Response:

1. Mobiles in Malawi A Rural Health Initiative Elizabeth Nesbit—Rice University Josh Nesbit—Stanford University Impact: Background Information: • St. Gabriel’s Hospital serves 250,000 Malawians spread throughout a catchment area 100 miles in radius • St. Gabriel’s Hospital is located 60 km from Lilongwe, the capitol city • The vast majority of the people the hospital serves are subsistence farmers, living on under $1 a day • The hospital has enrolled over 600 volunteers to act as community health workers (CHWs) in their respective villages • Many of the volunteers are active members of the HIV-positive community, and were recruited through the hospital’s antiretroviral therapy (ART) program. 3 Alex—the hospital’s HBC officer—travels to a rural village upon the SMS request of a CHW CHWs learning to use their cell phones Response: The system was programmed to automatically top up the phones. 2 Results: Stationed at the hospital, a laptop running FrontlineSMS acts as a text-message hub – coordinating the health network’s activities. 1 The CHWs, and the villages surrounding them, now enjoy previously unimagined connectivity 70 CHWs were trained to use their cell phones to contact St. Gabriel’s Hospital. Problem: HIV/AIDS support groups effectively organized • Many patients walk up to 100 miles to the hospital – to see one of the three doctors on staff. • In order to report patient adherence, ask for medical advice, or request the mobile clinic’s attention, CHWs had to travel similar distances to the hospital. • The most motivated of the CHWs kept their own patient records, and journeyed to the hospital when they could – by bicycle, foot, or oxcart. HIV/AIDS and TB drug adherence is tracked 5 The hospital staff has been trained to maintain the communication system The smart but simple nature of Frontline-SMS allowed the tool to be readily integrated into hospital programs CHWs check medication dosages before adminis-tering drugs in the villages Remote medical emergen-cies are reported and responded to by a mobile team The hospital now follows up on distant patients. 4 Commun-ities’ medical questions are fielded During the summer of 2008, FrontlineSMS was introduced, along with 100 cell phones, in order to implement a text-based communications network for the hospital and the CHWs.