Mobile phone use for integrated health services Guinea experience!

Jacqueline ARIBOT! ! GMHC2013, Arusha-Tanzanieq15-17 January 2013!

1!

Goal and objectives !

The goal of this presentation is to share Guinea experience on the use of mobile phone technology for integrated health services : " Describe the implementation strategy of the mobile phone eet" Describe results and lessons learned" Discuss problems encountered"
A head of rural health center with phone , Kouroussa (12/10/2011) !

2!

BACKGROUND ! 1
MCHIP/Guinea Majors Activities !
Family planning (providers, CHW)" Emergency obstetric and newborn care" Quality improvement through Standards-Based Management and Recognition" Child Health: Integrated Management of Newborn and Childhood Illness, community case management" Malaria (providers, CHW)" Community outreach and community-based service delivery" Pre-service education (doctors ,midwives)" Infection prevention"

Country indicators TFR : 5,7 CPR : 9% (6% modernes methods) MMR : 980/100 000 NV infant mortality : 91/1000 (39/1000 before 1 month)

Coverage : !
20 districts (606 healths facilities and et 1700 CHW villages) "

BACKGROUND2!
Almost total absence of means of communication between facilities of the health system! Low reference rate of pregnant women (4.6%)! Frequent Contraceptives stock out! Emerging technology services such as mobile phone helped to communicate in various sectors, including health."

BACKGROUND3 "
# Companies: 5 (4 privates)" Two Orange eets: " WHO/Guinea & MCHIP/Jhpiego "
"

Cost: $2-$4/month/line" Unlimited voice services"

5!

INTEGRATION STRATEGIES2 : PROCESS!

Deployment of a eet of 264 Mobile phones : !

Health services providers" Keys staff of the health system" Key project personnel"
Signing of an agreement to use the phone" Provision of management tools, guidance and supervision of the staff! Collection of data on utilization of the eet!
6!

PURPOSE OF MOBILE PHONE USE 1!

Communication between MCHIP staff and eld ! q Data collection & reporting" q Request for " technical assistance" q Planning & " Management of " eld activities"
MH Advisor (MCHIP)! SBMR Advisor (MCHIP)!

Midwife(Health Centre)!

7!

PURPOSE OF MOBILE PHONE USE 2!

Communication among eld staff ! q Referral of cases (FP, MCH, IMNCI)" q Drug/contraceptive stock management" q Consulting colleagues" q Coordination of health activities " q Transmission of epidemiological surveillance data"

8!

KEYS RESULTS 1 : GLOBAL USE OF PHONE !

(January to December 2012)

v Use by Region in descending order: Nzrkor, Conakry, Kankan and Faranah"

9!

KEYS RESULTS2 : REFERRAL CASES"

(January to December 2012)

v Fever and malaria are 76% of the referred children"

10!

ACHIEVEMENTS !
The phones are used not only for data collection and referral of cases! Fast communication, fewer trips to carry out (and reducing travel costs) between remote and central facilities/districts/region! Help providers to timely refer and to address some complications of pregnancy and childbirth on site! Sending the ambulance where available to transfer the woman quickly! Used for bench marking from successful SBMR sites
11

CHALLENGES / CONSTRAINTS !
Loss and recurrent breakdown of phones; Challenge by health providers to replace lost phones! Low retention capacity of the battery creates frequent and recurring costs of charging (scarcity of energy sources to recharge phones and poor quality)! Limitation of services (text messaging services are not included yet)!

12

LESSONS LEARNED"
Networking providers and managers of the health system:!
facilitates the information ow! improves the availability of health services and technical

assistance in remote Geographical locations

"

The timeliness and completeness of data collected greatly improved! Mandatory replacement of lost phone by the holder reduce losses ! Providing new sturdy phones reduce breakdowns!

13!

PROVIDERS AND HEALTHS SYSTEM MANAGERS TALK ABOUT !

PROVIDERS:! Fewer trips for medical evacuations;" Easier reference (the reference center is immediately informed of the case)" In MH: Support of Pre Eclampsia and Eclampsia management by communicating the protocol by telephone;" FP: the management of side effects of contraceptives is often discussed" MANAGERS/SUPERVISORS:! Reducing travel from health centers to districts," Reduced call charges to health facilities in our area or district" Improving the system of making referrals from health centers to district hospitals" Faster coordination of an ambulance in case of referrals from health centers to the district/regional hospitals" Improved drug/contraceptive stock management " "
14!

WAY FORWARD !
Use the phone for mentoring ! Evaluate the impact of use of telephone for references and data collection! Support the Ministry of Health for a sustained appropriation of mobile phones for health system! Expanding the eet to new project intervention areas ! Improve the communication system at all levels in order to prevent stock-outs! Plan refresher courses for FP providers and make available Jobs aids (management of side effects)!

15

RECOMMANDATIONS !
Improve the management of the phone (mode of use, security) in health facilities for a better accessibility to all providers! Expand the availability of other services to eets in health facilities (emergency, pharmacy)! Find more robust/sturdy Phones & Accessories!

16

THANK YOU ! MERCI !! ASANTE !!

17!