Saptarshi Purkayastha , Director R &D, HISP India

1. Technological Challenges and Approaches to Deploying Mobile Technologies for Public Health Information Systems Saptarshi Purkayastha, Director R &D, HISP India Brajesh Murari, Senior Software Developer, HISP India

2. Health Information Systems Programme (HISP) • The Health Information Systems Programme is a global south-south-north collaborative network of researchers, governments, health-care professionals and academic institutions. • Initated by and coordinated from the Global Infrastructures Research Group at Department of Informatics, the network has since 1994 been involved in many countries in "Global South". • Our aim is better health care in developing countries through the combination of research on and implementation of Health Information Systems. • Global Partners include Health Metrics Network, WHO, OpenMRS, Norad and many in-country partners in every implementation country.

3. Introduction • The presentation explores significant potential of mobile in HIS • Community-based Monitoring • Reporting • Health-record information • Feedback to health-service providers • Strengthen communication between health providers and patients and community • Also acknowledges many challenges as well to implement mobile technologies in resource • We present: • A review of how technology was selected among already available solutions • Creating a simple technology solution • Implementing an m-Health solution not as an independent application • Feedback of health workers on using the application • Learnings from the study

4. Low-Resource Settings Health Care Burden • Low-resources communities are not only economically poor, but generally have a huge burden of health-care provisioning • Low-resource also has poorly trained health staff • In technology terms, low-resource settings • Limited /Weak/Slow wireless networks • Price Sensitivity of phones • Lack of Electricity and other infrastructure • Low Technology Skills • Mobile phones in these low-resource settings are: • Limited processing power • Small screen size • Limited visualization • Limited memory Clinics!

5. Simple Technology (SMS, Low-end Handsets) • Allows transmitting facility-level data for all kinds of health programs and dataset including routine, surveillance, survey data for quarterly, monthly, weekly or daily periods • Works on lowest cost Java-enabled phones (Rs. 2000+) • Low operating cost (3-4 SMS/month – <Rs. 10/month) • Forms have pages similar to paper forms • Mobile application in local language • Integrated with state HMIS and reporting mechanisms Mobile Phone ANM at Subcentre 1 Feed-back 2 PHC Computerized PHC GSM Gateway SERVER GSM Gateway SERVER Block

6. Mobile-SCDRT Solution – Simple Technology

7. Health Worker using Mobile-SCDRT

8. How the pilot & study was carried out • Mobile phones provided by NHSRC under NRHM and SIM cards purchased by state • Mobile-SCDRT was implemented in 5 blocks in 5 states of different geographies, social structures and different health indicators • Himachal Pradesh (Hamirpur Dist – Sujanpur Block) • Kerala (Trivandrum Dist - Vizhinjam CHC Area/Athiyanur Block ) • Gujarat (Navsari Dist - Chikli Block) • Rajasthan (Jaipur Dist – Govindgarh Block) • Nagaland (Peren Dist – Jalukie Block) • 25+ training sessions, 220+ health-staff trained • Health workers trained on using mobile application by NHSRC, state and dist data managers, data managers and officers trained for analysis • Refresher training after 6-months of usage to monitor and improve the application • Data collection through questionnaires, interviews and official health system feedback.

9. Response: After initial period

10. Findings: After 6-months of use (Independent study)

11. Thank You • Questions are welcomed • We need support from developers who understand J2ME programming to scale the implementation. • Please visit: http://hispindia.org • Or write to: careers@hispindia.org or sunbiz@gmail.com