Health Management Information System (HMIS)

Up to now it can take three months before results from HIV tests would be reported. For a baby such a long delay in starting treament is fatal. In order to dramatically reduce the reporting timeline, several organizations and the Kenyan Ministry of Health teamed up to develop a solution based on mobile phone technology and cloud computing, replacing the current paper-based process. A scalable internet platform allows to gather data on a central server, structure workflows, deliver test results and  and produce activity reports on short notice. The partners expect that implementation of this platform can reduce the timeline for test result delivery to 2 weeks, allowing for appropriate, timely treatment.

This initiative uses a combination of mobile phones, SMS messages, a configurable campaign management platform and electronic mapping technology to generate information on stock availability of artemether-lumefantrine, ASAQ, Amoxicillin and rapid diagnostic tests. The information is collected weekly and made available in a set of reports, graphs, charts and maps to the Ghana Health Service. This visibility is meant to avoid stock-outs and ultimately to reduce the number of deaths from malaria. The pilot project in six districts launched in July 2011 and will run for 21 weeks to test it's effectiveness and suitability for a nationwide roll out.

Capacity Kenya had to manage and communicate with over 700 health workers hired under a rapid hiring plan and deployed to remote villages. Communication needs such as submission of timesheets, payroll-related queries or regarding accountability had to be done by postal mail, costing considerable time, or by landline phones, suffering from expensive and unreliable services. Based on a needs assessments a bulk text messaging system has been piloted, helping to streamline and speed up communication. Improvements include regular, more cost effective communication with staff via SMS, resulting in higher compliance rates in timesheet submission and improved response rates from staff.

"In June 2010, the SURE Program in partnership with the SPS project pioneered the use of mobile phones in collection of facility data for Presidential Malaria Initiative (PMI) End User Verification (EUV) activity in Uganda. The objective of the survey was to generate data for verifying the availability of malaria medicines and commodities at the end user level and for monitoring the treatment of malaria cases in facilities.

This was made possible by use of mobile technology developed by DataDyne- a Kenya based IT firm. The technology, hosted on a website (www.episurveyor.org), provides open source software for designing data collection forms online and downloading them on mobile phones. The phone user then activates the forms on the phone and is ready for data collection.  This removes both the creation of a database and the need to manually input data. As a result, costs, time and skill set and financial resources needed are significantly reduced. [...]

The SURE pilot survey proved that mobile phones can be adapted for data collection."

[projection description from SURE.ug, see below]

EpiSurveyor is a free mobile phone- and web-based data collection system. It is e.g. used for the collection of information regarding clinic supervision, vaccination coverage, or outbreak response, and it helps to identify and manage important public health issues including HIV/AIDS, malaria, and measles. As of April 2012, EpiSurveyor, home based in Kenya, has nearly 8,000 users in more than 170 countries worldwide including the US, Kenya, Guatemala, the UK, Tanzania, India, Pakistan, Mali, the Philippines, Zambia, Malawi, Nigeria, Peru, Brazil, Indonesia, and Liberia, making it the most widely-used mHealth software. Also included are the 15 sub-Saharan African countries where it has been implemented in conjunction with the World Health Organization's African Regional Office (WHO/AFRO).
Examples: In 2008, Kenyan health workers used EpiSurveyor to track an emergency vaccination campaign against polio and managed to stop a potential epidemic in its tracks. In 2010, the application was successfully trialed for feasibility and scalability in a pilot in Malawi to monitor the availability of malaria medicines with mobile phones.

Since 2003, 175 remote health facilities serving more than 1.5 million people are able to send and receive data and medical updates using PDAs. The system is used to transmit disease surveillance data, reports related to HIV/AIDS, tuberculosis, malaria, and data for monitoring drug usage and stocks. Capacity building among health workers is achieved through regular broadcasts of content pertaining to diagnosis, treatment, and prevention of major health problems.

This initiative uses a combination of mobile phones, SMS messages and electronic mapping technology to generate information on stock availability of Artemisinin-based Combination Therapy (ACT) and quinine injectables and delivers it on a weekly basis to all health facilities. This visibility is meant to avoid stock-outs and ultimately to reduce the number of deaths from malaria. The pilot project in three districts launched in 2009 resulted in a significant increase in the number of health facilities that had at least one ACT dosage form in stock and in the number of people that had access to all malaria treatments at the close of the pilot. Based on the successful pilot, the public-private initiative behind SMS for Life announced the nation-wide roll-out across 5,000 health facilities in April 2011.

The system was designed to collect, store, retrieve, and disseminate critical programme, drug, and patient information related to HIV/AIDS care and treatment. It allows health workers to report data from the field using mobile phones, as well as PCs and PDAs. The data is mapped and analyzed automatically and immediately available to health authorities via the web. The system also supports SMS alerting and notification.

The Ghanaian government instituted a National Health Insurance Scheme in 2003 to remove the financial barriers to quality health care for the poor. The 2-year project launched in 2009 developed an open source monitoring tool for use on handheld mobile devices to collect and share data on whether the poor are actually benefiting from the scheme. Using mobile technology enables the transmission and sharing of data with grassroots organisations and others despite a generally poor communication infrastructure.

mPedigree developed a SMS-based system to fight the exploding appearance of counterfeit drugs in developing countries. The scratch card method reveals a single-use numeric code on drugs that users can text for free from their mobile phone, instantly receiving information if the drugs are genuine or counterfeit.The system is operational in Ghana and Nigeria since late 2010. A pilot in Kenya was underway in early 2011 with the aim to scale it up.