Category Archives: Kenya

July 26, 2012 · 4:07 pm

mHealth in HIV/AIDS Programs: Exploring its Impact

By Michelle Betton

mHealth (mobile health technology) continues to be a big theme at this year’s International AIDS Conference. Wednesday morning, representatives from the Elizabeth Glaser Pediatric AIDS Foundation, Cell Life, the International HIV/AIDS Alliance, and the mHealth Alliance discussed various mobile technology interventions in HIV and AIDS programs.

EGPAF’s Dr. Apolinaire Tiam from Lesotho

mHealth is currently being used for many different interventions, including education and awareness, supply chain management, training for health workers, and monitoring and evaluation. The work of the panel participants focused on HIV/AIDS interventions in South Africa, Kenya, and Lesotho.

Dr. Peter Benjamin of Cell Life described the work of his organization, which uses technology to improve health and to meet social challenges. Cell Life works in 10 countries in Africa, primarily in South Africa, creating open source eHealth (electronic health) technology. Their products are used in social and behavior change communications, health systems strengthening, and policy amongst other topics.

Caricia Catalani of InSTEDD presented a literature review that delved into the question of whether or not evidence exists proving that mHealth is effective. From her findings (based on 62 articles focused on HIV/AIDS program studies), it remains unclear whether or not mHealth is effective overall in combating HIV/AIDS barriers. Several interventions have been quite effective, such as those focused on youth, community health workers, appointment and adherence reminders, and TB care, while others have not shown conclusive evidence of effectiveness. Catalani stressed that increasing local and end user development of mHealth technologies would likely increase the usefulness and effectiveness of these interventions.

Following on Caricia’s presentation, Evelyn Kibuchi of the Kenya AIDS NGOs Consortium (KANCO) described how a mapping system of facilities and clinics across regions makes facilitation and referral of services easier. Consortium member organizations enter their location and contact information into a database that then shows which services are provided in a given region, and exactly where. This makes it easier for clinics to refer clients if necessary, and helps clients facilitate transportation. In future, KANCO intends to begin sending SMS messages with information on services locally available. There is also the possibility of clients finding and receiving home-based care based on organizations in their vicinity.

EGPAF’s own Dr. Appolinaire Tiam discussed the impact of 3G technology and laptops in Lesotho. Because of Lesotho’s mountainous landscape, HIV test results can take up to 12 weeks to return to families. The Foundation’s Lesotho program acquired laptops with 3G technology for district clinical coordinators, allowing the program to receive digital lab results and send them to families in four weeks instead of 12. Tiam noted that, before the 3G-capable laptops, 55 percent of children who waited for more than two months for HIV test results died before receiving then. With 3G technology in clinics, child deaths have decreased to 5 percent.

While evidence is still inconclusive and barriers still exist to optimal effectiveness of mHealth interventions, there is some evidence that mHealth can have a considerable impact on the health of those affected by HIV/AIDS.

Leave a Comment

Filed under EGPAF, Kenya, Lesotho, mHealth, South Africa

Tagged as , , , , , , , , , , , ,

July 23, 2012 · 4:53 pm

Using Mobile Technologies to Eliminate Pediatric HIV: Evidence the Future is Bright for mHealth

By Michelle Betton

Photo: Dr. Seble Kassaye (Left) and Dr. John Ong’ech (Right)

Mobile health technology (mHealth) is a pretty hefty topic to delve into at 7 a.m., but this morning’s mHealth presentation at IAS – sponsored by the Elizabeth Glaser Pediatric AIDS Foundation, mHealth Alliance, and Johnson & Johnson – provided encouraging insight into how mobile technology can positively affect pediatric HIV work.

Several studies over the past few years have highlighted the impact of mHealth on pediatric HIV, which were cited by William Philbrick, consultant with the mHealth Alliance. Findings showed that when receiving SMS (short message service) messages and reminders, women were more likely to attend antenatal visits – one study showed this increased by as much as 25 percent through the use of mobile phones. Additionally, women were 57 percent more likely to adhere to HIV treatment when receiving SMS reminders and health information. Other areas in which SMS messaging has improved outcomes are exclusive breastfeeding, stigma, and water and sanitation.

EGPAF’s Seble Kassaye described a pilot study in Kenya to address the high prevalence of HIV in Nyanza Province. Kenya was a good test case, as 63 percent of Kenyan households have mobile phones. Mobile phone technology was used to reinforce key messages for women and men around maternal and child health, exclusive breastfeeding, prevention of mother-to-child transmission of HIV, and male involvement. An important point to note about the messages is that they were HIV-neutral; some women and men share mobile phones with others, so neutral messaging was important to protect study participants from stigma. Despite positive feedback from the study such as increases in exclusive breastfeeding among women who received the messages, barriers still hinder the full effectiveness of mHealth, particularly fear of stigma.

Merrick Schaefer of UNICEF illustrated Programme Mwana, a project that has now been scaled up nationally in Malawi and Zambia to decrease turnaround time for clients to receive HIV test results, and to manage health systems in real time. The program consists of two components: Results160, which is focused on health systems and targets clinic staff; and RemindMi, a community-focused application that helps community health workers follow up with and report on client health status through SMS. Results160 allows clinic staff to alert central laboratories through SMS that samples have been sent for testing; in return, laboratories send electronic test results to clinic staff, which are sent to clients (confidentiality is preserved through PINs). RemindMi alerts community health workers to follow up with clients around child births, clinic visits, and adherence to medications.

Overall, the future seems bright for mHealth interventions, although some issues, like stigma, need to be addressed for optimal effectiveness in the long run.

Leave a Comment

Filed under Kenya, Malawi, Uncategorized, Zambia

Tagged as , , , , ,

· 3:18 pm

“Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective” – Satellite Session on best practices, programmatic barriers and bottlenecks in the field

By Alex Ekblom

On Sunday, EGPAF, mothers2mothers (M2M) and Johnson & Johnson (J&J) hosted a satellite entitled “Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective – best practices, programmatic barriers and bottlenecks in the field.” This was a four-part/panel series of presentations moderated by John Donnelly, a journalist from GlobalPost.

EGPAF Swaziland’s Caspian Chouraya

The first part had to do with country-level approaches around building capacity of HIV service implementers, which highlighted Kenya’s mentor mothers approach (where HIV-positive mothers are trained to coordinate access to and retention in care among other HIV-positive mothers), EGPAF-Zimbabwe’s experiences in reducing costs of all-level health care worker training by reduction in time of training and facilitators (saving $185.00 per participant), and SAATHI’s experience in engaging the private sector to increase local PMTCT capacity (including collaboration of 17 NGOs to increase private site coverage, which has reached 1.2 million women with PMTCT care).

The second panel focused on supporting continuity of care and featured m2m’s work on mother mentors in retaining women through use of smartphones and SMS reminders, and NASCOPs implementation of a courier system to shorten turnaround time for early infant diagnosis of HIV.

The next panel was centered around how to create demand to increase uptake of PMTCT. Examples included the use of m2m mentor mothers, who increase quality of care to clients by relieving health worker burden/task shifting, EGPAF-Zambia’s integration of syphilis and HIV testing (through innovations in rapid testing) and the use of 8 steps to roll out effective integration, and EGPAF-Lesotho’s implementation of integrated health services and the use of Family Health Days, or mobile health services which offer a variety of testing and treatment options for HIV, opportunistic infections.

EGPAF Zambia’s Susan Strasser

The final panel focused on data use and highlighted m2m’s “let’s SOAR” initiative, which included a quarterly data review component, where site coordinators could review daily recorded data and assess areas for needed improvement, EGPAF-Swaziland’s data collection and review mentorship activities, EGPAF-Rwanda’s implementation of an excel macro tools to issue feedback to supported facilities through reports of facility and district data (from which facilities could see where improvements were needed), and EGPAF-Tanzania’s experience implementing quality improvement initiatives to strengthen pediatric care.

Delegates brought interesting questions into the discussion. One of which was how can we better prioritize the “keeping their mothers alive” portion of the global plan. It’s an important point for upcoming work on elimination of MTCT.

Leave a Comment

Filed under EGPAF, Global Plan, Implementation, India, Kenya, Lesotho, MCH, mHealth, Pediatric Treatment, PEPFAR, PMTCT, Rwanda, Swaziland, Syphilis, Tanzania, Zambia, Zimbabwe

Tagged as , , , , , , , ,

July 22, 2012 · 1:11 pm

Upcoming EGPAF Session: Overcoming Barriers to Implementing Global Plan

By Robert Yule

Join EGPAF, mothers2mothers, Johnson & Johnson, and our other partners at this upcoming session on overcoming implementation barriers to the Global Plan.

This fast-paced session – moderated by Global Post’s John Donnelly – will feature people working on the front lines of program implementation from high-burden countries and representing various implementing organizations. Each presenter will raise a specific challenge, explain how it was addressed, describe the result, and share what is being done next.

The audience will have the opportunity to interact with presenters for further discussion of implementation barriers and solutions.

“Eliminating Pediatric AIDS and Keeping Mothers Alive from an Implementation Perspective – Best Practices, Programmatic Barriers, and Bottlenecks in the Field”
Sunday, July 22, 1:30 – 3:30 PM
Mini Room 1

Leave a Comment

Filed under Global Plan, Implementation, India, Kenya, Lesotho, Malawi, PMTCT, Rwanda, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe

Tagged as , , , , , , , , , , ,