Simple technology, major health impact in Africa and the developing world

Simple technology, major health impact in Africa and the developing world

United KingdomMagadi & Loitoktok, Kenya
Project Summary
Elevator Pitch

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

The need for accurate, timely data transfer to support health outcomes in the developing world is acute. Basic SMS offers a well-understood, ubiquitous medium to transfer data throughout the healthcare system and to community level. We use SMS to meet multiple data needs, and thus accelerate health improvements now.

About Project

Problem: What problem is this project trying to address?

In the developing world the delivery of healthcare is undermined by a number of factors including: infrastructure, resources and capabilities. Governments and NGOs are seeking to tackle these issues through a variety of initiatives, but a critical issue that prevents more rapid improvements to health is the availability of high quality, accurate information. Where data is collected on health indicators, or is disseminated as part of health promotion initiatives this information is normally paper-based, and therefore cumbersome, complex, time and labour-intensive meaning that data collection, entry, aggregation can take months thus only allowing for retrospective analysis rather than timely identification of issues and appropriate, rapid deployment of resources.

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

Our proposal uses the most basic building block of mobile technology, SMS more universally so that there is a common methodology and technological language used to transmit health information between the population, governments and other NGOs. We would: • Train community members to report on key symptoms • Increase community engagement in healthcare. Eg. adherence reminders for chronic conditions • Automate the supply chain for remote dispensaries • Report accurately on health indicators Simple SMS could be widely deployed to generate data inputs which are linked to state-of-the-art cloud based analysis, mapping and reporting services. A joined-up approach across multinational telecommunication and pharmaceutical companies, NGOs and governments offers an opportunity to revolutionise the availability of accurate information at community level and drive the more effective deployment of appropriate resources whether financial, people or product across the developing world
Impact: How does it Work

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

Basic SMS offers a myriad of opportunities in terms of the information that can be requested from and transmitted to the community level to improve healthcare indicators. Deploying this solution would require coordinated efforts from NGOs and governments to access and train the population, and commitments from the multinationals (pharmaceutical, telecommunications, etc) to invest in and support the solution. A recurring anecdote relates the poor management of disease outbreaks. Firstly an outbreak might be observed in the community but not communicated to healthcare professionals to facilitate rapid resource deployment eg. typhoid Alternatively there may be national awareness of an outbreak eg. ebola virus may but no means to rapidly disseminate critical information on symptoms and prevention to healthcare professionals in the affected area as leaflets take time to print and distribute. Basic SMS could be used to resolve both the first and second scenario. In the first community members would be trained to use toll-free SMS to report unusual circumstances eg. Several goats dying or multiple instances of diarrhoea. In the second SMS could be used to either disseminate key facts to healthcare professionals (based on distribution lists by location and role), or to invite them to an urgent meeting. SMS eradicates the need for circulating paper and facilitates cost-effective transmission of key data to catalyse action, decision-making and resource deployment
Sustainability

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

To date no coherent solution has been articulated in mHealth due to the fragmented agendas of NGOs, governments and mobile service providers who compete through recurrent pilots which never scale up. Collaborations such as the mHealth Alliance are progressing, but are focusing on training not simple data transfer. Their efforts centre on complex applications for smart phones, which are not currently sustainable or appropriate given literacy levels and resources. We are differentiate by our focus on SMS as the scalable, cheap, common denominator that can have an impact now rather than in the future. This solution may need to evolve in time, but currently it offers the most potential for a universal solution to communicate health information.
Team

Founding Story

Whilst working for AMREF in Nairobi we spent time in the field in Kenya and Tanzania. The difficulties in improving and accessing healthcare services are obvious: physical distance, poor supply and insufficient resources (people, finance & product) all hamper delivery. Paper-based systems aim to fill certain gaps regarding healthcare information, but such systems are unpopular due to the time and effort involved. eg.walking 30K weekly to deliver a form. Additionally confusion arises as multiple NGOs and governments demand duplicative data to demonstrate project effectiveness. Initiatives are often short term, repetitive and rarely scale from pilot stage. Our solution had to focus on the ubiquity of basic mobile phones, and on collaboration, driven by governments, to ensure that a low-tech solution is universally adopted, with multinationals then supporting high tech commercial systems to enable data analysis and decision-making as part of a broad, scalable initiative.
About You
About You
First Name

Kimberley

Tell us about yourself/your team.

We come from different areas within GSK and have over 28 years commercial experience between us covering IT, Marketing, Strategy Development and Project Management. We were recently paired up for a 6 month project in Nairobi with the African Medical and Research Foundation (AMREF) as part of GSK’s CSR Programme – PULSE as the first phase of a potential five year commitment.

We discovered that strong peer-to-peer partnerships, involving complementary skill sets can add real value in developing and implementing creative, practical solutions. Additionally our secondment brought into sharp relief the opportunities that exist for multinationals to accelerate the resolution of social issues through mutually beneficial initiatives; we feel passionately about the role GSK could play in this.

What makes you an intrapreneur? What are the skills, capabilities, and personality traits that make you an intrapreneur?

Attitudinally we are naturally enthusiastic with the desire and ability to make things happen. Our combined skill set allows us to meet all challenges with optimism and pragmatism, rapidly progressing from ideas to solutions through respectful discussion. We both believe that we can make a difference, and have great commitment and energy for development initiatives.

Whilst our working lives centre on commercial organisations, we both devote time to philanthropic causes in our leisure time. We entered the NGO world from a corporate background, providing us with a fresh perspective on the challenges of the development sector. We tackle problems with flexibility and passion based on years of exposure to commercial thinking and our combined capabilities.

About Your Organization
Company Country

, LND

Primary country where this project is creating social impact

, EA, Magadi & Loitoktok

Additional countries or regions

Tanzania, Lake Zone & Ethiopia , Addis Ababa

Industry

Health Care

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Innovation
Select the stage that best applies to your solution

Start-Up (a pilot that has just begun operating)

The Solution: Why is this solution innovative for your company and industry?

GlaxoSmithKline is leading the way in supporting better global access to its medicines, but ultimately the expertise and resources the pharmaceutical industry can offer alone limits our potential impact.

Collaborating with other businesses, NGOs and governments would greatly increase the scope of what we can achieve. A cross-sector, non-competitive approach would enable implementation of a comprehensive, holistic solution which would accelerate improvement in health indica

Impact
What has been the impact of your solution to date?

Our proposal has broad support from the Ministry of Health in Kenya, and other key stakeholders as the initial phase of the project has focused on stakeholder engagement and concept testing.

Thus far we have rolled out a maternal, newborn and child health (MNCH) project in Tanzania including health promotion SMS for new mothers eg.vaccination reminders, and basic reporting by Community Healthcare Workers of key indicators eg. infant mortality via SMS. A similar MNCH program will shortly start in Ethiopia Q1 2013.

Additionally a pilot seeking to engage peer educators on sexual and reproductive health issues and increase awareness has commenced in Kenya, with a disease surveillance project scheduled to start in Q1 2013.

The pilots have data coming in via SMS, processed by a cloud-based system into reports. The end user-interface that allows self service is not yet complete, but the ability to access reports on demand is seen as a key benefit for supervisors and project teams.

What is your projected impact over the next 1 to 3 years?

Year 1 will prove that a general SMS system with cloud-based reporting can be employed to address varied data needs (reporting, health promotion) in diverse contexts (urban, rural, nomadic) and countries. Each pilot project has clear success criteria against which to measure the impact of SMS. We expect quantitative data to highlight the benefits / issues with SMS and improvement in health indicators such as vaccination uptake in MNCH. We are targeting a 5% improvement as a base case.

In years 2-3 collaborative partners would be involved in wider implementation of the technology to meet all the data needs of multiple projects. Building on learns whilst expanding the scope, will be key in order to deliver the targeted improvements to health indicators.

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

• Ministries of Health must be a key stakeholder in driving collaboration between NGOs. Without this competition is likely to continue. Identifying and persuading key decision-makers, and building advocates has proved effective in Kenya.

• Common health indicators need to be agreed across national borders and NGOs to reduce system complexity. This will rest on senior stakeholders and organisations eg. WHO to influence collaboration and willingness to compromise.

• A clear business model to outline the likely costs, responsibilities, investment required and incremental benefits for all stakeholders to commit. Building this model will be challenging and expert help should be sought

• Project management requires strong accountability despite geographical distances and varied cultures

Sustainability
What is the benefit or value you're creating for your business?

This initiative offers great reputational kudos for furthering access to medicine in the emerging markets and developing world, which are key growth areas. This proposal could significantly improve health outcomes for an underserved population whilst creating healthcare infrastructure through which companies can better meet patient needs.

By improving the data available on population health needs, the project facilitates responsible dissemination of resources, including medicines supply, and thereby commercial benefit for pharmaceuticals.

How are you leveraging internal resources (funds, time, knowledge, etc.) to support this initiative?

Through the PULSE scheme we have each received a six month secondment to AMREF and this has allowed us to observe the issues, research stakeholder needs and ultimately formulate the plans and implement the pilots that precede this proposal. This has represented a significant investment of time and funds.

Further investment of people resource is likely (but not guaranteed) via GSK’s PULSE scheme, with the opportunity to access and leverage different skill sets eg. legal and networks across the organisation as required. Additionally GSK’s initiative, whereby 20% of our profits in any African country are reinvested in healthcare projects in the country, may offer a source of funding for this project however no approach has been made to date.

Expand on your answer, explaining the long-term funding and support plan.

This system has an upfront cost to development and implementation. The pilot systems are extremely low cost, but for SMS messaging to be scalable, partnership with and investment from the telecommunications companies will be pivotal to setting up a sustainable cost effective solution. Investment in a more robust reporting platform, integrated with government systems with clear specifications may also be required. Pharmaceutical companies, government and NGOs all have a role to play in delivering training, according to their expertise.

Once set up, the technology will be self sustaining. The cost model should be based on a minimal fee for partners eg NGOs to access comprehensive data and reporting capabilities as a service which is cheaper and easier than setting up your own.

Tell us about your partnerships across your company and externally that are key to your project's success.

The project is currently a partnership between GSK and AMREF, but requires telecoms to be a success. A basic relationship exists with Safaricom and Ethiocom.

We have also forged partnerships, through AMREF, with the Ministries of Health in Tanzania, Kenya and Ethiopia and with other NGOs as their views are central to adoption of the concept. Within GSK, both the PULSE team and wider networks have been used to access expertise eg. fundraising which should continue.

What internal support have you gotten for your project? What kind of push-back have you received?

We have received full support for the early stages of this work from the PULSE team and our line managers. This proposal to expand the general purpose SMS system into a something broader, involving other corporate organisations and multiple stakeholders to target access to medicines in a more holistic, comprehensive way, whilst simultaneously considering commercial benefit is an evolution of our existing work and will need further management consideration.