Wednesday, January 28, 2009

Some Highlights

Images below depict some of the highlights from the Mangochi project in terms of patient registration, business calls vs health calls, volunteer turnover during the period.

bye but see you again

Finally my time is up and have to say bye but it will not be forever as I will still be part of mobile technology and mobile technology will still be part of me. My bye will therefore be from one level to the next. So see you in the next chapter of my mobile technology life I have embarked upon.

Tuesday, January 27, 2009

Out to Namitete

Tuesday afternoon - visited some communities in Namitete (around St. Gabriel Hospital) who are part of another mobile technology project utilising FrontlineSMS. First pitcure depicts an Internet cafe built within a water reserviour, the second shows Alex, the man in charge of the FrontlineSMS project at St. Gabriel at work and the last is the frontview of the hospital.

Monday, January 19, 2009

Mobile Phones for Health Services


By George Ntonya

When Agnes Banda fell critically ill in Mozambique where she got married, her husband took her back home in Mangochi district and abandoned her.

He returned to Mozambique secretly, reportedly thinking that his wife was going to die anytime. “I was left for dead,” Agnes said in an interview at her house recently.

Over six months have elapsed since her husband disappeared and Agnes has bounced back to health life. Members of a home based care (HBC) group in her area helped her to survive.

They reported her condition to St. Martin’s Hospital for medical attention using mobile phone they received from Evangelical Association of Malawi (EAM).

“I have survived because of the support I have been receiving from the home based care volunteers,” Agnes explained.

Her sister Christina, who acts as her guardian, said that “If Agnes’ husband decides to go back he would be surprised to see her looking healthier than she used to be before she fell ill.”

“He would not believe his eyes to see her alive because at the time he left her she was on the verge of death,” Christina said. Agnes is one of the many patients who at one point or the other suffered from a chronic disease and managed to get prompt medical assistance because of mobile phones which EAM distributed to home based care (HBC) groups from different villages in Mkope and Malindi in Mangochi district.

EAM launched a K16 million mobile technology project in February 2008 with a view to help community based organizations and health workers improve the quality of service they provide to patients, particularly those infected with HIV.

The mobile technology project was piloted in Mangochi district with financial support from Tearfund UK, a Christian organization which is supporting different organizations involved in initiatives such as food security, water and sanitation as well as HIV and AIDS.

According to EAM Head of programmes Bryer Mlowoka, the project’s main objectives were to improve the quality of care provided by the HBC volunteers, to help the volunteers generate income from the phones for their sustainability and offer a technology solution that effectively supports information and communication technology related to health services.

The Association bought several mobiles phones from Celtel Malawi Limited, which is now called Zain Malawi Limited. The phones were distributed free of charge to different community based organizations whose volunteers provide home based care to the chronically sick people in Mkope and Malindi areas, respectively. The Association also trained the home based care givers on how they could effectively use the phones to help the sick access medical assistance in times of an emergency.

They were also trained in new methods of community home based care to enable them improve on the quality of care services that they provide to the chronically ill.

The Association also provided training to enable the volunteers to use the phones for income generation to support their activities. “We conducted a study and we realized that there was an acute communication problem between community members and health facilities in Mkope and Malindi in Mangochi. That is why we decided to pilot the project there, “Mlowoka said.

Mcford Moda, Clinical Officer and HBC Coordinator at St. Martin’s Hospital said that EAM bought a digital telephone switchboard and fixed extension lines in all the hospital’s departments to improve communication within the hospital as well as with communities that require its services.

“At first we had one telephone line and people had to walk from their offices to the phone room to take their calls. People had problems to reach us because most of the time our phone was engaged,“ Moda said.

“This is no longer the case because EAM provided us with modern equipment,” he added.

All the HBC groups call the Coordinator directly whenever they require an ambulance or any medical information. When the case is not serious, the Coordinator advises the volunteers what locally available resources to use to help their clients.

“If they can not handle the case, we send an ambulance to collect the patient,” Moda explained.

Mkope Health Centre also received a new set of communication equipment, said Senior Medical Assistant Petre Mulauzi.

Davis Mchengani, Chairperson of Chiwalo Home Based Care Group at Mkope expressed gratitude to EAM for supporting HBC groups in Mangochi. He said that many patients are being saved from death because the groups are now able to communicate with the health facilities fast whenever there is an emergency.

“Our relationship with health workers has also been strengthened so that whenever we take our clients to the health facility they are attended to immediately,” Mchengani said.

By bridging the gap between the communities and the health workers through the mobile technology, EAM has also managed to increase the number of people going for voluntary counseling and testing (VCT) in the project areas.

“We advise our clients to go for voluntary HIV testing so that if they are infected with the virus, they can be registered for anti-retroviral therapy (ART),” said the Chairperson of Iliyoni community based organization (CBO) Jafali Mtakataka.

“Most of our clients who were critically ill because of HIV related illness are now healthier because of ARVs and this encourages many others to go for VCT even before they fall ill,” he said.

As the number of HIV infected people that require special attention continues to grow, home based care becomes the only feasible option for the majority of patients. It is a holistic concept that incorporates the full needs of the sick and address the worries of family members. Home based care has also helped people to become more open about HIV and AIDS, thereby addressing the problem of stigma and discrimination.

Results of the monitoring and evaluation study on the project have shown that since the inception of the project have shown that since the number of the chronically ill that have registered with the HBC groups has increased because of the benefits the patients get from services offered by the HBC groups.

There has also been an increase in VCT activities and ARV utilization.

However, the mobile technology has also faced some challenges. “At first we were able to generate reasonable income from the mobile phones to support our activities. But the introduction of cheap cell phones had impacted negatively on the income generating component of the project,” said Nellie Mpanjira, Treasurer of Chikomwe CBO.

“Now many people have their own cell phones and no longer come to our bureau to make a call,” she said.

According to Mary Mlembe, Secretary of Mkuli CBO, the demand for support from community members has increased tremendously since EAM introduced the project such that the volunteers sometimes spend more time caring for the sick than engaging in economic activities for the benefit of their families.

“We have also sometimes had difficulties to communicate with the health facility because of network problems,” she added.

Country Representative of Tearfund-UK, Vincent Moyo said that they would like to provide more financial support to EAM to scale up the project by introducing SMS and Internet services, among others.

“We will try to all we can to help communities improve the quality of life they lead through the use of modern technologies,” he said adding that they would use lessons learnt during the pilot phase to improve the project.

* Published in The Sunday Times, January 18, 2009, page 11