The blog talk-share-learn recently posted a roundup of international development projects that are using mobile phones to deliver information and services. This list highlights what a powerful tool the mobile phone is and how many ways it can be used in low-resource settings. Here are some of the applications used for health care:
- An Indian software company, ZMQ Software Systems, is using SMS to alert pregnant women as to what vaccines they need, when to get checkups and other prenatal tips.
- Grameenphone, a cell phone provider in Bangladesh, offers its subscribers interactive telephone consultations with licensed physicians.
- Cell-Life uses mobile phones in South Africa to collect medical information from and schedule appointments for HIV-AIDS patients.
Community health workers in Rwanda.
One of IntraHealth International’s projects, the Last Mile Initiative, is designing an Open Source application for data collection and reporting via cell phones and other mobile devices to create a telecommunications-enabled Community Health Services Information System for the health sector in Rwanda.
The automated system itself is designed to rely on a centralized voice-response unit. Community health workers will make phone calls to the central processor and will be prompted to provide service data on a set of pre-determined indicators. The data collected via the voice response system will then be written to the database. Managers will be able to call into the system to retrieve performance data indicating how well their communities are meeting targets or performing as compared to the district, regional and/or national averages. The automated system also will support the broadcasting of updates from district, regional or national authorities that will keep health workers abreast of recent policy changes and disease outbreaks.
This project is just now getting under way. Stay tuned for updates over the coming months.
Posted by
Shannon Turlington on 9/22/2008 • Tags: Cellphones, ICT4d, Mobile Technology, Open Source, Public Health, Resources, Telephony
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I wanted to share some resources I’ve recently discovered that promote the use of free and open source software (FOSS) in Africa. Some of these applications are for health, some are for other purposes. But the more open source software becomes familiar to users in the developing world, and the more they use and trust free software, the more likely they will be to adopt an open source information system like iHRIS. We are all working toward the same goals: providing low-cost, sustainable software that helps these countries improve their systems.
- The Free Software and Open Source Foundation for Africa is promoting the use of FOSS and the FOSS model in African development, and the organization supports the integration of FOSS in national policies.
- Open Source Africa provides a migration guide and a connection to the FOSS community in southern Africa.
- The Google Africa Blog is sharing news, stories and thoughts about using Google tools in sub-Saharan Africa.
- OpenMRS is an exciting project to develop an open source electronic medical record system framework specifically for the developing world.
Posted by
Shannon Turlington on 7/30/2008 • Tags: Africa, FOSS, Free Software Community, Open Source, Software
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Next week in Washington, D.C. some of us here in the Informatics group will be attending the 35th Annual International Conference on Global Health.
We’re excited that Pape Gaye, our CEO, will be moderating and presenting a panel on “The Impact of Weak Health Systems on the Health Care Worker Crisis” and hope everyone will take the time to attend. In addition I will be hosting a round table discussion on Global Health Open Source Development and Online Community .Please drop in, join in on the discussion, and say hello. After the roundtable I will make sure to share some of the discussion here so check back in if you aren’t attending.
Posted by
David Mason on 5/23/2008 • Tags: Events, FOSS, Open Source, Public Health
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This morning Kate Somers (IntraHealth Senior Program Development Team Leader) and I went to a class at the UNC School of Law. The class is a contracts law class which is taught by a close friend. What Kate talked about was a recent contract she wrote for a project which we will be announcing shortly. I was there because the project in question will deal very directly with open source technologies and the professor thought it important to explain the work as well as the contract.
The class went very well as it dealt fairly evenly with both our planned initiative, and the details of the contract. I think the point of having us there was both to capture the attention of those students who are very interested in contract law and to show those who might not have as big an interest in the required class how powerful a tool a good contract can be. I would imagine that in the course of their regular classwork these students don’t come across contracts that are quite like the ones Kate has to draw up dealing with an organization like IntraHealth, and the work we do with open source technologies.
For me it was great to note the interest the students had in the work we are doing here at IntraHealth, and more specifically in the Informatics group. Of course, any student is eager to take the opportunity to discuss things outside of those which are assigned, still there were some great questions about our work and the project in question.
I have not been in a college classroom since my own days in college which are too far back now for me to want to mention. Nonetheless, when I was in college there were no such things as laptops. Now, the group of folks staring at the front of the classroom are doing so just over the tops of their laptop screens. In trying to explain why an organization like IntraHealth is working within open source licensing I pointed out that throughout that classroom I could see many Apple computers, some Dells, and a few HP’s. I assumed that most of the non-Apple computers were running Windows. I’m not entirely sure how many people are in that class but perhaps it was around 40 people. If we were to very conservatively assume that the license fee for each machine (just for the operating system) was $200 that would be $8000 worth of operating systems in that room alone. When we go into relatively poor countries, and into relatively poor Ministries of Health and attempt to put in systems with expensive per-seat license fees it typically cannot work. Add to that the fact that specialized systems usually have license fees that dwarf those of operating systems and you can see the problem. All this before we even get to upgrade-fees and the cost of customizing a system to suit the users specific needs.
Of course there are many more benefits to us using open source technologies but in many ways it all comes back to this economic question. For most of us, I think it is safe to say that to help health care workers do their work more efficiently so that they can help more people, we really aren’t concerned whether the tools are open source or proprietary - as long as we are helping them. However, there is an organic path with the finances and with the ownership model that very directly leads us to use and promote open source for this work. When we consider long-term sustainability on top of that, to me, we again come back to open source due to its usual adherence to standards as well as the complete and open access and ownership of the code.
Posted by
David Mason on 3/25/2008 • Tags: Open Source, Resources, Sustainability
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As I have promised, we are releasing versions 3.0 of iHRIS Manage and iHRIS Qualify this month. We will start by posting new live demos on the HRIS Strengthening website and stable release versions of the code on our Launchpad hosting site. We’ll follow that up with complete packages that you can download from the HRIS Strengthening website, which will make it easier to install and try out the software.
Writing information systems is hard and sometimes frustrating work. As soon as a new version comes out, our users are clamoring for new features. We feel like we’ll never catch up with the demand. This can be discouraging, until we realize that the systems must be serving a purpose if the users keep wanting more. One thing we have to balance is the need to create software that is general and useful enough for any potential user but can be readily customized for specific settings.
As all software users know, software rarely fits your specific needs out of the box. We knew that there would be different requirements particularly for HR information systems from country to country and even among different facilities. We have striven to make our software easily customizable by the end users, and Version 3.0 builds on this by introducing configurable modules. System administrators can turn off modules they don’t need or set custom settings for modules without requiring programming experience. Programmers can write their own modules and easily integrate them into the system. We plan to follow up these improvements with a customized report-building tool and customizable roles; both should be available by summer.
Another big improvement in Version 3.0 is the ability to export data from reports in a variety of formats, including an attractive printable PDF. This will make data much more useful as it can easily be brought into Excel for more intensive analysis or imported into other systems.
We are looking forward to making versions 3.0 of iHRIS Manage and iHRIS Qualify available for you. But even more, we are looking forward to seeing what users will do with the software. We already have local developers in Uganda and Kenya customizing both systems for their own needs. As more developers contribute customizations and modules, our information systems can only improve for everyone. We welcome all contributions. There’s a lot that still needs to be done.
If you are interested in contributing to this Open Source development project, please contact us.
Posted by
Shannon Turlington on 3/7/2008 • Tags: Development, HRIS, Information Systems, Open Source, Releases, Software, iHRIS
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I’ve been in Rwanda for a little over a week now. Its my first time here and so far I really do love this country. Its quite beautiful, much more lush and green than I had imagined. The people are quite friendly and always offer up a smile. I am here to start a new project that will involve using hand-helds to collect health data (more on this in a later post). To that end I’ve been working closely with the folks at the Twubakane project. Its great to be here and see some of these bigger projects working outside of the context of my comfortable office at home. There is a lot of great work going on here.
After meeting with the folks I will be working with at Twubakane, I was taken to the Ikigo health center in Kicukiro. Its a small facility that seems to be handling a great number of folks in a densely populated area. We had a surreal experience riding out to the center as we were bumping along the pothole-filled dirt road only to run into a film crew in the middle of a shoot - camera on rails, mic booms, the works. I’m still left confused by it. Nonetheless we met with some of the community health workers who go door to door in their villages to collect data. I learned that they are elected by their peers in the villages to do the job - there is a great deal of trust there. Twubakane should be praised for these kinda of approaches as it brings a sense of honor to these important tasks. We talked at length (with much translation) about what has worked and what has been difficult with the paper-based system we hope to replace or enhance. There are some very important steps in the paper system we’ve got to think on. The current system allows all of the workers and the program supervisors to review the data together as they compile it. This lets them figure out if changes in the numbers are due to a growing health problem, or mistakes in collection. If we have the data in our system doing the compilation for them we might skip this step and that would be bad for the communities. We must keep this in the program itself.
Meeting with the health workers was worth the trip for me on its on, but of course I’ve done more than that while here. We hope to be able to hire a local developer to join the team, but only have a couple days left to get that done. It is possible though. I’m excited about this project and being here in Rwanda has brought home to me the importance of certain aspects of our approach at IntraHealth. The use of open source hit me in the head as I was asked very pointedly about it (unprompted, I promise!) It seems the idea of having to fly someone in to work on a couple of extra proprietary systems has grown old. But more than that, the true ownership of these projects in terms of Stakeholder Leadership Groups, or the elected health workers, or hiring local talent seems to be the right approach for this kind of work.
Posted by
David Mason on 3/3/2008 • Tags: Africa, Cellphones, Data Collection, Digital Divide, Mobile Technology, Open Source, Public Health, Technology, Volunteers
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