By Lauren Bailey, TC309: mHealth – Mobile Phones for Public Health alumna

Lauren Bailey

My final project for TechChange’s mHealth online course overlapped a final project for a master level global environmental health course. I’m currently working towards a Master of Public Health degree, concentrating in global environmental health, and specifically focusing in water, sanitation, and hygiene (WASH). I recently became interested in mHealth and decided to do my global environmental health course project on mHealth in the WASH sector. Since I was new to mHealth, I kept the project simple, touching on some basics. This background document includes: (1) applications of mHealth in WASH; (2) case studies; and (3) recommendations.

Throughout TC309, I became increasingly interested in how mHealth can be applied to behavior change, a major component of reducing WASH-related illness. The mHealth online course has been a wonderful way to learn about the different applications of mHealth, the challenges and successes of programs, and the future possibilities of mHealth. I’ve been inspired by many of the articles, discussions, and live presentations and am now incorporating mHealth into my master’s thesis.

Here is the infographic I created, using Piktochart as part of my course project:

mHealth-in-WASH-infographic_Lauren Bailey


  1. Mobile phones offer a means to reach most at-risk populations, particularly those in rural areas, to change health outcomes.
  2. More individuals in most African countries will have access to a mobile phone than they will to an improved water source by 2013.
  3. Mobile phones have been deployed over the past decade as tools to improve water, sanitation, and hygiene.
  4. Client education and behavior change communication, data collection and reporting, financial transactions and incentives, and supply chain management are potential mHealth applications categories.

To read Lauren’s entire final project from the online course, mHealth: Mobile Phones for Public Health, please click here.

Interested in learning more about how mobile phones are impacting WASH, healthcare, and promoting health worldwide? Register now for our 4-week online on mHealth here.


Last month, 130 doctors, nurses, development workers, techies, government officials, and academics from 35 countries joined us on an exciting four-week journey through the latest developments in mHealth.

Imagine how difficult (and expensive) it would have been to assemble this group into one classroom in person!

Thanks to the amazing team at the mHealth Alliance and an all star-roster of incredible experts, we managed to build upon the great success of our inaugural effort and deliver a powerful second installment of the online certificate course TC309: Mobile Phones for Public Health.

Three observations/trends emerged during the course:

  1. Mobile data collection most discussed! Mobile data collection, management and analysis gained significant attention in the course forums. We were thrilled to be joined by Yaw Onokwa, one of the founders of Open Data Kit and Jeremy of CommCare who provided students with live demos of their respective software packages and shared a number of insights and best practices for developing surveys, acquiring and managing users, scaling data projects and more. The always-engaging Alain Labrique (Johns Hopkins University) joined us for a fantastic session on the continuum of care that touched on his exciting work in Bangladesh and the importance of investing in the evidence base.
  2. The importance of human centered design (HCD): Human-centered design also featured prominently throughout the four weeks. Isaac Holman (co-founder of Medic Mobile) led participants through an exercise in drawing/mapping a health ecosystem based on HCD principles. Design experts Erica Kochi (UNICEF Innovation) and Robert Fabricant (Frog Design) shared a wealth of insights from their experiences in successfully launching and sustaining mHealth projects in a number of countries. For many of these world-class practitioners, this was the first time they had ever presented in an online course like this.
  3. Fewer pilots + design for scale: After the New York Times featured an article last spring entitled The Benefits of Mobile Health on Hold there was certainly a lot of room for debate and critical discussion about “pilotitis”. Patty Mechael noted that one trend she has observed in last year is fewer organizations are starting pilots more are focused on designing for scale from the onset of a project. And finally, Gustav Praekelt shared the amazing work his foundation has undertaken to team up with leading private sector entities in South Africa to achieve scale (1 million+) in fighting HIV and preparing mothers for childbirth.

Three highlights from the course:

  1. Techies + Healthies: We featured a TEDx Talk by Josh Nesbit titled, “Techies + Healthies”, which prompted an insightful discussion about the need to promote more engagement between practitioners from both fields. We also asked participants to reflect on their own orientation on the healthie – techie spectrum.
  2. Zombies, Zombies, Zombies: What would a TechChange course be without a Zombie Apocalypse. This time, participants had to respond to an impending zombie invasion and practice gathering vital health and preparedness data using tools like Magpi, FrontlineSMS, CommCare formhub, OpenDataKit and more.
  3. What a Map! We asked participants to describe the health systems in their own countries and then crowdsourced an interactive Google Map of everyone’s responses. I personally learned a tremendous amount about the challenges and opportunities that exist in other countries through this visualization and am excited to do more of these kinds of activities in future courses.

While there are always improvements to make and things we’ll work to do differently next time, overall, the course was a huge success. But don’t just take my word for it. Of the 30 participants so far who have completed our post-course survey, all 30 said the course fulfilled or surpassed their expectations and 27 out of the 30 said they are likely or very likely to recommend the course to a friend or colleague.

Here’s a selection of what our participants had to say:

  • “The blend of high notch experts with various diverse experiences in the mHealth and social spaces, the expert coordination, moderation and tech support by Nick and colleagues, brought practicality and vividness to the course. Are you a healthie or a techie? It does not matter. If you want to do mHealth right, then come to this course.” – Francis, World Vision International
  • “I felt truly engaged by this course, and was somewhat surprised by that as other online courses I have taken for credit have felt very distanced and flat in terms of educational energy. If you want to know what the leading experts in mhealth are saying about the state of the field, take this course. The best part? Live webinars that felt like inner circle information (how the insiders talk over drinks) coupled with direct access to ask your specific questions through text chat. I can’t wait to take a refresher course next year to see what’s new!” – Kirsten, Rice University
  • “The TechChange online course platform is amazing! They provide you with online learning that is exciting, user-friendly and highly informative. The speakers in the mHealth course are really great and I have learned a lot from the presentations and exercises. For people who are busy and cannot catch up on-time (like me!), you don’t need to worry because TechChange has provided a platform where you can retrieve videos, materials, audio recordings. So, go with TechChange as your top online course provider!” – Mary Rose, ACCESS Health International

The TechChange online platform also underwent all kinds of upgrades thanks to the tireless efforts of our dev team led by Will Chester. See what some of our participants had so to say:

  • “Here is a learning platform that is designed completely for the convenience of the individual – you can participate in as many sessions as you can and still have opportunity to catch up on those you’ve missed even 4 months after completing the course. You can even rate your performance by the tech points earned and look at what others have earned – which is a great way to motivate or encourage participation.” – Apera Iorwa, mHealth Alliance
  • “I thought the platform was great–very dynamic and user-friendly. I’ve taken several other online courses and this was the best platform thus far.” – Kiara Reilly, Booz Allen Hamilton

Stay tuned for details about the fall mHealth course and be sure to check out our lineup of upcoming courses: Social Media for Social Change, Intrapreneurship: Innovating from Within, and Tech for Emergency Management and more.

We’re excited to announce that we’ve teamed up with Mobile Alliance for Maternal Action (MAMA) to support capacity building and learning for their global community of users and implementers.

[Maximizing Mobile Infographic. Source: World Bank]

This is a guest post by Avatar of Joellen RaderstorfJoellen Raderstorf, a participant in the TechChange course: TC105: Mobiles for International Development. You can follow Joellen on Twitter: @actingupmama 

How many people have had the experience of telling people you are studying ICTD or working in the field of ICTD to watch their eyes glaze over. How do you explain ICTD to a friend in the grocery line, your grandmother at a family reunion, or your father who thinks technology is ruining young people?

Most commonly, ICTD is described as an attempt to bridge the digital divide—the disparity between the ‘haves’ and ‘have-nots’ in the technological world. Some consider it to be the latest golden bullet—with access to technology comes the ability to improve a livelihood. A farmer can access commodity information in Cameroon to ensure a fair price and expand reach beyond the local market. A family living in a rural community, who once found doctors out of reach, can significantly improve the chances of a child surviving past the age of 5 due to a community health worker equipped with a mobile health application connecting to doctors real time. A child can grow up with access to education and the opportunity to take college courses without great expense or the necessity of leaving her community.


Alternatively, perhaps a less altruistic view of ICTD depicts the field as a marriage between telecom companies in search of expanding markets and NGOs in need of new solutions to addressing hunger and poverty. The proliferation of the mobile phone in the developing world has been nothing short of a technological revolution according to the World Bank. Powerful infographics from the World Bank and USAID depict an undeniable success story regardless of the original intention. On a planet of 7 billion, there are over 6 billion mobile subscriptions and over 75% of the world has access to a mobile phone. Besides providing a link to markets, education and health providers, mobile technology is employed to create a safer and less corrupt world. Of course ensuring the bandwidth to handle the mobile data traffic expected to reach 1.2 GB per user by 2016 will present a challenge to the FCCs of the world and a subject for a future blog post.

One last point of interest in the world of ICTD identity is confusion around the acronym. ICTD is often interchanged with ICT4D, a nuance on the surface, but politically charged when peering more deeply. What implications are being asserted when one says ICT for development? Some suggest this is another version of colonialism. Terminology does evolve over time and development lingo could certainly use an overhaul, perhaps alleviating the need to define what ICTD means to everyone. For an in-depth definition, refer to the Wikipedia page for ICT4D where some (or one) ICTDers have been doing a commendable job educating the world about this enigmatic field.


This has been reposted from the DataDyne blog. If you’re interested in learning more about this topic and Magpi, check out our upcoming course with the mHealth Alliance on Mobile Phones for Public Health. Class starts on June 3!

More features, more speed, more ease of use, same prices!

In January 2013, DataDyne will unveil a completely new version of EpiSurveyor — including a new name! Yes, we’re retiring the venerable “EpiSurveyor” — with 10,000 users in 170 countries easily the most widely used mobile data collection system in the development sector, and the most successful ICT4D (ICT for development) project ever — and replacing it with “Magpi”.

We chose Magpi (rhymes with “sky”) because we realized that a lot of people thought a product named “EpiSurveyor” could only be used for epidemiological surveys.

That’s understandable, but we want to make sure people know that EpiSurveyor is being used to collect all kinds of data: in health, agriculture, supply chain, consumer surveys, and more. So we’re losing the name.

More Than 40 New Features!

Our Nairobi development team has added more than forty new features, more speed, more ease of use — and all the same pricing, including the free version. Magpi is a completely new application, written from scratch, that works like EpiSurveyor (so you’ll have no trouble using it if you’re used to EpiSurveyor).

Mapgi’s beta testing is ongoing, and the 1.0 release will be in January 2013. Note: there will be NO interruption in service when we make the switch. Sign up for our mailing list to make sure you are notified when Magpi goes live! (if you’re an EpiSurveyor user, you’re already on the list).

Watch Magpi in Action!

And in the meantime, you can watch this video (made with the help of our friends at TechChange) of DataDyne CEO and co-founder Joel Selanikio demoing both EpiSurveyor and some of the big improvements in Magpi. The Magpi section starts at about the 3:25 minutes mark:

If you’re interested in mapping in crisis zones, consider taking our course Tech Tools and Skills for Emergency Management that runs from September 3rd – September 28th. 

Cross-posted from Greg Maly’s blog, Multitracked. He is currently working on a mapping based research project run by the University of Denver in New Delhi, India.

This past May we published a blog piece outlining some of the basic lessons learned from TechWeek at Korbel. One of the main takeaways was that technology solutions, though a potentially powerful set of tools, are only 10% tech and 90% people power.

This includes not only putting people in the drivers seat for the use of these tools over time, but also at the onset of any project when considering the need, or gap, they are intended to fill. A few months later, these lessons have become ever more salient as my team from the University of Denver works on the design of a maternal and child health monitoring system for the community of Jasola – a high risk population that borders the Yamuna river in New Delhi, India, and consequently suffers from high child and maternal mortality rates.

Keeping the importance of local ownership in mind from the onset of our project, and working with our local counterparts in the region – a Gender Resource Center (GRC) staffed by women who both live and work in the community – we began by holding a series of focus group discussions with the primary stakeholders in the region: young mothers and pregnant women, doctors who run small health clinics, and community health workers. In each meeting a number of grievances arose, from a lack of resources and shortage of doctors relative to the size of the population in the region, to the difficulties of maintaining effective communication between doctors and patients. As an example of the effectiveness community driven conversations, through these focus group sessions we learned that knowing the location of pregnant mothers was one of the greatest obstacles to routine checkups. This we could work with relatively quickly.

A simple fix was the breakdown of the community into the separate Mohallas, or neighborhoods, which are already well known to community members, but haven’t made it into any form of visual representation. A few afternoons of community mapping using handheld Garmin GPS units and an OSM update quickly fixed the problem and moved the conversation forward a few steps, allowing new ideas to unfold – many of which came from the GRC staff themselves.

Like many health projects around the world, this one has a long way to go. The problems are greater than any solution of this scale can begin to truly address. However, small wins like these slowly begin to even the playing field as communities become empowered to address problems one a time, and with sustainable solutions that do not require a large number of additional resources. In this case, we’re happy to report that community members are on board, including some young mothers who have joined the conversation. Updated maps are being connected with a system that will aim to track mothers from conception through to birth. And though our DU team is set to return home in just two weeks time, I can already tell that the community members see the benefit of this project, and are ready to push it forward with or without us for the long haul. Who knows – there might even be a tablet involved. Stay tuned.



Text to Change’s Chief Technology Officer, Marcus Wagenaar, sat down with me yesterday to discuss new projects on the horizon and innovations in the mHealth field.  Text to Change is an international NGO which uses technology for social change, or as Marcus puts it, “not just a tech company.”  Instead, outreach is where Text to Change works. As the knowledge bearers about mHealth systems and needs, they help design, conceptualize, manage and analyze outreach and projects with their implementing partners to address gaps in healthcare systems and information.

I asked Marcus to talk a bit about some of his favorite projects:


Mobiles for Reproductive Health (m4rh), in collaboration with FHI, uses SMS and web based software to send targeted messages about reproductive health.  The user gets their first message and is given 1-3 options for response, such as “if you want more information about condoms, text back 001.” They are then inside a tree of responses win which they can navigate back and forth and discover new information.  The project has been running in Kenya and Tanzania for over a year with pilots in Ghana and Rwanda underway. FHI provides the content and updates, Text to Change runs the IT backend in each country, all from Kampala.

m4rh is one of Marcus’ favorites because it’s “inherently scalable, once it’s set up anyone can access it for free by texting the first keyword to get the main menu” and it’s the “perfect example of Text to -Change because it provides people with information to make informed choices about their lives. In situations where information is lacking or inaccurate around sensitive issues of reproductive health, m4rh allows people to access information that can give them more control over their lives.  They still make their own decisions but at least they have all necessary information to make an informed choice.”

As example of its popularity; in May 2012 more than 40 thousand people have accessed the M4RH information service in Kenya alone. The specific information people access in the system is analyzed. Also, SMS surveys amongst users are carried out to enable deeper analysis of behavioral patterns. By combining this information various things can be deduced. Examples are: which contraceptives are popular in which age groups, what are the differences in male and female use of the system, are the choices people make influenced by the system, etc. These research results or not yet in the public domain but have been shared at various mHealth conferences and we hope to be able to share the results with a wider audience in the near future.

Medical Male Circumcision

The Medical Male Circumcision project, in partnership with Jhpiego in Tanzania and potentially Uganda, is a service hat sends information, similar to m4rh, as well as supporting patient recovery.  Individuals in the beneficiary population get messages regarding where they can receive Medical Male Circumcision and why it’s important, such as “Male circumcision can reduce the risk of female-to-male HIV transmission by 60%”.  After surgery, patients receive messages as soon as the surgery is complete regarding what to expect during their recovery. The Medical Male Circumcision project provides a Virtual Nurse who advises patients: “Make sure that you do not have sex for the first two days,” for example, or later on in the recovery “if your urine is discolored, visit the clinic.” The messages are “specific but lighthearted” with quiz questions every week to engage the patients and to assess how much they know about Medical Male Circumcision. Messages are meant to be encouraging and a “positive way to ensure recovery,” reduce stress, and “decrease health costs overall” by addressing concerns before they become serious health issues.

Text to Change monitors how many people they reach with their messages, how often they are reached, and how much it costs to reach a person. Researchers were able to show a statistically significant association between those men who texted in to the toll-free number asking where male circumcision was available and those who actually followed through and got circumcised. This is a good example of providing people with information to help them making informed decisions about their own health.

Data Collection

The data collection project is in the pilot phase with the Center for Disease Control in Tanzania within the mHealth Alliance. The project targets mothers after they have delivered and will speed up data collection about Vertical or Mother-to-Child-Transmission (MTCT) of HIV.  Currently, midwives and nurses fill in registers for mothers and babies to track their data by hand.  The individual patient data is rarely analyzed and often inaccessible to researchers and government representatives so that today there is no reliable number for the transmission rate for MTCT in Tanzania.  This Data Collection tool pilots a new form for tracking MTCT data, where healthcare workers take data from the standard register, write it on a worksheet and then copy it line by line and send it to a central location using SMS.  The data collected will allow the CDC to calculate the transmission rate for the first time in Tanzania and will enable impact evaluation of interventions that aim to lower the number of Mother to Child Transmission of HI, which is part of the Millennium Development Goals.

I also asked Marcus to give a window into exciting innovations in the pipeline:


FormHub is an Open Source initiative by Columbia University.  Text to Change is working with Columbia to develop and use their platform in the field. Text to Change is currently implementing this technology with one of their partners. The partner will conduct a survey in Uganda’s Luwero District, interviewing 1000s of teachers and students in secondary school about physical abuse, sexual abuse, living conditions, and emotional and physical wellbeing of children.  This is the first ever large-scale survey about these sensitive issues performed in Uganda. The partner designs the survey questions, Text to Change enables easy data collection using mobile technology and the formhub platform. Using cheap Android phones, 60 trained Ugandans will carry out the survey using FormHub.

Marcus also wants to use FormHub to automate data gathering in health and medical setting in remote clinics because it’s simple to use for the designer, data collector and data analist and it’s open source.  Many more interesting projects to come!


Vusion is a new SMS open source platform development by Text to Change. The backend is based on the Vumi system developed by the Praekelt Foundation.  Marcus sees Vusion as the next big thing in SMS messaging, and here’s why:

  • Vusion is focused on providing a scalable enterprise messaging platform
  • It can connects to multiple telecom companies and aggregators in multiple countries and multiple shortcodes
  • Once Vusion is set up, you won’t need a programmer to design campaigns or access data so it’s easy for non-technical project managers to use without programming skills
  • An API enables access to SMS data from external applications, which enables easy development of for example; advanced real-time data visualizations, website-widgets, twitter integration, etc.
  • Vusion has different access levels and enables organizations to implement and manage multiple SMS programs in parallel from one central platform.

Programmer? You can download Vusion from github and see what the skeleton looks like.

Some of the cost implications of SMS projects are annual dedicated shortcode fees and aggregator costs.  Vusion reduces this by enabling shortcode sharing. Users can use the same shortcode for small projects to share infrastructure and still be in full control over their campagins and projects  This is the approach Text to Change has been pioneering for years but Vusion will make it easier for organizations to be more involved in their own campaigns by having full access to their projects and the associated data.

Vusion was launched with an extensive demo on the 15th of June in Amsterdam. There is no recording of real-live demo but an accompanying presentation is available on slideshare.

Interested in learning about Mobiles for International Development? Check out our upcoming course, mHealth: Mobile Phones for Public Health, starting in November.