Featured image credit: Andy Miah Creative Commons License

Today we had the opportunity to chat with Steve Ollis of D-tree International, who will be a guest expert for our Mobile Phones for Public Health course. Below, he discusses his experience working in the mHealth field!

Can you tell us about your background and experience in mHealth?

I came into mHealth and global health in a somewhat non-traditional way. I actually started off as an accountant and management consultant with BearingPoint, working with various US government military branches on their accounting systems. I moved into IT consulting with a focus on program management for the next six years, working at progressively smaller companies, bringing web applications to state and federal agencies and addressing issues like help desk, user training and support, and change management needed to introduce and sustain new applications in large organizations.

My career in mHealth and global health started with a few short volunteers stints in Kenya and South Africa followed by a position with the Clinton HIV/AIDS Initiative (now Clinton Health Access Initiative) for two years in Tanzania, working in pediatric HIV, commodities, lab systems and Prevention of Mother to Child (PMTCT) programs.

With this exposure to the global health world and my background in information technology, I was intrigued by the possibility of working in the mHealth space and joined D-tree International in Tanzania six years ago. I have been fortunate to work on cutting edge mobile decision support tools focusing on design, development, deployment and support. I have seen projects grow from 1-2 facility to over a hundred facilities, and 5-10 community health workers to thousands of health workers. Over the years I have also seen a dramatic price drop for Android phones from $650 t0 $80. I have worked in Tanzania, Benin, Malawi, Kenya, Sri Lanka and India as part of small and large teams, and have worked at both the community health worker and Ministry of Health levels.

How is mHealth incorporated to your work currently?

D-tree International is a health NGO that uses mobile technology to improve the care provided by frontline health workers. We are working at the government, donor, implementing partner and ground levels to develop applications and systems that support decision makers at all levels, from the community health worker and nurse level to health systems supervisors. We focus on providing mobile decision support tools to health workers, and creating health systems to provide them adequate support. We use mobile technology to improve health outcomes by developing supervisory applications, dashboards, mobile money integration for transport, vital events tracking, and point of care diagnostics.

Why do you think mHealth is important / what impact can learning about the use of mobile phones for public health have on development projects?

It is amazing to think about how we can do things more effectively and efficiently using mobile devices, including data collection, applications, closed user groups and telemedicine. At a higher level it is useful to think about how these innovations can be introduced, scaled and supported in order to create significant impact and change.

What are your thoughts on the future of mHealth, and where you think this field is heading?

We’ll see continuing availability of smartphones at all levels of society and the prices will come down further. The price of data and sms will also be reduced and connectivity will increase at greater bandwidth. These forces will allow for increasingly complex mHealth systems to be developed where data, images and video may be able to be shared even in the most remote areas. Point of care diagnostics will continue to evolve, where the prices and power requirements for certain tests will drop to a point that they become more feasible to deploy at the community level. Mobile money, vouchers and mobile insurance will also play a role as the health workers and clients become more familiar with their use in their day to day lives. Power and lack of unique identifiers will remain significant challenges, but innovative solutions should be available soon in areas where we work.

We believe mHealth skills have the potential to make a huge impact in your work. Why do you think taking this class is important, and who would you recommend it to (public health professionals, field workers, etc etc).

This course provides a great overview of different types of mobile technologies and mHealth projects in addition to providing a unique opportunity to connect with a community of implementers and experts in the field. It will also provide some guidance around processes and structures required to include a successful mHealth component to a project. I am a firm believer in the potential of mHealth to radically transform the current state of healthcare. Everyone from policy makers to healthcare workers need to think about how we can use these tools to save lives and help people live healthier, happier lives.

Any advice for someone who wants to make a career in mHealth?

There are many opportunities available for people from all backgrounds. There is a need for people not only with health and technology skills, but also with sociology, anthropology, finance and business, project management and analytics skills. I think it’s important to be conversant in the technology, but to keep exploring these other areas which are critical to the work we are all doing to introduce and support game changing innovation in health systems for the good of the communities we serve.

About Steve
Steve is D-tree’s Chief Operating Officer with over 20 years experience in management consulting, information technology and public health. Steve holds a Bachelor’s degree in Finance from The American University and a Master’s in Business Administration in Information Systems and Finance from the University of Maryland. He is also a certified Project Management Professional. Prior to joining D-tree, Steve worked for the Clinton HIV/AIDS Initiative in Tanzania directing programs in Pediatrics, Prevention of Mother to Child Transmission of HIV, and Rural Care and Treatment.

SteveOllis

According to a recent report by Grand View Research, Inc., the global market for the mHealth (mobile health) industry will reach $42.12 billion dollars by year 2020. That same year, GSMA estimates that smartphone connections will reach 6 billion, fuelled by growth in the developing world and mobile broadband expansion. The mobile phone market, the largest and most profitable segment of the global device market, is expected to total 1.9 billion units in 2015 alone.

With these high expectations for mHealth and smartphone adoption, what are the biggest opportunities for this $42.12 billion market?

We discussed this topic when we held a panel discussion in partnership with General Assembly DC at their office in Washington, DC in November 2014. In a rare opportunity to combine both “healthies” and “techies” in one room, we gathered a panel including Arthur Sabintsev, lead mobile architect at ID.me and instructor of General Assembly DC’s Mobile Development classes and workshops; Jessica Taaffe, global health and science consultant and writer at the World Bank; and our own Kendra Keith, mobile health specialist; and TechChange CEO Nick Martin – both of whom have facilitated our popular online course on mHealth. During this hour-long panel, we discussed a wide variety of topics on the mobile applications for public health.

Here are some of the highlights of “Mobile Development for Public Health” panel where the panelists shared insights that still ring true across the $42.12 billion dollar mHealth space.

1. mHealth can strengthen health systems

The need to strengthen health systems are the biggest challenges for public health, according to Jessica and Kendra, both of whom hold graduate degrees in microbiology and public health, respectively.

“The greatest opportunities for mHealth field and mobile developers focused on public health are in the public health sector, said Jessica. “The biggest public health issues are governance and figuring out the roles needed to fight infectious diseases and non-communicable diseases that are on the rise, especially as people are living longer.”

There are already several great examples of mHealth apps and programs that are strengthening health systems, including MAMA, MedAfrica, Dimagi, CommCare, and others.

2. mHealth can allow healthcare services to reach more people across the world

The ubiquity and diversity of mobile phones and their global usage will be a key driver of the mHealth industry reaching up to tens of billions of dollars, especially as GSMA estimates that there will be one billion unique mobile subscribers by 2020.

In their experience teaching the one of TechChange’s most popular online courses on mHealth, Nick and Kendra discussed the unique challenges of mHealth outside developed countries.

“Pay-as-you-go mobile phones are the most prominent form of mobiles in developing countries,” said Nick. “This model makes it more affordable for people to get internet access, and it will only get cheaper especially as players like Facebook and Google are ambitiously trying to get the entire world online.”

Clockwise from the top-left: TechChange CEO Nick Martin, mobile developer and General Assembly instructor Arthur Sabintsev, global health expert Jessica Taafe, and TechChange mobile specialist Kendra Keith.

Clockwise from the top-left: TechChange CEO Nick Martin, mobile developer and General Assembly instructor Arthur Sabintsev, global health expert Jessica Taafe, and TechChange mobile specialist Kendra Keith.

3. Mobile development for health will become a hotter space for mobile developers through 2020

As a former nuclear scientist turned mobile developer himself, Arthur stressed how there are never enough mobile developers to meet demand in the current global market, much less the global mHealth market. Across the panel, everyone agreed that is it not easy to become a mobile developer, and to keep up with the quickly-evolving skill set demanded for building modern apps.

“Why aren’t there more developers building mHealth apps? Because it’s hard and time-consuming,” said Arthur. “There’s simply not enough time in a day to keep up with all the different standards for different operating systems, as well as all of their respective constant software updates. Although Android phones are used more in the developing world than iOS in western societies, there is a huge problem of Android fragmentation. What you tend to see more of now is that jobs in mobile development are mostly in the finance and advertising industries. If mHealth is truly going to grow to be worth $42.12 billion dollars, I’m excited to see more mobile dev jobs and incentives for this space to grow.”

So how do you incentivize mobile developers to build more mHealth apps for public health?

Nick mentioned that doing so will not be easy, given that mHealth/public health initiatives are often funded by governments or foundations that have procurement cycles. Though there are some initiatives such as the IBM Watson Venture Fund that has contributed to companies such as WellTok, funding long-term mHealth development has proven tough to sustain so far.

Another opportunity for mHealth will be in protecting the data collected in mHealth apps and programs. mHealth is fraught with mobile data security concerns in places where privacy policies are both well-established or barely existent.

What opportunities do you see for the growing mHealth global market? Let us know in the comments below, or tweet us @TechChange.

If you’re interested in learning more about the opportunities for mHealth, sign up now for our mHealth online course! The next round begins this Monday, 30 March 2015.

By: Carolyn Moore and Lesley-Anne Long
Photo credit: Moses Khanu

Since the launch of the first free Training Health Workers for Ebola webinar series in October 2014, we have seen hundreds of members of the global health community come together to share vital, timely information to save lives and prevent the spread of the disease. This real-time and archived delivery of information has been critical to the continued response. We are excited to be working with partners, IntraHealth International, Ebola Alert, and TechChange, to continue growing this community as the response continues and countries begin to rebuild from the outbreak.

A team of organizations, led by mPowering Frontline Health Workers and IntraHealth International, are coming together to share tools and information on how to support health workers responding to and rebuilding from the Ebola crisis.

Please join us in a three-part webinar series beginning April 1.

Health workers in West Africa have been responding to Ebola since 2013, and, according to the latest WHO situation report, the pace of the outbreak is beginning to decline. This calls for relief and celebration. However, this is far from final for those who have been affected by Ebola.

The virus has left indelible marks on their lives, and their stories are many and severe:

The Ebola situation is once more improving in terms of infection rate, but the socio-economic needs are enormous.” (Moses Khanu, Pastor, Sierra Leone)

What comes next for Guinea, Liberia and Sierra Leone, the three most affected countries? And how can countries nearby and in the region plan for future potentially deadly outbreaks?

Health workers remain at the center of community response and support. At the same time, the governments and international organizations that support health workers are seeking answers for how they can restore health services in West Africa, strengthen health systems, and prepare for future health emergencies.

What’s next for Ebola affected countries?
Many organizations are working closely with all actors across the health sector. In our second series of Training Health Workers for Ebola webinars in April, we will have a group of colleagues who have been working in the affected countries talking about lessons learned and planning for rebuilding and strengthening health systems.

We invite you to join the discussion in the webinars.

Reviewing lessons learned, and looking ahead
These webinars will focus on tools and strategies that health workers, as well as the governments and organizations that support them, can use to continue the response, protect their communities and help rebuild health systems. Free training and information resources are concurrently being posted in the Ebola Resource Center http://www.hrhebolaresources.org/

Please join us in the webinars! Here are the details:

Webinar Schedule:
April 1: Working with Youth, Volunteers, and Vulnerable Populations
April 8: Community Mobilization and Preparedness Planning
April 15: Effective Use of Data

All live sessions will be held from 10.00 – 11.00am EDT.

These webinars will bring together more than 15 international health organizations, led by mPowering Frontline Health Workers and IntraHealth International.

Registration and more information are available here. The webinars are open to all, and will build upon the presentations and discussion in the first Training Health Workers for Ebola series.

All of the webinars will be available for viewing at www.techchange.org after the air dates.

The webinar series has been made possible by the generous support of the USAID-supported Health Communication Capacity Collaborative.

With the emergence of the 3D printing industry, how can 3D printing help kids who need upper limbs and fingers?

Join us in a free webinar discussion with e-NABLE, a global online community of humanitarian volunteers designing, building and disseminating inexpensive, functional 3D-printed prosthetics for children.

3D Printing Prosthetics:

A conversation with Jon Schull & Jeremy Simon of e-NABLE
January 22, 2015 at 10:00-11:00 am ET
Register here.

Please register in advance to participate in this free live event. If you cannot attend the event live, the session will be recorded and archived so anyone will still be able to sign up to see it after January 22.

In honor of World AIDS Day 2014, we celebrate several TechChange alumni who are heroes in the front lines of fighting HIV and AIDS across the world. From their communities in San Francisco, Vietnam, Malawi, South Africa, and Zambia, these extraordinary individuals are using mHealth technology, online training for HIV preventing, and more to save lives with HIV awareness campaigns through online trainings and SMS campaigns, Android mobile apps for accurately prescribing antiretroviral medication, and more. Check out the top five ways TechChange alumni are using technology to fight HIV.

1. Encouraging HIV testing and care in Vietnam with mHealth gamification programs
Caroline Francis and her team across FHI 360 Vietnam have launched mHealth pilot programs to encourage HIV testing and care maintenance through gamification with mobile phones. In their programs in Hanoi and Ho Chi Minh City, mHealth is a key strategy for FHI 360 “to incentivize health-seeking actions, increase the timeliness of data collection, improve patient communications, and document system-client interactions. MHealth can also facilitate workforce development through task shifting, performance support, and human resources management.”

Check out this video on their “Fansipan Challenge” mHealth pilot program here.

2. Promoting HIV support group and health management classes with SMS reminders
In her blog post on “mHealth: Healthcare Reaching Remote Places with Mobile Phones and SMS”, Reverend Neelley Hicks describes the success of a community health worker’s use of SMS messages to remind HIV+ members of a community in Malawi to attend support group and HIV health management classes. The significance of reaching these program beneficiaries was not small, as “community health workers often must walk miles to find someone only to learn they are away. But the mobile phones stay with the person – making them much easier to reach.”

Mercy-mHealth-United-Methodist-Communications

Mercy (pictured with Maeghan Ray Orton from Medic Mobile) at UMCom workshop in Malawi

3. Scaling HIV Prevention in California via eLearning
A&PI (Asian and Pacific Islander) Wellness Center, a San Francisco-based organization with that started to fight the HIV/AIDS crisis in A&PI communities beginning in the late 1980s, collaborated with Project Inform and TechChange to develop the California Statewide Training and Education Program (CSTEP), a curriculum that sets the standard in HIV treatment and technically and culturally competent training for clinical and non-clinical providers working in the HIV field. The A&PI Wellness Center works to address the health needs of marginalized and vulnerable groups, regardless of race, ethnicity, gender identity, sexual orientation, or immigration status.

To register for these free online courses on HIV prevention training, please click here.

4. Correctly prescribing HIV antiretrovirals (AVR) drugs with an Android smartphone mobile app in South Africa

To help clinicians to correctly prescribe antiretrovirals, Dr. Musaed Abrahams, an alumnus of our mHealth – Mobile Phones for Public Health online course, has launched a mobile app for managing antriretroviral treatment (ARV) medication in South Africa.

The Aviro HIV mobile app acts as a virtual mentor for clinicians to easily consult for proper ARV (Anti-retroviral) initiation and treatment during the patient consult. Designed for Android and based on the current South African guidelines, it provides real-time, immediate feedback and guidance for the clinician, so that excellent and reliable care can be delivered to every patient. Following a care checklist, it gives clinical prompts aiming to educate and raise the standard of patient care.

Download the Aviro Android app on the Google Play store here.

5. Advocating for reproductive health education in Zambia with SMS
After taking several online courses with TechChange, Priscilla Chomba-Kinywa created a SMS solution called U-Report to promote sex education to prevent HIV in Zambia among youth. She incorporated the feedback from Zambian youth in the process of building out this campaign and program. The first year of the program’s pilot in 2 provinces had 50,000 young people voluntarily sign up and engage the 24/7 trained counselors by asking them questions on HIV, sexually transmitted infections, and other reproductive health issues.

Zambia-U-Report

Want to learn how you can use technology to address challenges such as HIV and other global challenges? Enroll in one of our online courses here and get $50 off any course with the coupon code, ENDAIDS2014, before December 5, 2014.

 

Frontline health workers in Guinea, Sierra Leone, and Liberia are responding to the largest Ebola outbreak in history. To protect themselves and their communities, health workers responding to Ebola need clear, reliable, and timely information on how to detect the disease, prevent its spread, and care for patients.

To respond to this crisis, mPowering Frontline Health Workers and IntraHealth International approached TechChange to deliver a free online webinar series on “Training Health Workers for Ebola—Protection, Detection, and Response”. In these webinars, more than 15 international and in-country health organizations will share information with participants on how to support health workers responding to Ebola. The four one-hour webinars will air on October 21, 23, 28, and 30, each starting at 10:00 am EDT.

The webinars are open to all, and we welcome participation from as diverse an audience as possible. This includes Ministries of Health, health workers, community leaders, program implementers (in-country and international), policy makers, and others. Health professionals from over 15 countries have already signed up, and participants represent government, health care facilities, international NGOs, and civil society, and other sectors.

The presentations and discussions in the webinars will (1) describe how to leverage available resources to train, support, and communicate with frontline health workers and others involved in the direct Ebola response through mobile technology; (2) consider ways to connect implementers to resources, collaborators, and sources of information; and (3) explore how to improve opportunities to enable implementers and programmers to share efforts, collaborate, and avoid duplication.

Webinar schedule:
October 21: Learning and information needs for frontline health workers
October 23: Health system support for frontline health workers
October 28: Community mobilization and interactions with clients
October 30: Data to support effective response and case management

All live sessions will be held from 10.00-11.00am EDT. For those who cannot attend the webinar sessions live, all webinars will be recorded and available here after the air dates.

These webinars are being supported by a 4-week discussion in the Health Information for All (HIFA) forums and we invite you to join and add your views. In addition, IntraHealth and mPowering are launching an online Ebola Resource Center for participants and others to share messages, training content, guidance documents, and other information. This site will also be a place for programs to share information about their work and to connect to others for support, ideas and collaboration. The Ebola Resource Center will launch on October 21.

If you and/or your organization have content on Ebola that you would like to share in the Resource Center, please email Dave Potenziani at Intrahealth at dpotenziani [at] intrahealth [dot] org.

We look forward to meeting you in the webinars & invite you to participate in the conversations in the HIFA forum.

You can find the webinar page and registration information at https://www.techchange.org/live-events/training-health-workers-for-ebola/.

Please share this information on this webinar series information with anyone interested in responding to the Ebola outbreak.

Photo credit: BBC

By Timo Luege, TC103: Tech Tools and Skills for Emergency Management facilitator

As Ebola continues to ravage Sierra Leone, Guinea and Liberia, people from all around the world are working together to stop the disease. In addition to the life saving work of medical staff, logisticians and community organizers, information and communication technology (ICT) is also playing a vital part in supporting their work.

After consulting the TechChange Alumni community and other experts in international development and humanitarian assistance, I pulled together a list of different technologies being applied to manage Ebola. Below are six examples showing how ICT is already making a difference in the current crisis.

1. Tracing outbreaks with mapping and geolocation
Aside from isolating patients in a safe environment, one of the biggest challenges in the Ebola response is tracing all contacts that an infected person has been in touch with. While that is difficult enough in developed countries, imagine how much more difficult it is in countries where you don’t know the names of many of the villages. It’s not very helpful if someone tells you “I come from Bendou” if you don’t know how many villages with that name exist nor where they are. The Humanitarian OpenStreetMap Team has helped this process through creating maps since the beginning of the response.

See: West Africa Ebola Outbreak – Six months of sustained efforts by the OpenStreetMap community.

Monrovia OSM pre-Ebola
Map of Monrovia in OpenStreetMap before and after volunteers mapped the city in response to the Ebola crisis. (Humanitarian OpenStreetMap)

In addition, the Standby Task Force is supporting the response by helping to collect, clean and verify data about health facilities in the affected countries. The information will then be published on UN OCHA’s new platform for sharing of humanitarian data.

2. Gathering Ebola information with digital data collection forms
Contact tracing involves interviewing a lot of people and in most cases that means writing information down on paper which then has to be entered into a computer. That process is both slow and prone to errors. According to this Forbes article, US based Magpi, who just won a Kopernik award, is helping organizations working in the Ebola response to replace their paper forms with digital forms that enumerators can fill out using their phones.

Digital forms not only save time and prevent errors when transcribing information, well designed digital forms also contain simple error checking routines such as “you can’t be older than 100 years”.

If you are interested in digital forms, check out the free and open source Kobo Toolbox.

3. Connecting the sick with their relatives using local Wi-Fi networks
Elaine Burroughs, a Save the Children staff member who is also TechChange alumna of Mobiles for International Development, shared that they are using their local Wi-Fi network to connect patients in the isolation ward with the relatives through video calls. Both computers have to be within the same network because local internet connections are too slow. In situations where video calls are not possible, they provide patients with cheap mobile phones so that they can talk with their relatives that way. Elaine added: “Several survivors have told us that what kept them going was being able to speak with their family and not feel so isolated when surrounded by people in hazmat suits.”

4. Sharing and receiving Ebola information via SMS text messages
I have heard about a number of different SMS systems that are currently being set up. Some are mainly to share information, others also to receive information.

mHero is an SMS system specifically designed to share information with health workers. It works with UNICEF’s RapidPro system, a white label version of Kigali-based TextIt which is one of the best SMS communication systems I know. RapidPro is also at the heart of a two-way communication system that is currently being set up by UNICEF, Plan International, and the Scouts.

The IFRC is of course using TERA to share SMS, a system that was developed in Haiti after the 2010 earthquake and already used in Sierra Leone during a recent cholera outbreak.

5. Mythbusting for diaspora communities via social media
Social media also has a place, though not as much as some people think. With internet penetration at less than 5 per cent in Liberia and less than 2 per cent in Sierra Leone and Guinea, it is simply not relevant for most people – unlike radio for example. However, all of these countries have huge diasporas. The Liberian diaspora in the US alone is thought to be as many as 450,000 people strong – and they all have access to social media. Experiences from Haiti and the Philippines show that the diaspora is an important information channel for the people living in affected countries. Very often they assume that their relatives in the US or Europe will know more, not least because many don’t trust their own governments to tell the truth.
Social media can play an important role in correcting misinformation and indeed, both the WHO and the CDC are using their social media channels in this way.

6. Supporting translations of Ebola information remotely online
Last but not least, Translators Without Borders is helping NGOs remotely from all over the world to translate posters into local languages.

Low tech does it
As a final word, I’d like to add that while technology can make a real difference we must not forget that very often low tech solutions will be more efficient than high tech solutions – it depends on what is more appropriate for the context. So don’t start an SMS campaign or launch a drone just because you can. It’s not about what you want to do. It’s not about technology. It’s about what’s best for the people we are there to help.

A Summary Infographic

TechChange Ebola Infographic

We will be discussing these technology tools, Ebola, and many similar issues in TC103: Tech Tools and Skills for Emergency Management and TC103: mHealth – Mobiles for Public Health. Register by October 31 and save $50 off each of these courses.

Do you have additional examples of how ICT is helping in the Ebola response? Please share them in the comments!

This post originally appeared in Social Media for Good.

About the TC103 facilitator: Timo Luege

Timo Luege

After nearly ten years of working as a journalist (online, print and radio), Timo worked four years as a Senior Communications Officer for the International Federation of Red Cross and Red Crescent Societies (IFRC) in Geneva and Haiti. During this time he also launched the IFRC’s social media activities and wrote the IFRC social media staff guidelines. He then worked as Protection Delegate for International Committee of the Red Cross (ICRC) in Liberia before starting to work as a consultant. His clients include UN agencies and NGOs. Among other things, he wrote the UNICEF “Social Media in Emergency Guidelines” and contributed to UNOCHA’s “Humanitarianism in the Network Age”. Over the last year, Timo advised UNHCR- and IFRC-led Shelter Clusters in Myanmar, Mali and most recently the Philippines on Communication and Advocacy. He blogs at Social Media for Good and is the facilitator for the TechChange online course, “Tech Tools & Skills for Emergency Management“.

Hamlet (community) health workers in Vietnam learn to interact with mCare (Photo credit: FHI360)

With international development program cycles often having a “project design phase”, how can online learning as a team improve project design?

How do you design a technology program intervention to improve health outcomes?

HIV Challenges and Keeping Up with mHealth

According to the WHO, HIV has claimed 39 million lives so far globally with 1.5 million lives in 2013 alone. At the end of 2013, there were 35 million people living with HIV, with 2.1 million becoming newly infected. With 24.7 million people living with HIV in 2013, Sub-Saharan Africa is the most affected region in the world accounting for almost 70% of the global HIV infections.

HIV often gets highlighted as a major problem in Sub-Saharan Africa, but it is also a major public health concern in Southeast Asia, particularly in Vietnam where the use of needles to inject drugs drives the epidemic. As of 2012, 260,000 (of the 89 million) people in Vietnam are living with HIV, according to UNAIDS Vietnam. As a result, FHI 360 is working with the Government of Vietnam to address the country’s HIV challenges with “effective programs that cost less, are implemented locally, and decrease donor dependence”.

Technology developments in public health change very quickly, especially with the emergence of mHealth – there’s more mHealth programming, new applications, and emerging research.

MHealth is a key strategy for us as these applications can be used to incentivize health-seeking actions, increase the timeliness of data collection, improve patient communications, and document system-client interactions. MHealth can also facilitate workforce development through task shifting, performance support, and human resources management.

According the blog Tech in Asia, “For every 100 Vietnamese people, there’s 145 mobile phones. For a country whose population is just over 90 million, that amounts to more than 130 million mobile phones.” RefWorld.org reported that, as of January 2012, census data indicated there were 119 million mobile users in Vietnam when the population was at 88 million. Given the emergence of the mHealth industry and the large percentage of the Vietnamese population with cell phones, we at FHI 360 need to effectively mobilize this ubiquitous technology for impactful programming that helps individuals in all areas of the country protect their health and well-being.

A Social Online Learning Solution

In 2012, I first participated in TechChange’s 4-week online certificate course called “Mobile Phones for Public Health.”  I decided to take the course again in 2013 – this time with numerous colleagues — to share our mHealth programming experiences and to continue to learn from renowned mHealth practitioners around the world.

Like all busy development professionals, it is difficult to find time to cultivate learning during our day-to-day work.  The TechChange course was structured and delivered to meet our needs.

Nick Martin mHealth course social map

Here’s a social graph from Mobile Phones for Public Health showing participant interaction

Cutting-edge, timely, and relevant information

  1.  TechChange updated its courses at least once every 3-6 months, based on direct feedback (through crowdsourcing and surveys) from its broad learning community to deliver the most up to date and relevant course content.

Great format for busy working professionals in Vietnam and beyond

  1.  Keeping our busy schedules in mind, the course content was designed to be mobile and tablet-friendly, allowing us to learn wherever and whenever fit our schedules. All live events were recorded so that learners could access materials according to their schedules.
  2. For those of us who had difficulty finishing the course in the one-month period, access (and technical support) is available for four months after the end of the course so that we can complete our final project and receive the formal certificate.
  3. The online interface was the most intuitive learner platform we have ever used:  An online course map visually illustrated all components of the program, while a calendar highlighted a variety of live discussion events with renowned experts from around the world.
  4. The main facilitator actively participated in all discussion boards; introduced weekly themes (through video, email and platform) and summarized (through print and video) the highlights of each week.  He and a facilitation team also provided “office hours” for those who needed extra support (and this support was provided in various time zones).

Interactive learning experience

  1. There was great communication between facilitator and learners. The course required 7-9 hours of effort per week and the 50 or so participants were motivated to actively participate. Learner outcomes were clearly defined and each week’s themes were well-articulated so that we knew what to expect and what was expected from us.
  2. Instead of relying primarily on print materials, sharing video, audio and weekly live events/”chats” allowed learners from various cultural backgrounds to gain knowledge and skills through a variety of channels through interactive learning.
  3. Practical exercises and interactive simulations ensured knowledge application and exchange.
  4. Individuals got to know each other through a variety of “get to know you” activities and collaborative exercises.
  5. TechChange added some fun by integrating game dynamics into the course, awarding points each time a person participated in a discussion or attended an event, with a minimum participation threshold established in order to earn a certificate.

Joining a professional network and community

  1. All learners also became TechChange alumni upon finishing the course. We are now connected through social media with others in mHealth (and offered substantial discounts on upcoming courses).
  2. It’s been great to see other mHealth alumni like Lauren Bailey making strides in the field after joining this course.

Here are some additional comments from two of my colleagues:

“I really enjoyed reading the forums at my own pace. I liked that other participants put so much thought into them.” – Deen Gu

“I like the discussion parts most as they offer me many interesting thoughts and experiences of TechChange’s members on different topics.” -Nguyen Thi Van Anh

As a recent graduate of TechChange’s courses, I can speak to the benefits of participation.

USAID/SMART TA training

USAID/SMART TA team provides hands-on training to hamlet health worker in Nghe An (Photo credit: FHI360)

Results of mHealth Training with TechChange

Through this mHealth course, my team learned best practices as a group to explore ways to implement mHealth projects. My colleagues learned how mobile technologies are being used in other countries and sectors and thought about ways it could be applied in Vietnam. The individuals who have participated in the TechChange course are now our office mHealth champions and are actively identifying areas of work where mHealth solutions can be applied.

Here are two current mHealth pilots we have launched in Vietnam through the USAID/SMART TA program to address HIV challenges:

1.  Fansipan Challenge – uses the metaphor of Fansipan mountain (Vietnam’s highest peak), gamification, and mobile technologies to support people who inject drugs and their intimate partners to test for HIV and be linked to care if they are positive.

Fansipan was created by USAID funded SMART TA project in Vietnam. Learn more about SMART TA here.

Here is a Prezi presentation explaining the Fansipan project in Vietnam called How Mobile Technologies and Gaming are Improving HIV Program

2.  mCare – is the first case management application in Vietnam that utilizes mobile technologies to support and track clients across the cascade of HIV outreach, testing, care and treatment services.  It also manages performance-based incentives for hamlet health workers who identify potential clients, encourage them to test for HIV, and support them to enroll and be re-engaged in HIV care and treatment and methadone maintenance treatment.

confirmation message

A confirmation message sent from mCare (Photo credit: FHI360)

The Results of the mHealth Pilots So Far

While mCare is in its early stages of deployment and refinement, the Fansipan Challenge has shown a dramatic reduction in programmatic unit costs, combined with significant increases in testing uptake and HIV yield among underserved key populations.  Between June – November 2013, 62% of 656 injecting drug users and their intimate partners tested for HIV after a single contact. Approximately 71% of these individuals were first time testers; 17.8% were diagnosed as HIV positive. Comparative expenditure analyses of USAID/SMART TA-supported outreach services show a 50% reduction in costs associated with identifying an HIV positive person.  And preliminary data further suggest that HIV positive people identified through Fansipan have higher CD4 levels (average 287.5 cells/mm3) and will thereby have better treatment outcomes than those who initiate treatment when they are severely immuno-compromised.

These new initiatives rely on mobile technologies and we, like other technical assistance providers in the development sector, need to be constantly learning about mHealth innovations, and emerging knowledge and applications.  The TechChange mHealth class was a great investment in having my team become more familiar with mHealth as we introduced our mHealth initiatives.

About Caroline Francis

Caroline Francis

Caroline Francis is FHI360’s Deputy Country Director in Vietnam and completed TechChange’s Mobile Phones for Public Health course in 2012 and in 2013 when she took the course again with her team in Hanoi and Ho Chi Minh City. She is currently involved in FHI360’s Sustainable Management of the HIV/AIDS Response and Transition to Technical Assistance (SMART TA) project in Vietnam and her areas of expertise include HIV and AIDS prevention and care and Social and behavior change communications. Caroline has previously worked as the Associate Director (HIV Prevention, Mitigation, Strategic Behavioral Communications and M&E) and Deputy Director for FHI 360 Cambodia. She received her M.A. in Anthropology from University of Victoria.

The Asian & Pacific Islander Wellness Center (A&PI Wellness Center) partnered with TechChange to develop a two-part training course designed for clinical and non-clinical providers to provide HIV education in California. For the first time ever, these trainings combined both the self-paced and facilitated course structures. Participants will be asked to proceed at their own pace through the Articulate Storyline-based APIWC 101 course, before taking part in the four-week facilitated course that features chats with guest experts.



HIV Today – The Context
We have come a long way when it comes to HIV treatment. Thirty years of research and campaigns have transformed HIV from being a death sentence into a chronic condition that permits those who properly manage it to live relatively normal lives. The problem is, only one in four HIV-positive Americans currently follow all recommendations for managing HIV.

According to the Center for Disease Control (CDC), only 25% of HIV-positive Americans reach viral suppression, the current end-goal of HIV treatment. This means that the other 75%, or roughly 825,000 of the 1.1 million Americans estimated to be HIV-positive, are not receiving the support they need to successfully navigate through the obstacles to seek care. As a result, these individuals are not getting the treatments they need to manage and maintain their personal health and consequently, have a greater risk of transmitting the virus to others.

Many agencies have encouraged use of the HIV Care Continuum, also called the HIV Treatment Cascade, as a tool to visualize the proportion of HIV-positive individuals engaged at each stage of care.

HIV Care Continuum

Source: AIDS.gov

This cascade shows an estimated percentage of how many people fall out of care at each step along the way to viral suppression. Nearly one in five HIV-positive Americans do not know their positive status, keeping them from engaging in the cascade at all. Of those that are initially linked to care, nearly half fall out of treatment before being prescribed antiretroviral therapy (ART).

Even more important than this cascade is the breakdown of HIV prevalence by race and sexual preference. African Americans, for example, bear the biggest burden. According to a 2013 CDC report, African Americans makes up 14% of the US population, accounting for 44% of Americans living with HIV. The burden is similarly unequal for other minorities and men who have sex with men (MSM).

CDC estimated rate of new HIV infections (2010)

source: CDC

These statistics highlight the need for responses tailored to the communities most affected by HIV; these groups are more likely to face poverty and racism, as well as distrust with the medical system. When societal challenges are combined with the challenges of navigating HIV, people tend to drop out of care. Diverse communities require varied responses that are culturally aware and take into account the needs of disenfranchised groups.

The Challenge of Scaling HIV Prevention
Response to HIV requires service providers to play clinical and non-clinical roles. Many counselors, social workers, advocates, lawyers, and clinicians frequently work with HIV-positive individuals and in the field of HIV prevention and treatment; it is vital that they understand both the medical and complex social realities faced by their clients.

Born out of a grassroots movement to combat the HIV/AIDS crisis in A&PI communities in the late 1980s, the A&PI Wellness Center works to address the health needs of marginalized and vulnerable groups, regardless of race, ethnicity, gender identity, sexual orientation, or immigration status. In collaboration with Project Inform, the A&PI Wellness Center developed the California Statewide Training and Education Program (CSTEP), a curriculum that sets the standard in HIV treatment and technically and culturally competent training for clinical and non-clinical providers working in the HIV field.

An eLearning Solution

APIWC Module 1

Participants will advance to APIWC 201 upon completion of the first course (APIWC 101). Hosted on TechChange’s facilitated course platform, this online course will provide more in-depth information about barriers to care and supporting clients in a dynamic era of HIV treatment. The month-long 201 course integrates elements of the self-paced course into the facilitated learning environment – participants are able to review the 101 content as well as slides specifically produced for the 201 course, share their knowledge with other providers in the forums, and interact with experts during live events. The ability to work with experts is what really sets this training apart – participants hear from former presidential advisors on HIV policy, specialists in linking HIV-positive people to care, HIV trainers, and those with decades of experience researching the virus and advocating for those affected.

APIWC Guest Expert Dr. Cynthia Gomez

Participants are able to engage with experts such as Dr. Cynthia Gómez (pictured above) during live events. These events are recorded and made available for later review.

The content of both courses is available 24/7 so that providers are able to take part whenever their schedules allow, while the forums and weekly live sessions add a social dimension uncommon in online learning. As all participants have some experience with HIV prevention or treatment, this course provides a unique opportunity for collaborative learning; providers can learn from the experiences of one another, share resources, and strengthen their networks of HIV prevention and treatment specialists.

In the first month alone, the training attracted over 70 participants from a variety of organizations. Additionally, the combined course has little in the way of overhead costs and can easily be repeated or scaled for different audiences, making it a viable strategy for training providers across California, with the goal of improving health outcomes and supporting HIV-positive individuals as they move toward viral suppression.

To register for these free online courses on HIV prevention training, please click here.

Live session recording

Charlie Weems and Emily Fruchterman of TechChange record a live session at the TechChange recording studio in Washington, DC.

Emily Fruchterman, Catherine Shen, Charlie Weems, and the A&PI Wellness Center contributed to this blog post.

If your organization is interested in developing online training with TechChange, please contact info@techchange.org.

I’ve always been a visual learner. As a digital animator, one of my responsibilities is trying to make important information in international development and public health organizations easier to understand and share. With 65 percent of all people as visual learners, it is important in data-intensive fields such as international development and public health to have training content that is easy to digest through graphic organizers and data visualizations. I’ve learned how creating an animation or interactive graphic mimics the learning process: breaking down components of a concept and putting them together. When animating, I see the pieces of an animation as creating joints for a once inanimate object. I am always learning more about that topic as I break down components and put them back together.

When working with Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU∙CCP), USAID, and FHI 360 on their new Global Health eLearning (GHeL) Center online course, Health Communication for Managers, I learned about the basics of health communication for global development professionals and academics and tried to make it engaging with an interactive infographic.

Although the creative process in building out this interactive graphic was a constant feedback loop with many iterations, here are the basic steps of how the process of creating an interactive infographic works:

1. Map out the vision and purpose of the infographic, and understand its constraints
When crafting a training program for health communication for managers, the Knowledge for Health Project (K4Health) at the JHU∙CCP contacted TechChange to produce animation videos to create an engaging learning experience with its infographic. They gave us a lot of creative freedom to make one of the training’s main infographics interactive. After a consultation with JHU∙CCP, we all agreed on the vision for the interactive graphic and its purpose for the graphic to be intuitive, visually appealing, simple, and easy to understand. Then JHU∙CCP sent us reference materials that included a general brief of interactivity requirements for the platform and technical specifications.

Last year, GHeL went through a significant site redesign and now hosts its 65+ free courses on an open source, open access Drupal platform. JHU∙CCP was excited to test out the new site features and, in keeping with latest trends in online learning, was interested in adding an interactive layer to its primarily text based courses. However, the majority of GHeL learners access the site from low and middle income countries where access to high speed internet remains a critical barrier. Any interactive elements added to the site needed to load easily and quickly in low bandwidth environments in order to cater to learner needs.

We decided to go with HTML5, the latest standard for HTML, as it is becoming almost a universal standard in terms of web browser support. Where it was previously only possible to do this level of interactivity with graphics either with Flash (a technology that is almost obsolete with more flaws than advantages) or with rather complex javascript, authoring something like this in HTML5 with a product like Adobe Edge Animate is relatively easy and powerful. By using HTML5, we can create a lightweight infographic that can load with minimal bandwidth without losing any graphic quality or interactive elements. The infographic will not only load quickly, but it will also be accessible on a tablet or mobile device without loading any additional resources.

Starting with the initial static images in text, PDF, and .jpg format, JHU∙CCP informed us that they didn’t want just a basic .jpg image with hotspot (an area on an image that has a function attached to it); they wanted a bit of “edge” to it. As a result, we interpreted the graphic similarly to the Google Doodle interactive logos. However, we tried to keep the graphics consistent with static printed version of graphic, yet with an interactive element.

2. Convert and reformat content to be web-friendly & break apart the graphic itself into layers and components.

For the next step, I traced these .jpg files to stay consistent with the original graphics, which appear in other parts of the training. I then created vector files with certain colors using Adobe Illustrator. When working with these files, my thinking process involved questions such as, “What part of the graphic will be clickable? What colors will change?” I then made a basic mock-up in Illustrator and used Adobe Edge Animate (Adobe’s version to HTML5 animation that is similar to Flash) to combine the component. This simple animation tool lets you create animations by combining multiple images within a time frame.

3. Build interactivity and triggers into graphic
JHU∙CCP sent us a brief of each graphic with buttons and Adobe Edge Animate, HTML5 animation web development authoring tool. The software resembled animation tools used including basic Adobe software. I then created a timeline where different states of the graphic appeared, adding breaks between the states. For the concentric circles within the graphic, I had to create each circle as a separate asset (or a button, picture, graphics, icons, illustrations, texts; components of an animation/infographic/illustration).

4. Combine animation with web development
I worked with my colleague Matthew on addressing bugs and optimizing the interactive infographic for different window sizes. He also assisted with responsive design (or designing for multiple devices and services), quality assurance (QA) and worked out the HTML5 coding. As an animator, it was a straightforward process to build graphic assets on a timeline, but I had issues with “what happens when you press on the thing”. Matt coded a conditioning system that made transitions smoother and user-friendly.

5. Get feedback and refine (ongoing)
In total, we created five graphics. Throughout the process, there were small edits in the text. Overall, I approached this interactive infographic project like any other animation project, but with interactive elements.

To access the free online course on “Health Communication for Managers”, please click here.

Interested in animating some of your static training content? Contact the TechChange Creative team at info@techchange.org.