All posts by Carolyn Moore

Getting Started with Digital Health: New Guides and Resources

We know that mobile phones have the power to provide health workers with up-to-date training and information. Digital tools  can allow training to reach more people in their own communities. However, with so much training happening in person, and the wealth of information that’s available in paperform – where do we begin? How can we change our practices to incorporate new technologies into training and communication?

 

mPowering Frontline Health Workers, USAID’s Maternal and Child Survival Project (MCSP), and the Knowledge for Health Project (K4Health) hosted an event to look at this very question. During a presentation at MCSP, our teams shared tools and resources to help program managers, technical experts, and trainers begin to incorporate digital content and approaches in their work. Some of the resources we shared included:

  • K4Health’s Content Adaptation Guide: This interactive guide helps users understand how to adapt content to a new context, language, delivery mechanism, or other form. Through worksheets and case studies, users can practice changing existing content to make it meaningful to a new audience.
  • Creating with Mobile in Mind: This advocacy document explains why it matters to design materials and resources that can be used on a mobile device. Mobile-friendly materials matter, as more people now are accessing the internet for the first time on a mobile device than on a computer.
  • Creative Commons FAQ: Creative Commons licenses are important tools for sharing digital content. This document answers frequently asked questions like: Where can I learn more about available licenses? How do I choose the one that meets my needs?
  • Mobile Training Discussion Guide: Using digital health in a new or existing program can take a number of forms, but it always requires careful planning. This guide will help a team consider a new idea to integrate a digital tools and content into a training program. It asks questions about each phase of development, implementation, and evaluation; and provides space for teams to make notes.

We encourage you to access these resources, and contact info@mpoweringhealth.org with any questions. These are only a few of the tools that can help you integrate digital health into training and communications programs – for even more ideas, take a look at the mHealth Knowledge site or join the Global Digital Health Network. If you use any of these tools to develop a mobile training or product, send us an email and let us know.

By Carolyn Moore and Liz Eddy.
Images:
Midwifery students in Ghana use a tablet in training. Kate Holt/MCSP
Cover of Making Content Meaningful, K4Health

ORB Resources for World Water Day

On World Water Day, mPowering recognizes the role of health workers in improving access to clean water in their communities.

Our partners at UNICEF report that every day, 800 children die from causes related to poor sanitation, poor hygiene, or a lack of clean water. This number is tragically high, but only begins to tell the story of the health burden faced by the 2.5 billion people worldwide who don’t have access to improved sanitation. Frontline health workers, like community health workers and nurses, work every day to help their communities have access to clean water and practice healthy behaviors like handwashing with soap.

Through ORB, mPowering connects trainers and health workers with quality-assured, mobile-optimized training materials on topics related to maternal and child health, including water, sanitation, and hygiene (WASH). The new WASH domain on ORB holds resources that health workers can use to improve their skills and knowledge, like this mobile course on Urban WASH.  It also includes resources, like this video on handwashing that health workers can use to promote healthy behaviors in their communities.

Head over to ORB to view our WASH resources. If you have resources to share that meet the ORB criteria, click here to share them on ORB.

To learn more about World Water Day and how you can get involved, visit www.worldwaterday.org.

 

Photo Credit: Allan Gichigi/MCSP

A community health volunteer shows a woman the importance of handwashing after toilet use. Migori County, Kenya

Scale the Technology Now: Separating Content and Technology in Digital Health

At this year’s Global Digital Health Forum, I was excited to see the range of ways that digital tools are helping us move towards a healthier world. Despite the variation in the types of programs presented, two questions came up in nearly every conference session: “How do we get these approaches to scale, quickly and sustainably?” and “How can we evaluate these approaches to understand which parts are most effective?”

A new white paper from mPowering and Qualcomm® Wireless Reach™ proposes a simple solution to help answer these questions: separate the technology and its content. Scale the Technology Now balances public health and engineering perspectives to propose a new way of looking at the procurement, implementation, and evaluation of mobile health programs.

Most mobile health systems consist of two basic parts: a channel and its content.  For example, a smartphone (channel) can be used to distribute educational videos (content) to a health worker.

25149552100_39d6d2df98_m

Despite these two distinct parts, analyses of health interventions too rarely separate the functionality of the channel from the effectiveness of the content. For example, systematic reviews may consist of programs which only share the fact that the programs utilize technology, despite their separate methods, goals, and contexts. Viewing the technology and the content as a single element makes it difficult to accurately assess the success of either factor.

Scale the Technology Now reminds us that “In almost all cases… the engineering problem is ‘solved’ long before the problem related to the health intervention is addressed.” The crucial elements of a successful digital health system are found in the content, deployment, and context, rather than the basic functions of specific software or hardware.

This same idea helped mPowering develop the Open Deliver process for mobile content delivery. Open Deliver is a process-based solution designed to provide educational content to workforces in low-resource settings. It streamlines digital content delivery by reconfiguring existing technologies into a single integrated process. For example, Open Deliver enables content from mPowering’s freely available ORB platform to be structured through a learning management system and delivered to health workers via a user-friendly mobile application.

Separating content and technology increases our ability to create processes and systems that can cross sectors and easily adapt to improvements in technology. It allows us to see mobile training processes and technologies not as approaches for a specific audience or subject area but as distribution methods that could be used for health, agriculture, disaster response, or nearly any other area.

To learn more, read Scale the Technology Now: Applying Engineering Principles to Promote Rapid Deployment of Mobile Digital Content Delivery Systems, which was authored by Mike Bailey for mPowering Frontline Health Workers, with sponsorship from Qualcomm Wireless Reach. It is available on our web site here, and we welcome your questions or responses at info@mpoweringhealth.org

 

Photo credit: Kate Holt/ MCSP

Learn About Mobile Training at HSR 2016

Mobile technology is a powerful tool to deliver on-demand training to health workers, at scale. Join mPowering for a satellite session at this year’s Health Systems Research Symposium in Vancouver to learn how to design training for mobile delivery.

The interactive session, Open Deliver: A Process for Distributing Quality-Assured Digital Training Content, will introduce you to the steps, technology, and context to deliver training content to health workers via mobile devices. You’ll leave the session with an understanding of how to use open-source technologies to collect, structure, deliver, and evaluate training content for health workers.

The session will introduce and provide hands on experience on the technologies that support each step in the process, including mPowering’s ORB platform. You will have the opportunity to try out a range of technologies, including OppiaMobile, an app for mobile learning. We’ll also discuss key contextual factors, with examples from Guinea, Nigeria, Zambia, and more.

Join facilitators Mike Bailey and Carolyn Moore of mPowering Frontline Health Workers, with Huguette Diakabana of eHealth Africa Guinea, to learn how you can use mobile technologies to enhance health worker training efforts toward stronger health systems. Bring your questions and lessons from your own experience – we look forward to seeing you there!

The Open Deliver satellite session takes place on November 15th, from 3 pm to 5 pm. For more information on the 2016 Health Systems Research Symposium and satellite sessions, visit http://healthsystemsresearch.org/hsr2016/.

How to Support Community Health Workers? Reflections on a year of global learning

This month, mPowering will be responding to the World Health Organization’s call for public input into the development of guidelines on community health worker (CHW) programs. In preparing our response, we’ve been reflecting on our last 12 months of global learning activities on the roles, needs, and potential of community health workers.

Over the last year, we have heard from governments, health workers, trainers, donors, private sector, and more. Three international events coordinated by mPowering have provided opportunities for dialogue between major actors in the health sectors in both West and East Africa. Even with the diversity of CHW roles and programs around the world, key messages have emerged.

15294793889_416454800f_m (1)

Image: A CHW in Mozambique greets a patient at her home.

Well-supported CHWs make an impact.

The Ebola crisis highlighted communities’ critical need for health care from a trusted, accessible source. CHWs can fill this need, but they in turn need support – like training, supervision, and supplies.  When these supportive elements are weak or missing, CHWs are less able to give the care their communities need.

Writes Shelby Wilson, Program Officer at the Bill and Melinda Gates Foundation, “Ebola highlighted the need to understand what makes a community health worker program successful, and how the design of those programs should be influenced by the structure and financing of primary health care in those countries. Not having a clear answer to these questions undermines the work of countries, partners and donors, and, as a result, limits our collective capacity to have a real impact.”

At our  Unlocking the potential of the community health workforce conference at Wilton Park, governments, training implementers, and donors came together to move towards true collective impact for CHWs. Delegates presented successful CHW models including effective training; supporting health workers through structured supervision and mentorship; and recognizing and rewarding CHWs. The challenges, participants acknowledged, lie not only in implementing each of these models, but in tying these lessons together into a comprehensive approach.

25149552100_39d6d2df98_m

Image: Health workers in Ghana play an educational game.

 

Technology presents new opportunities to support health workers.

Technology can and should be an integral part of this comprehensive approach. Information and communication technologies (ICTs) can help community health workers learn and use information, collect and share data, and communicate with their supervisors and each other. Three major factors make this possible: a well-functioning health system, a strong ICT system, and a diverse set of genuinely engaged partnerships.

At our (Re)Building Health Systems after Ebola event at Wilton Park, delegates discussed  the importance of CHWs in rebuilding health systems in West Africa, and the role of ICT and mobile to support them in their  work. Key points included the high degree of coordination required, not only between Ministries of Health and ICT, but also between donors and implementing partners, to develop and sustain strong health systems.

In April, mPowering convened senior level representatives from the Ministries of Health and ICT in Malawi and Senegal together with donor agencies, private-sector partners, and implementing partners. The Collaboration for Scaling Digital Health event discussed how to create stronger cross-sector collaboration between health and ICT authorities to improve health service delivery and health outcomes.

Over two days, participants addressed the systems and infrastructure required to support a comprehensive digital strategy, including investment in frontline health workers to use digital health tools and make decisions using health data.  There was strong agreement that country investment strategies require greater coordination between government ministries, as well as between funders, to avoid duplication and ensure smart investments.

26924988976_46c925febf_m

Image: A CHW in Kenya at a weekly mothers’ meeting.

Work Remains to Build the Systems that CHWs need.

CHWs work in the face of enormous challenges. Technology shows great promise to help address well-documented and long-standing problems around training, supervision and other support. Many governments are making progress, and increasingly integrating the use of mobile as part of health systems strengthening at the community level. But as participants have told us, across many conversations and events, much more needs to be done.

One of the major recommendations from our expert interviews on CHWs was to “Invest in health systems so that…care given by CHWs is amplified by a skilled, trained workforce.” Experts noted that the sustainable funding of these systems remains a challenge in the context of growing health worker shortages and evolving public health needs. They urged a need to explore new and non-traditional ways of funding health systems and workforces.

As Katie Taylor, former Deputy Assistant Administrator, Global Health, at USAID wrote, “[There is a] need for national governments and development partners to substantially increase investment in Community Health Workers as part of integrated health care systems. We need financing solutions to be shared, adopted and adapted, as well as spur thinking on new ones.”

Join the Conversation.

WHO’s guidelines aim to advise governments and their partners as they design and support CHW programs that advance progress towards universal health coverage. Your experience and perspective can help frame their guidance.  WHO’s online hearing is open through August 31, 2016. To learn more or to submit your response, click here.

All photographs used in this post credited to Kate Holt/ MCSP.