mEduText: SMS Learning Communities to Improve the Quality of Healthcare in Rural Africa

mEduText: SMS Learning Communities to Improve the Quality of Healthcare in Rural Africa

Kampala, UgandaKampala, Uganda
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Start-Up
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

mEduText builds communities of rural health workers in Africa through SMS texts to share knowledge, improve clinical practice and save lives.

About Project

Problem: What problem is this project trying to address?

Rural health workers cannot access knowledge about the newest lifesaving methods for the care, prevention and treatment of infectious diseases resulting in thousands of avoidable deaths each year worldwide. One example is the case of Prevention of Mother to Child Transmission of HIV/AIDS (PMTCT). Without intervention, the risk of HIV transmission from mother to child is 20-45%. This risk can be reduced to below 2% using Antiretroviral Therapy (ART). Rural health workers, particularly midlevel cadres such as nurses and clinical officers, do not adequately use ART for PMTCT due to a lack of training either because they do not have the resources to attend training or because their facilities do not have enough personnel to support them leaving for training. mEduText addresses this need.

Solution: What is the proposed solution? Please be specific!

Using available technologies like basic mobile phones, IDI disseminates lifesaving post training information to distant rural healthcare workers in Uganda and Africa that increases knowledge retention and improves clinical practice in the care and prevention of HIV/AIDS, Tuberculosis and Malaria management. Post-training support and trainer-trainee interaction improves national indicator performance across disciplines in medical care. mEduText is a community of healthcare workers from IDI trainings that (1) supports current trainees, (2) expands access to training materials to other staff of facilities represented in trainings and (3) creates a collaborative learning community of healthcare workers in Uganda that is replicable in sub-Saharan Africa who can turn to each other for information and support. Participants receive mobile messages about the newest development in their fields, encourage colleagues to subscribe, and join learning community groups to share their expertise.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

MEduText sends SMS reminders and quiz questions to IDI trainees based on training objectives. After 12 weeks of SMS targeting IDI training alumni, a team from IDI visits each facility to assess the project outcomes and encourages other healthcare workers to subscribe to mEduText. At this point, participants subscribe to different subjects such as “Laboratory Methods and Best Practices (LAB),” “Paediatric HIV Care and Management (PAED),” and/or the “Prevention of Mother to Child Transmission of HIV/AIDS (PMTCT).” These participants text in their key word (LAB) and are automatically subscribed to a listserv of lab technicians and trainers throughout Uganda. After a preliminary 12 weeks of receiving SMS and responding to questions from the IDI Learning Hub, participants are encouraged to send messages and questions to the entire group as they proceed in their work. The model supports continued medical training while minimizing the costs and time constraints of traditional onsite training. MEduText began with 4 week-long courses in Paediatric ART Management. Participants began to receive messages from IDI on January 30. After 6 weeks, they will be assessed regarding knowledge retention and clinical practice, based off of national indicators and a baseline assessment performed January 23rd to February 3rd. They will also be asked to contribute their views of mEduText learning. After 12 weeks, a final assessment will establish the most effective and appropriate mobile education project to expand to health workers throughout Uganda and replicate throughout sub-Saharan Africa.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Our peers in sub-Saharan Africa recognize the potential of mobile phones in promotion of quality healthcare; specifically, Grameen Foundation, D-Tree International, AMREF, FHI360, Partner’s in Health, Dimagi and IntraHealth, among others. Only FHI360’s Satellife program focuses on levels of health workers other than Community Health Workers (CHWs) and most of our competitors in training, such as Satellife and eMocha, rely on PDAs or smart phones. mEduText is distinctly collaborative and emphasizes basic phones. Competitors pose challenges to mEduText’s growth; specifically concurrent training, language barriers, and funding competition among donors and health workers themselves, but challenges in the mobile health and mobile learning communities are lessons learned for mEduText expansion.
Team

Founding Story

In 2008, IDI recognized the potential of eLearning for rural health workers. The results of the initial eLearning training on pharmaceutical management showed that the use of mobiles could significantly improve clinical practice whereas online learning tools were difficult to access and less effective. In 2011, the distance learning team found that 94% of a random sample of IDI trainees have access to a phone and 96% of those were interested in using their phone to improve their clinical practice. With this community feedback, IDI redirected towards an integrated model that uses both mobiles and computer based learning. mEduText in the Paediatric ART Management training currently underway promotes an integrated model as participants are overwhelmingly eager to receive SMS messages but feel that they lack the experience to replace mentorship with computer based learning. Using basic mobile phones, mEduText has the potential to improve clinical practice of rural health workers worldwide.
About You
Organization:
The Infectious Disease Institute
About You
First Name

Allyson

Last Name

Krupar

About Your Organization
Organization Name

The Infectious Disease Institute

Organization Country

, KMP, Kampala

Country where this project is creating social impact

, KMP, Kampala

How long has your organization been operating?

More than 5 years

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Innovation
How long have you been in operation?

Operating for less than a year

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Cost.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

The goal of mEduText is to reduce mortality and morbidity related to HIV, Tuberculosis, Malaria and other infectious diseases by improving the quality of care through capacity building, training and post-training support of rural healthcare workers. mEduText builds communities, empowers healthcare workers, and recognizes expertise by creating SMS networks over distances to ensure updated and consistent care. Through participatory development, IDI will design and implement the most effective SMS learning communities with rural healthcare workers using technologies available to healthcare workers throughout the region. The proposed intervention will build capacity of IDI as well as produce mobile learning communities that can expand to other institutions, subject areas and interventions.

What has been the impact of your solution to date?

mEduText has begun outreach to participants in the Paediatric ART Management course using daily SMS reminders and weekly quiz questions. The first group of trainees in the mEduText program have a 50% response rate after the first week of SMS quiz questions and have received daily SMS messages and weekly quiz questions since January 30, 2012. These participants will help develop the mEduText platform for future expansion to other content areas and to build an interactive community. The AIDS Treatment and Information Center is also currently supporting health workers via a toll free call in center with an average 800 users annually which will be an initial source of participants for mEduText expansion. While results are preliminary, a Knowledge, Attitudes and Practices assessment conducted by IDI since October 2011 of trainees throughout programming has yielded positive support of a mobile learning platform.

What is your projected impact over the next five years?

Following the Paediatric ART Management course, participants will have improved their knowledge and practice by at least 75% compliance with national indicators from the baseline to the final assessment. By the end of 1 year IDI will deploy mEduText in 6 trainings and build a network of health workers in Uganda that is replicable across borders. IDI has the capacity to run 128 week long trainings a year, reaching at least 10,000 health workers in 5 years. mEduText can supplement each of these trainings and grow to include healthcare workers not trained in IDI trainings but subscribed to a community. Within Africa in 5 years, mEduText can reach 30,000 health workers focusing on best practices in the care, prevention and treatment of infectious diseases, partnering with local organizations.

What barriers might hinder the success of your project? How do you plan to overcome them?

Health workers in the pilot may attend concurrent trainings resulting in difficulties ascertaining what changes in clinical practice relate to mEduText. In order to properly assess mEduText’s impact, trainees in the pilot will be asked at every evaluation about their involvement in other training. There are also structural barriers to success such as the availability of medication, electricity outages, telecommunication network coverage, weather and road conditions. mEduText responds to these structural problems, relying on SMS which arrive on phones when they are charged and providing a week to respond to SMS questions. mEduText learning communities supports health workers encountering stockouts and other institutional barriers to quality care by providing a forum to brainstorm solutions.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

At six month, mEduText is implemented in at least 3 trainings and expanded to a community of 1,200.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Successful completion of pilot

Task 2

Identified and implemented best tools for post training support and evaluation

Task 3

Built SMS content and groups for 2 new content areas

Now think bigger! Identify your 12-month impact milestone

mEduText is implemented in 6 trainings with 2400 subscribers in at least 3 subjects, including Paediatric ART Management

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Build SMS content and network for 3 new content areas in addition to 3 from 6-month milestone

Task 2

Analysis of mEduText impact across regions, gender and cadre, including site visits whenever possible

Task 3

Completion of 6 rounds of mEduText, including on site training and 5 year plan.

Sustainability
Tell us about your partnerships

IDI partners with several organizations for the Distance Learning program that houses mEduText, including Global Health Corps, the Regional AIDS Training Network and the Accordia Foundation. IDI is currently seeking a partnership with Ashoka Changemakers, the Uganda Communications Commission, the Uganda Ministry of Health, and the Intel Foundation, among others, for future development of the Distance Learning Program. IDI’s training partners locally include Inter-Religious CU, the Ministry of Health and the Kampala City Council, Stop Malaria Project, BD, and the U.S. Department of Defense.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

IDI has proposed to reach populations of rural healthcare workers focusing particularly on the PMTCT of HIV/AIDS, Paediatric HIV/AIDS care and Advanced Anti-retroviral Management in order to enhance the adherence to new WHO regulations on these topics as well as to reach particularly vulnerable populations of people living with HIV/AIDS. IDI is also approaching telecom and computer markets to promote information and communication technology use and literacy throughout rural sub-Saharan Africa in relation to the care, prevention and treatment of infectious diseases.

What type of operating environment and internal organizational factors make your innovation successful?

The training department at IDI is committed to providing the most effective and lifesaving training and information to rural healthcare workers throughout sub-Saharan Africa concerning the care, prevention and treatment of infectious diseases. This dedication and the known obstacles of access to and continuation of onsite training throughout the region, in particularly in rural areas, foster an attitude of innovation and acceptance of new tools to expand training among target beneficiaries. IDI’s organizational structure itself, with automated transparent audits in line with international standards, a robust grants management system, and independent organizational board of directors provide checks and balances for successful implementation of mEduText.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

With minimal investment from granting agencies, IDI can create a network of learning communities to supplement training and stand alone. mEduText requires marketing to reach rural healthcare workers across borders. Organizational collaborates and partners in the health and mobile health field worldwide can use and grow mEduText to further their own training or enroll health workers.