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							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
 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.
 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
                                                     Health
 Low-resources communities are not only              Care
  economically poor, but generally have a            Burden
  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!
 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
                                               ANM at Subcentre           Phone
                                         1
                                               Feed-back           2

                                                           PHC
                                Computerized
                       GSM
                      Gateway      PHC
                      SERVER                                                   GSM
                                                                              Gateway
                                                                  Block       SERVER
 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.
                                Question                                                 Response
1.) Did you get mobile phone with the sub-centre form?                100% YES (167)

2.) Did you fill monthly report on mobile and send the SMS?           100% YES (167)

3.) Is the form on the mobile phone as the one given to you?          82% YES (139)
                                                                      18% NO (28) – No linelisting
4.) Were you oriented on new forms?                                   90% YES (151)
                                                                      10% NO (16) – No training from state
5.) How did you find filling the form on the mobile phone?            a)   94% EASY (157)
                                                                      b)   5% NOT EASY (8) – No localization
                                                                      c)   1% DIFFICULT (2) – No training manual
6.) Can you fill the form on the mobile phone independently?          99% YES (165)
                                                                      1% NO (2) – Retiring, Will not fill the form
7.) Do you think sending sub-centre report through mobile phone help 100% YES (167)
     your work?
8.) Do you think it will help to send all reports through mobile phone 100% YES (167)

9.) Could you easily read the form on the mobile phone                93% YES (156)
                                                                      7% NO (11) – Localization / element number
10.) How do you think mobile phone can be made more useful to you     GENERAL QUESTION:
                  Questions are welcomed


 We need support from developers who understand
 J2ME programming to scale the implementation.
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