Neal Lesh, D-tree International, Dimagi Inc

In search of effective mHealth.

Phones won’t save the worldbut we can build some great

toolsdeliberately.

Roadmap

• Introductions and overview• CommCare • Five cautionary suggestions

1. Open source is a deep concept2. Design under the mango tree3. Don’t automate broken systems4. Beware unused data5. Building capacity takes time

91-97: PhD computer science, UW97-04: Artificial Intelligence & HCI04-05: MPH global health, Harvard05-08: Vagabond eHealther…◦ Tanzania (Harvard PEPFAR, D-tree, MVP)◦ Rwanda (Partners in Health, Columbia)◦ South Africa (D-tree, MRC )◦ Bangladesh (BRAC, Dimagi)◦ Malawi (Baobab)

Me

4

Many other collaborations: IRC, Ifakara, OpenMRS, OpenROSA, Intrahealth, DataDyne, UW, PATH, Cell Life, …

Almost everywhere, somebody local has a phone.

mHealth Areas

Outreach

Data Collection

Decision Support

Tele-Medicine

OpenROSA Consortium

OpenROSA Consortium

Cell Life Makerere DataDyne

SSI D-tree Dimagi

…..

…. …. UWCommCare

To strengthen and monitor community health programs

JavaROSA open source software

Growth Spurt for D-tree

• Office in Dar es Salaam, TZ

• Five pilot projects, ~55 users

• Two controlled studies• Starting to standardize

our practices

Roadmap

• Introductions and overview• CommCare • Five cautionary suggestions

1. Open source is a deep concept2. Design under the mango tree3. Don’t automate broken systems4. Beware unused data5. Work glocally

CommCare

10

HEALTHY PREGNANCY

Vitamin A, IronStarted tetanusFinished tetanusStarted IPT (Malaria)Finished IPT (Malaria)Deworming tabletHas birth planTested for HIV

Child Mortality in Tanzania(per 1000 births)

The Lancet, Volume 371, Issue 9620, Pages 1276 - 1283, 12 April 200 11

Video

• Population health data• Implementation monitoring

• Process improvement• Evidence-based change

• Supervision

• Checklists, Protocols• Scheduling• Job satisfaction

Benefits of CommCare

13

Field Office

Community Health Organization

Government, other development efforts

Roadmap

• Introductions and overview• CommCare • Five cautionary suggestions

1. Open source is a deep concept2. Design under the mango tree3. Don’t automate broken systems4. Beware unused data5. Building capacity takes time

Open source is a deep concept

• Not free (total cost of ownership)• Get by giving , but giving can be

uncomfortable for many organizations• Much open source code is not collaboratively

built, some not even released• Conducive to local ownership• Not conducive to good tech support

Design under the mango tree

16

Don’t automate broken systems

• CommCare doesn’t save lives, CHWs do.

• Tech won’t get health workers to take temperatures, but it might help supervisors to get them to.

• mHealth is tools, so find places where better tools will have impact.

17

Map it before you automate it

18

Beware unused data

Successful Report

Unsuccessful Report

Building capacity takes time

• So start now! Don’t expect a lot right away.

• Invest in local capacity and give opportunities to local innovators

• Coded in Country– Akin to FairTrade label for software

What are we going to do today, Brain?

The same thing we do every day, Pinky….

Make a plan to TAKE OVER THE

WORLD!!!!!

neal@equalarea.com