Mhealth tools can be deployed with many functionalities, such as: data collection, point of care, logistics, remote monitoring, treatment adherence, education awareness, training, and disease tracking.
While in many cases, tools are developed to be use for one type of application only, there are some experiences where mhealth applications can respond to more than one need. A clear example is RapidSMS , an open source tool that has been deployed in support of remote monitoring, logistics, nutrition surveillance and education awareness.
While UNICEF initially developed RapidSMS using basic mobile phones and SMS messages to collect information from field workers and improve the speed and quality of data collection, it is now being used for all sorts of non-UNICEF technology for development projects.
In Malawi, for example, it was used to monitor malnutrition conditions in children under 5 years old. A simple sms containing coded information about age, weight, height and MUAC tape value of the child was sent by sms and displayed on a web platform through the RapidSMS system.
In Rwanda, RapidSMS was tested in the district of Musanze in the second half of 2010 with the objective of reducing maternal and newborn death rates and supporting antenatal, postnatal care and newborn health and nutrition. The project is based on ensuring key points of contact between women, children and health care providers. To prevent negative outcomes and deaths from occurring in pregnancy and childbirth, the project follows the three critical factors which may stop women and girls accessing the levels of health care which they need:
– Delay in decision to seek care
– Delay in reaching care
– Delay in receiving adequate health care
The integration of innovative Tech tools to facilitate two way communication between patients, healthcare providers and supervision cadres will help to both identify emergency conditions that demand immediate care and critical events in programming that demand immediate management response. The communication also allowed improved response with the system of ambulances to deliver women and children to the care providers.
CHW (Community Health Workers) were supporting local communities in the provision of medical care, their comments were sent to medical centers or hospitals in order to help them getting ready to assist patients arriving at hospitals, at the same time ambulances were receiving alert messages to help them managing critical situation. The project was successful and in 2012 the use of RapidSMS was escalated at national level.
The system could definitely be improved for example by sending back information to CHW, having a better control of the costs, improving management of mobile devices or investing more in training of CWH. However, the success of RapidSMS in Musanze was determined by the fact that a lot of women returned to the health posts to receive ANC (Antenatal Care), the number of home deliveries were reduced and newborns received immediate care from the day of birth, reducing maternal and neonatal death rates.
An evaluation pre-post the introduction of RapidSMS demonstrated the success of the project, that monitors over 14000 pregnancies per year. (UNICEF Rwanda Country Office, 2010). Following the project implemented in Rwanda, the same RapidSMS application has been set up in Burundi throught th KiraMAMA project in 2015.
The Ministry of Health Burundi recognized the urgent need to reduce maternal and child mortality. With the support of UNICEF Burundi, the launch of the KiraMAMA project intended to improve delivery of maternal and neonatal health services. This innovation project gives an opportunity to evaluate of the introduction of new technologies to accelerate mortality reduction. The project will build on the comprehensive RapidSMS based reporting and analysis tools developed in Rwanda.
The project will be piloted first in two provinces (Gitega and Muyinga). The experience in these two provinces will provide feedback for any needed corrections before scaling the project to national level. The project is expected to support both the medical system and to encourage positive changes of social norms in the community.
Using text message, CHW register new pregnancies, births, deaths, vaccinations and control the weight of newborns to monitors the child development.