee-based version of Mobile Midwife that targets urban, middle-income women. The revenue from the fee-based service is then split equally between Grameen and MTN. Grameen’s portion of the revenue is used to pay for air time and to subsidize the free version of the service to poorer women. Grameen launched this service with MTN in December 2013. MTN advertised the service via SMS to approximately one million women, and since then the service has signed up over 1,400 people. Grameen will continue to monitor the service in partnership with MTN after the grant and will explore additional sustainability plans.

Grameen Foundation also plans to expand their fee-based Mobile Midwife service in Nigeria. This opportunity to test user fees as part of the Mobile Midwife sustainability plan will contribute to global learning on what is possible for scaling and resourcing mobile messaging for maternal and child health in the African context. It could generate significant revenues that could be used by Grameen to cross-subsidize Mobile Midwife in Ghana and other countries. Grameen estimates that the service can reach just over one million subscribers after one year of operation.

Lead contact: Karen Romano, Grameen Foundation Ghana
URL: http://www.grameenfoundation.org/
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IRD –Interactive Alerts for Vaccine Coverage (Pakistan)

IRD’s electronic vaccine registry system, Interactive Alerts, utilizes SMS reminders to mothers and caregivers of children, radio-frequency identification tag stickers for immunization cards, and an innovative lottery system of conditional cash transfers to vaccinators, mothers and caregivers in Pakistan. The program focuses on retaining 18,547 children as they progress through infancy and ensuring timely immunization completion through the use of the SMS reminders and conditional-cash transfers. These efforts have improved the uptake, timeliness and completion of vaccinations in 12 high-volume government and private Expanded Program on Immunization (EPI) centers in Pakistan. IRD will continue to integrate Interactive Alerts into existing immunization systems through public-private partnerships with government and private clinics. To further scale-up, IRD is exploring the option of merging the Interactive Alerts program with a social enterprise that provides diagnostic testing and treatment for lung health diseases. This would increase access to vaccinations and strengthen routine immunizations, which are more cost-effective than mass immunization campaigns or door to door activities. 


Lead contact: Asad Zaidi, IRD Pakistan Country Office 
URL: http://irdresearch.org/
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MoH Rwanda - RapidSMS and mUbuzima (Rwanda)

In Rwanda, the Ministry of Health (MoH) has introduced RapidSMS and mUbuzima to support and monitor activities of Community Health Workers (CHWs) as a means of strengthening health worker contributions to community health systems. RapidSMS is intended to save newborns and mothers through routine surveillance of health events by CHWs. mUbuzima allows CHWs to report data into a national database where health officers at district and national levels can access it and make decisions to improve community health. To ensure health workers at every level are able to utilize these innovative solutions to their full potential, the MoH organized training of trainers sessions for 976 CHW supervisors and data managers who in turn trained the 45,000 CHWs they manage. After training, the MoH has found that 80% of CHWs are effectively utilizing the mHealth applications for reporting. The MoH has laid out a national policy that “No Woman and Newborn will die of Preventable causes” by December 2014 and is committed to using these applications to accelerate progress towards that goal.


Lead contact: Erick Gaju, Ministry of Health Rwanda 
URL: http://moh.gov.rw/english/
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Novartis - SMS for Life (Ghana, Cameroon, and Tanzania) 

In Ghana, Novartis Foundation uses SMS for Life to track blood supplies to reduce maternal mortality due to hemorrhage during childbirth. The eBloodBank project makes sure correct blood supplies can be quickly located in emergency situations. At scale, the blood tracking solution has the potential to benefit 776,000 childbirths per year. Following the first year of operation in the region where this was first rolled out, not a single instance was reported where blood supplies could not be found. Based on the improved functionality and the positive outcomes, the Ghana Health Service has decided to expand the service to all 150 hospitals across the country, which should be achieved by end of the first quarter of 2014. 

In Tanzania and Cameroon, Novartis Foundation aims to directly provide weekly visibility of malaria medicine stocks at all public health facilities to help ensure every malaria patient has access to a cure. SMS for Life is operating at scale in Tanzania (5,100 health facilities) and added new features to the SMS for Life application in order to enhance data quality and some processes and completeness. The new add-ons support the National Malaria Control Program in their daily monitoring and reporting activities. In Cameroon, SMS for Life is in the process of national level deployment across the public health system (3,800 health facilities) and will complete roll out in 2014.


Lead contact: Jim Barrington, SMS for Life
URL: http://smsforlife.com
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