Thursday, January 27, 2011

Lessons Learned from AppLab's First Three Years in Uganda

Interesting blog post from Eric Cantor, who led Grameen Foundation’s AppLab Uganda. Nice to see that we have listened to what was learnt there, and are putting in place systems which build on that experience.

 

http://grameenfoundation.wordpress.com/2011/01/21/lessons-learned-from-applab%E2%80%99s-first-three-years-in-uganda/#more-1450

 

Creating a World Without Poverty

Lessons Learned from AppLab’s First Three Years in Uganda

By grameenfoundation

Eric Cantor has led Grameen Foundation’s AppLab efforts in Uganda for the past three years, and continues to serve as an advisor on the project.

More than three years ago, I landed in Uganda to establish Grameen Foundation’s “Application Laboratory” – a program conceived to explore the potential of mobile phones to improve the lives of the poor.  In our quest to test, develop and expand mobile services that are useful for the most often-ignored people on the planet, our team spent (and spends) extensive time talking to our users, in the places they work and live, to hear about the good and the bad of the methods we are testing to empower them.

We sit under the mango tree at the rural health clinic, hearing about how people learn to avoid and treat common and devastating diseases like malaria and HIV.  We walk the banana plantations of farmers in the West, trying to gauge how they can best control banana wilt, using locally available resources and techniques.  We observe the effects of the rapidly growing “mobile money” phenomenon – essentially digital currency delivered through a mobile phone network – and assess how it can improve the lives of villagers.  We see how people interact with the Internet and other unfamiliar services available through the few laptops and smartphones in a community.  And we listen to farming groups, led by Community Knowledge Workers (CKWs), as they plan and prepare to bulk their crops for sale to the highest-paying buyers.  As white winter washes over the US, and the rains wind down and planting season approaches in Uganda, we share some lessons learned through this work in the hopes that our growing body of work, as well as that of other practitioners in this field, will benefit.

In AppLab’s early work, we tested a number of information services, leading up to our launch, with MTN (one of the primary mobile phone services providers in east Africa) and Google, of Google SMS Tips, the product that won the award for “Best use of Mobile for Social and Economic Development” at the 2010 GSM Mobile World Congress.  It was rewarding to sit on a farm and hear how making organic pesticides using local chemicals or even waste products found on the farm helped save a farmer money, and increase her yields and incomes.

Community Knowledge Workers act as valuable local intermediaries, bridging the "last kilometer" to bring essential information to other rural farmers in Uganda. Here, a CKW uses her high-end mobile phone to check for information on banana wilt.

Community Knowledge Workers act as valuable local intermediaries, bridging the "last kilometer" to bring essential information to other rural farmers in Uganda. Here, a CKW uses her high-end mobile phone to check for information on banana wilt.

But what became quickly apparent was that information alone is not a complete solution.  A reference pointer or a tip about maternal health techniques may be useful to an expectant mother, but creating deep, impactful behavior change – what information-driven development initiatives seek – requires a context in which that information has a value. People certainly have a hunger for knowledge and a willingness to embrace the mobile phone to search for answers, as shown by all the questions they asked from the beginning about family planning, and HIV and other sexually transmitted infections, which affect them directly and for which few reliable, anonymous sources are available.  But we require several things to make this information actionable and impactful: specific information, a context in which to make it useful, and relevant services and resources.

We’ve also found that village-based intermediaries help increase the benefits of mobile phone-based applications.  We saw this in our Village Phone work, as well as other involvements in microfinance and social enterprises serving the poor.  CKWs are farming group leaders, nominated and elected by their peers because they meet a number of important criteria, who have been rigorously trained to harness the power of mobile technology to benefit the group.  She or he encourages, cajoles and reminds the group to farm better and organizes them to get to market, enhancing the information already being shared among the group and then funneled back to the NGOs, government agencies and buyers they interact with.  By closing the loop and covering the “last kilometer,” intermediaries like this can ensure that information is put to best use by those who can best benefit from it.  As Kentaro Toyama points out in a recent piece, “the human intent and competence ICT4D [Information and Communication Technologies for Development] aims to generate must already be in place for the technology to work.”  In the case of CKWs, the competence and intent are already in place in functioning agriculture extension programs and liquid markets. The addition of the technology through a trusted intermediary adds efficiency.  And as farmers increase yields and sell more at the market, their incomes rise.

Another thing we learned during our early work in Uganda was how carefully messages must be communicated.  With more than 800 languages spoken in Africa, and varying degrees of literacy, linguistics remains a clear challenge for mobile service practitioners.  Though we launched Google SMS Tips in Luganda, the local vernacular, it proved difficult to parse incoming queries and match keywords using the English-language logic behind the app.  Adding in one more language – let alone the remaining 45 necessary to reach all Ugandans – would have proven exponentially complex because of the overlap of words and the fact that most of those languages were not designed to be written.

That said, the challenge in communicating in a written form makes us excited about the potential for using voice-based information to deliver the message more effectively.  Few studies exist documenting the comprehension of information delivered en masse, which is understandable given that this approach is new, and that mobile provides a more scalable way to deliver information than anything that previously existed.  And even if we get users to understand the message, changing behavior based on that understanding is another step. People hear the “don’t smoke” message over and over, but they still do.  We are exploring the best ways to leverage voice-based technologies and to test comprehension and changes in behavior as the work moves forward.

The movement to realize the potential of mobile phone-based apps for the benefit of underserved markets is in its infancy, but there is an urgency to demonstrate value and share what we learn.  Grameen Foundation’s AppLab programs will continue generating insights on how best to leverage information and communication technologies to improve the lives of those who are least connected.  As we succeed or fail, we will continue to keep you posted on the journey.

 

Friday, January 7, 2011

mLearning: A Platform for Educational Opportunities at the Base of the Pyramid

The GSMA Development Fund is pleased to announce the publication of its new report entitled mLearning :  A Platform for Educational Opportunities at the Base of the Pyramid.  This is an exciting area exploring how mobile devices can be used as an intervention tool to extend the reach and raise access to educational resources at the base of the pyramid. The GSMA's initial thoughts and findings have been compiled into this comprehensive report with an aim of generating the thinking that will catalyse the growth of mLearning in the future.

 

The key areas highlighted in the report are :

  • The current challenges facing learning today
  • The benefits and opportunities afforded to and by mLearning
  • An interesting selection of case studies 
  • Recommendations for Mobile Network Operators and how to get involved.

If you would like to read more about this exciting area, download your copy here

RE: Mobile money services in health care

In this two-part series, MobileActive.org explores how mobile money services can support health care in developing countries. In part one, we described the key ways in which mobile money services can be adopted by the health sector.  At the primary level of care, subscription-based mobile payment services can create two-way links between patients and health care providers, as summarized here…

http://www.mobileactive.org/mobile-money-mobile-health-use-cases

 

 

 

Monday, November 29, 2010

Live from CHIM workshop

Abigail explaining security settings in OpenMRS, then demonstrating patient search by finding CHIM's Richard Darku's record - he just registered himself using the mForms app.

Live from CHIM Workshop!

Antoinette and Freddy Amponsah of CHIM connect live to the call center through the MOTECH toll free hotline.

Monday, August 9, 2010

Live from the MoTeCH Support Center

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Today was the first day with a fully staffed support center operating
out of their new office. Abigail and Antoinette manned our support
center in style, ready to take on any and all calls, SMS messages and
emails from all of our MoTeCH users, with gusto. They've already done a
great job over the last few weeks doing these same tasks, but now they
have a nice new, quiet home outside of the field so they can take
registration calls from Mobile Midwife registrants without a chorus of
babies at CWC outreach in the background.

Friday, July 16, 2010

Observation's from MoTeCH First CWC Outreach - July 6, 2010

The leaves of the shea nut tree at Kurugu CHPS Compound could only protect us for so long. The configuration of wooden benches, health record books, and babies fell neatly in the shade at the start of last Tuesday’s Child Welfare Clinic (CWC). But as the sun moved across the sky, families started to grow uncomfortable in the heat. Vaccinations and Vitamin A supplements were paused momentarily to move everyone back into the shade, but a few spats were inevitable as mothers differed in their recollection of who came after whom. Despite the weather, the crowds, and being several months pregnant, Community Health Officer Erica kept a cool head and managed to see all 100+ children.


Attendance at that day’s CWC was slightly higher than usual because the community got wind that MoTeCH and Mobile Midwife registrations would be taking place. However, this is a pretty typical day for the staff at a CHPS (Community Health and Planning Services) compound. Long queues of patients and few health care providers mean that each patient encounter is relatively brief and formulaic. Provision of care is centered around the big killers—polio, diphtheria, pertussis, haemophilus influenza, measles, malaria, worms, malnutrition—but with such time and staffing constraints, there is little flexibility to respond to emerging and, even worse, emergent illness. Furthermore, how do they treat the patient who isn’t at the facility to begin with?

The very first release of MoTeCH takes steps to ensure that no one falls off the map by calling patients to remind them that they are due for care. MoTeCH also identifies the patients who are past due and notifies the CHPS staff every Monday morning at 8am by text message. Previously, it would take at least a month to know that someone has defaulted. This delay can be devastating in the delicate first months of life. And once you’re done manually processing all those hand-written records to identify the at-risk individuals, there’s no time left to track them down.

MoTeCH has the potential to transform health care delivery in the UER beyond mere efficiency gains, however. Patient records are currently bound into massive ledgers: one for children, one for pregnancies, and one for sick visits. The book you are carrying that day prescribes your approach to your patient. When you are carrying your Nokia 1680 Classic with MoTeCH version 0.6.8, you are pressed to think about the patient in front of you and determine what care that individual needs. Perhaps this 4-year old is here for a weight check, but as I pick him up to put him in the weighing sling, I notice he feels warm—how long has he had that fever and cough? A pregnant woman might come in with symptoms of malaria, only for you to discover that she hasn’t had any prenatal care thus far. Having more time is great. Spending that time doing the right work is even better.

--Posted by Amanda K Johnson.  Amanda K. Johnson is a second-year MD candidate at Harvard Medical School working with MoTeCH for the summer.