Soon it will be possible for a health worker in a remote rural area of South Africa to use a mobile phone to transmit HIV test results and other patient information from the clinic, directly to the Department of Health’s central database.
The National Department of Health is partnering with the private sector in a pioneering mHealth venture to improve health service delivery across the country. A monitoring and reporting system using mobile phones has been designed to capture information from health facilities and rapidly transmit it to the District Health Information System at the national level. This will significantly speed up data flow and reduce the workload in capturing data at sub-district level.
In the past decade there has been a groundswell of eHealth and mHealth initiatives in low- and middle-income countries and South Africa, with its relatively sophisticated telecoms infrastructure, is ideally placed to benefit from this. Several nongovernmental organisations have already successfully piloted mHealth monitoring programmes, but this is a first for the National Department of Health.
The project was initially discussed by the South African National AIDS Council as a strategy to speed up and improve the accuracy of the data flow during the national HIV Counselling and Testing campaign (HCT), which aimed to test 15 million people in an eighteen month period. That campaign was then transformed into an ongoing national focus on HCT and antiretroviral treatment expansion, and the mobile monitoring and reporting system will be scaled up to keep track of this ambitious programme. It will also be used by the community outreach teams that are to be established as part of the primary health care (PHC) re-engineering process. The new system is also designed to capture information from other health campaigns and can be easily and inexpensively expanded to cover reporting in other programmes such as neonatal and maternal deaths, notifiable medical conditions and as an early warning system.
In 2011, the three big cell phone companies in South Africa - Vodacom, MTN and Cell C - donated about 12,000 new phones to the National Department of Health as part of their contribution to the mobile monitoring system. The SARRAH programme is funding a consortium of Cell-Life and the Health Information Systems Programme (HISP) to design, implement and maintain the system over a twelve month period. A pilot will be implemented in nine health districts initially and then rolled out to all 52 districts. Facility information officers will be trained in the use of mobile phones for uploading data and dissemination to a web-based central database.
This one-year pilot, funded by DFID in partnership with the National Department of Health, will test the role that mobile phones can play in improving quality of data for informed decision making and service delivery in the health sector. The project will be evaluated at the end of 2012 with a view to informing the expansion of mHealth initiatives in other aspects of primary health care.
Progress so far includes:
- The development of the system for monitoring the ART expansion programme and HCT campaign;
- Initial training of DOH staff to use the system; and
- Training of trainers in nine selected districts.
Two data sets are being captured in this phase of this project: HCT data and 'number of new initiations on ARVs'. The system is now being stress-tested, to ensure that sufficient data can be stored and presented in real time. Once this is stable the programme will be rolled out to the remaining districts.
Comprehensive health information is an essential component of a functional health system. As South Africa gears up for the implementation of a National Health Insurance scheme, the need for swift and accurate data has never been greater.
The SARRAH programme has also supported the establishment of the National
Health Information Repository and Data Warehouse at the National Department of health in Pretoria, where all health data will be collated to provide an up-to-the-minute picture of the health burden and health response across the country.
More:
SARRAH Project Brief: Phase One: Support for the establishment of a pilot HIV Counselling and Testing (HCT) mobile monitoring system.
Read...SARRAH Project Brief: Phase Two: The design and implementation of a mobile monitoring and reporting system for the NDOH and SANAC.
Read...Powerpoint presentation on mHealth initiative.
Read...
GMSA and mHealth Alliance mHealth Summit
mHealth and Health System Strengthening. Presentation by Dr Bob Fryatt.
Read...