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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.

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

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

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“.

Filming of Malaria Consortium staff doctor counselling a client on proper treatment of malaria. Uganda. (Photo credit: Maddy Marasciulo-Rice, Malaria Consortium)

Malaria in Context

There is an undeniable malaria problem in the world today. According to the World Health Organization (WHO) in March 2014, half of the world’s population is at-risk, hundreds of millions of cases are reported each year, and hundreds of thousands die annually of this disease. Around 90% of these cases occur in Africa, with children under 5 years old making up the largest demographic affected.

The burden of this disease on the health care systems of developing countries is immense: Uganda has the highest malaria incidence rate in the world with 478 cases per 1,000 population per year. Fully half of inpatient pediatric deaths in Uganda are caused by this disease and in Nigeria, the most populous African country, 97% of the population is at risk.

(Source: WHO 2013 Global Malaria Report)

How are the countries of Uganda and Nigeria addressing malaria?

While both Uganda and Nigeria have national malaria control and elimination programs, due to long waiting periods and frequent stock outs of the appropriate medications at local health facilities, individuals prefer to go to private clinics, pharmacies and local drug shops to solve their health needs. When these pharmacists―often untrained in accurately diagnosing febrile illnesses―see a client complaining of fever, they often presumptively prescribe antimalarial medicines. The reverse scenario is also a common problem: pharmacists do not always give out artemisinin-based combination therapy (ACTs) when it is actually needed.

Pharmacists in Uganda assist customers with recommending antimalarial medications (Photo credit: Maddy Marasciulo-Rice, Malaria Consortium)

Presumptive treatment ― the overuse of antimalarials greatly increases the chances that malaria parasite resistance will develop and spread. In the future we might have one less weapon in our arsenal against these parasites. This overuse also means that the medicine is put over

How can rapid diagnostic tests (RDTs) help treat malaria?

Fortunately, rapid diagnostic tests, or RDTs, allow malaria to be diagnosed quickly, accurately, and cheaply, using only a drop of blood and a few drops of a solution. The problem is―there is no official quality control within the private healthcare sector―the pharmacists who provide the RDT to the patient have no way to choose a good RDT from the many options on the market and the wrong choice could lead to inaccurate diagnosis. Furthermore, many of the RDT sales representatives haven’t been trained to properly explain their product to their clients.

Challenges of RDT Training for Malaria in Uganda and Nigeria

RDTs to test for malaria and drugs to treat the disease are currently available in the private healthcare sector. However, there are several challenges to scaling up RDTs in this sector in Uganda and Nigeria.

1. Lack of training with Rapid Diagnostic Testing Materials

The primary barrier to appropriate care is the lack of training among pharmacists and RDT sales providers about how to use the test and interpret the results correctly to effectively diagnose and treat a range of febrile illnesses.

Malaria Consortium, based in the UK, is one of the world’s leading non-profit organizations specializing in the prevention, control, and treatment of malaria and other tropical diseases. Their projects can be found across twelve countries in Africa and Southeast Asia. The organization strives to find effective and sustainable ways to control and manage malaria through research, implementation, and policy development. They came up with the design for a plan that could greatly help manage the disease in both Nigeria and Uganda:

If the RDT sales representatives and RDT providers can be trained to correctly use the RDTs and recognize the symptoms associated not only with malaria but with other common illnesses, then the burden of misdiagnosis and mistreatment can be greatly reduced. Furthermore, as the sales representatives travel and frequently interact with providers, they can act as trainers and further disseminate the knowledge and skills necessary to accurately diagnose and treat these diseases.

2. Prohibitively high costs

The costs associated with arranging such a training are enormous―between transporting the students and teachers to a centralized location, renting a venue, arranging lodging, and coordinating a schedule, the budget for a large-scale training would quickly be out of control. Additionally, pharmacy owners and other stakeholders working in the private sector would most likely have to assume a loss of revenue during their time away from their business while at a training.

3. Technical limitations

An eLearning platform is much more ideal for these circumstances―it’s flexible, participants don’t need to travel far, you need fewer instructors, and the information can be processed at the student’s pace and repeated when necessary. The information is also standardized and consistent, which means that a large number of people can benefit from a high quality training experience.

But how do you deliver an eLearning course when your audience has intermittent power and whose computers are not only often out-of-date, but lack the RAM, bandwidth, and software standards that such hi-tech learning platforms have come to expect?

eLearning Solutions for Reaching 3000+ Healthcare Providers for Malaria

Malaria Consortium partnered with TechChange to build a comprehensive digital course to train private sector health workers and RDT sales representatives in this context. This 11 module course includes around 400 slides for 6 hours of content takes participants through the biology behind the malaria parasite, discusses the medical philosophy behind diagnostic practices, and walks users through interactive scenarios for patients presenting a range of symptoms.

Sales representatives and drug store owners in Uganda testing eLearning modules designed by TechChange and Malaria Consortium on rapid diagnostic testing for malaria. (Photo credit: Catherine Shen, TechChange)

1. Offline access and Ease of Use

Despite significant benefits such as flexibility and scalability, e-learning courses also face challenges in the developing world. Lack of sufficient internet bandwidth, reliable computers, and computer skills can pose major barriers to a training’s effectiveness.

To troubleshoot the technical issues, this course is designed to require nothing more than a computer and headphones – it comes preloaded onto USB drives so not even an Internet connection is necessary, allowing health workers in even the most rural areas to access this training. A computer tutorial is also included for health workers with little to no prior experience with computers. Our tech team is also devoted to helping solve any other technical issues that arise due to out-of-date software and hardware malfunctions, working as a remote IT team as Malaria Consortium rolls out the project.

2. Localized content

In addition to including the relevant national laws, case studies, and local examples, the narration features Nigerian and Ugandan voice actors, art, and scenarios to make the training as culturally-relevant as possible.

3. Hybrid learning

Only one part of the training won’t be computer-based; participants will still practice actually conducting the RDT tests in a face-to-face session before they begin pricking patient’s fingers for diagnosis.

The course is designed to reach upwards of 3,000 healthcare providers in the two countries and build their capacity to effectively serve their community’s needs. We look forward to seeing the impact of this training in improving quality of care in Uganda and Nigeria hopefully in the near future.

To learn more about TechChange’s custom training solutions, please contact us at info@techchange.org.

Emily Fruchterman, Catherine Shen, & Charlie Weems contributed to this post.

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.

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

Cutting-edge, timely, and relevant information

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

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.
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.
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.
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

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.
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.
Practical exercises and interactive simulations ensured knowledge application and exchange.
Individuals got to know each other through a variety of “get to know you” activities and collaborative exercises.
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

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).
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 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.

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 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.

After a study-abroad semester in Spain and a summer at TechChange in Washington D.C., Emily Fruchterman is heading back to William & Mary to finish the final year of her undergraduate career. Before heading to Williamsburg to finish her Biology degree, she looks back on her summer internship at TechChange as an educational technologist.

1. How did you hear about TechChange?

At the start of 2014, summer internships were the last thing on my mind. I was off to spend the semester in Seville, Spain, and any thought relating to life-after-study-abroad was a painful reminder that my time in paradise wouldn’t last forever.

When my final exams forced me to face reality, I wasn’t quite sure where to start my search (the ocean between me and potential employers seemed pretty daunting). A friend referred me to internships.com, where I found out about TechChange.

2. Why did you choose TechChange to spend the summer between your junior and senior years?

TechChange piqued my interest with its goal of using the power of technology to advance social change. The broad range of courses that demonstrate the utility of technology to a very international audience showed me that this was more than a cursory commitment. Contributing to an organization with such goals seemed like a worthwhile way to spend the summer.

On a personal level, TechChange seemed like a great complement to many of my previous experiences at nonprofits and NGOs doing research while giving me new exposure to a startup culture. TechChange’s upcoming projects also aligned well with my interest in public health, plus the networking opportunities afforded by spending a summer in DC seemed too good to pass up.

3. What are your interests?

While I’m generally interested in the field of development, my passions really lie with public health. I’d really like to work for organizations (like TechChange) that have projects relating to the various aspects of health and healthcare – although my dream is to work for an organization that coordinates healthcare responses and works to improve health outcomes on an international basis. I’m also an avid coffee drinker, science fiction fan, and aspiring flamenco dancer (my time in Spain might have influenced this last one).

Emily goes over how to create an online course with the TechGirls on TechGirls Job Shadow Day

4. How did you use your TechChange internship to explore your interests?

Fortunately for me, TechChange had several different public health related courses this summer. I was able to engage with a course on Malaria, for use in Nigeria and Uganda, as well as take on a large part of a facilitated course on HIV for clinical and non-clinical care providers. Both of these have been extremely valuable experiences, as I’ve not only learned a great deal about both illnesses, but also looked at how to structure health-related interventions and training programs.

5. What did you do at TechChange this summer? What was your role at TechChange?

The instructional design team was finishing up a self-paced course on Malaria when I arrived in June. I was not only able to help with edits and testing, but built a few interactive elements. I got more experience building out lessons, writing storyboards, and coming up with engaging lessons while working on other instructional design projects.

I got my first taste of the facilitated platform as a teaching assistant (TA) for a course on Social Media for Social Change, during which I familiarized myself with WordPress and the structure/pacing of a four-week course. This came in super handy, as a couple weeks later I started to manage content development and build out the four modules for the course on HIV treatment. I also helped write several blog posts relating to projects, participated in meetings with clients, and taught the TechGirls from Tunisia and the Palestinian Territories how to create online courses.

6. What did you learn during your time at TechChange?

The first big thing I learned was how to use Articulate Storyline. This eLearning program might look like a fancier version of PowerPoint, but it has it’s tricks and idiosyncrasies. It was very cool to learn how to create interactions, design variables, and troubleshoot glitches to develop quality modules. This was super useful, as it helped me think about learning in a much more user-centered way.

I also learned to be much more comfortable in front of the camera – while I still had my fair share of outtakes, it became a lot easier to speak to a blinking red light instead of an audience. I learned how to manage time during interviews, ask the right kinds of questions, and (most importantly) what to do with my face when I wasn’t the one talking.

My tech skills also improved – my co workers tried to show me some coding basics (parts of which I picked up on better than others), I increased my audio editing abilities, became super familiar with WordPress, created several graphics, and set-up and took down AV equipment.

I also improved my communication skills by working closely with various members of the team on different projects and writing emails/participating in phone calls with clients.

Emily in the recording studio at TechChange before recording a live session for a course

7. Did your TechChange experience end up going as you expected?

In some ways – based on my impressions of TechChange from their website and my interview, I’d expected to find a group of young and tech savvy individuals interested in promoting social change.

I hadn’t expected how much support they’d give me for pursuing my own ideas from the get-go. I think it was my second or third day here that I suggested an interaction be added to a part of a self-paced course to a member of the instructional design team. The response I received – “great, want to build it?” – really surprised me. I’d barely started learning the program, was still figuring out where I fit in, and yet was already being offered the chance to work on the product. This “great, want to build it?” philosophy was present throughout my internship here – I had a lot of flexibility and opportunity to build off of assigned tasks.

8. Would you come back to work at TechChange one day? Why?

Yes, and without a second thought. TechChange has to be one of the best work environments I’ve ever encountered; it’s fun and collaborative, the work is engaging, and the company is small enough that everyone can play a variety of roles. You might be hired as an educational technologist, but you’ll have the chance to do a little bit of graphics editing, write blog posts, sit in on business development meetings, teach a course, and have your voice featured in animations.

More importantly, this work has real value. The courses developed by TechChange are used by different organizations around the world to train staff members and health providers, as resources to newly-formed NGOs, and to put the spotlight on the role technology can play in the developing world. TechChange collaborates with organizations that work for real, sustainable change, and TechChange alumni go on to do incredible work. Being a part of this team has been a wonderful experience.

9. What advice would you give to future TechChange interns?

Take initiative! This is an awesome opportunity to grow your skill set – make use of that. If something needs to be done, volunteer to do it. Even if it’s not something you’ve done before, the team will support you and make sure you learn how to do it well. The TechChange team is also super supportive – if there’s something you want to learn about (even if it’s not directly related to your job), they’re more than happy to help.

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.

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).

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

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.

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.

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.

A group of girls in Zambia learn about Zambia U-Report (Photo credit: Mark Maseko – UNICEF 2013)

Information Communications Technology for Development (ICT4D) holds exciting promise, especially on the African continent where we have so many systemic problems that could benefit from different mindsets and new ways of looking for solutions. When I was making my first serious foray into the world of ICT4D in 2012, I first heard about TechChange courses from a friend. When I went to the website, I was very excited to see that they were offering courses that I had been trying to take and hadn’t been able to find anywhere, least of all in Zambia. My plan was to take one course in mHealth: Mobiles for Public Health but the course was so interactive and I learned so much from the course content, online sessions and other learners’ experiences that I ended up taking the following 3 courses in just about as many months!

The result: Zamba U-Report, a SMS-based youth counseling and engagement platform that allows young people to ask trained counselors questions, take part in polls and influence decision making at policy level.

Here are some of the lessons I have learned through my course work at TechChange and applying them to ICT4D in Zambia:

1. Validate the need for your solution
Before diving into an ICT4D solution, focus on the problem you’re addressing first and establish if there is a valid need for the solution. Too often, a tremendous amount of resources are wasted when people jump ahead to create a ICT4D solution first and then try to find a problem to wrap around it.

In building Zambia U-Report, we first identified the problem as high HIV infection rates among young people in Zambia.

2. Involve the end users
Make sure you’re not just building solutions from your desk at an office. The end user of the solution must be involved in the very initial design of the solution, and give feedback throughout the process of prototyping and quality assurance (QA). You would be surprised at how often the community you are trying to help may already know what needs to change to improve their lives.

After identifying Zambian youth affected by HIV, we then involved them in designing the U-Report SMS solution and coming up with the key strategic objectives. These young people regularly give feedback and are involved in any further planning or reviews of the programme. The first year of this program’s pilot in 2 provinces has seen 50,000 young people voluntarily sign up and engage the 24/7 trained counselors by asking them questions on HIV, STIs and other sexual reproductive health issues.

3. Invest in continuous learning to keep up with ICT4D issues
TechChange courses have enabled me to better articulate and sell the idea of using technology for development to my office and I was able to contribute to various projects including one I am very proud of, the Zambia U-Report (an SMS-based youth engagement and HIV counselling platform). I have since changed jobs from ICT Officer to Innovations/Technology for Development (T4D) Officer.

To get the most from these courses, students need to commit the time required to write the blogs, take part in class conversations, read recommended materials, and engage with the instructors and other participants. It is always interesting and there is always something new to be learned from the very diverse group of people you meet in any given TechChange course.

Of course, there are more lessons learned in implementing an ICT4D programme and I would like to engage other industry practitioners. Looking forward to taking the Technology for Monitoring and Evaluation course as it will tie in very well with my work with programs helping adolescents and young people!

Priscilla Chomba Kinywa is the Innovations and T4D Officer at UNICEF Zambia. She holds a BSc Business Computing, CCNA certification, a post-graduate Diploma in Business Administration and various certifications in using technology tools and skills for international development work including TC105: Mobiles for International Development, TC309: mHealth – Mobiles for Public Health, and TC103: Tech Tools and Skills for Emergency Management. Priscilla has more than 13 years’ experience in ICT, working with WFP for six years and UNICEF for seven. She has also supported the creation of different innovative solutions to challenges that face Zambian children, adolescents and women. Among these are Zambia U-report, a SMS-based youth counselling, engagement and participation platform that has over 58,000 young Zambians signed up; and Programme Mwana, an intervention that uses SMS to reduce the time it takes for HIV test results for infants to reach a mother in rural Zambia from the labs in Lusaka and Ndola. Also see Priscilla’s work highlighted earlier this year on UNICEF here.

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

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:

Highlights:

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

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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.

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

Posted by TechChange alumnus, Neelley Hicks, ICT4D Director of United Methodist Communications.

Mobile phones seem to be everywhere in Africa, and they’re keeping people in touch with health, education, banking, and community empowerment.

“Email and Facebook are problems…but this text messaging – it’s no problem,” says Betty Kazadi Musau who lives in the Democratic Republic of Congo (DRC).

In early August 2013, I spent the week with Mercy Chikhosi Nyirongo, who provides healthcare in communities in Malawi. Recently, she took an online course through TechChange called “Mobile Phones for Public Health.” She wondered what impact mobile phones could have on her health program in Madisi, so she conducted a test.

The problem: HIV+ men were not coming to the support group and health management classes.

The test: Separate into two control groups – one would receive text reminders about the next meeting and the other would not.

The results: Out of the 20 who did not receive text messages, five attended. Out of the 30 who did receive text messages, 25 attended and were standing in queue when she arrived.

One client said, “You reached me where I was.” This isn’t a small thing. Often community health workers 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 conducted this test directly through her mobile phone and it took her nearly all day. But with FrontlineSMS, she can enter mobile numbers easily for group messaging. She said, “After the online course, the UMCom workshop (in Blantyre), and these conversations, my eyes have become wide open.”

Join us in our next round of Mobiles for International Development and mHealth: Mobiles for Public Health online courses!

To read the original post on Neelley’s blog, “Stories in ICT4D”, please click here.

What if your old phone could help improve the health of populations in developing nations? Did you know that 500,000 cell phones are discarded in the United States every day?

TechChange is donating phones to empower global health practitioners in developing countries via Medic Mobile’s Hope Phones mobile donation program. The program’s goal is to responsibly reduce hazardous waste from mobile electronics while simultaneously promoting public health in developing countries.

When Nick Martin and Medic Mobile’s president, Josh Nesbit, last met during PopTech 2013, they instantly connected over their common interest in mHealth. Although the number of mobile phones and mobile subscriptions are increasing worldwide, there is still a significant need to empower global community health workers with these tools to promote better health for more people. According to the Medic Mobile, “If we can recycle just 1% of disposed phones each year, we can outfit 1 million health workers, improving the lives of 50 million people.”

There is also a need to learn the latest best practices and innovations in mHealth. Learn how you can donate your phone here and join us in our upcoming mHealth online course with the mHealth Alliance! This course regularly attracts an exciting global community of doctors, public health practitioners, mobile service providers, health research specialists, and others to learn how mobile technology can address HIV, tuberculosis, maternal health, vaccinations, and improve healthcare delivery. Hope to see you in the course!