Mobile phone use for integrated health services in Guinea- Experience of Guinea

Jacqueline ARIBOT GMHC2013, Arusha-Tanzanieq15-17 January 2013

Goal and objectives

The goal of this presentation is to share Guinea experience on the use of mobile phone technology for integrated health services : Describe the implementation strategy of the mobile phone fleet Describe results and lessons learned Discuss problems encountered
A head of rural health center with phone , Kouroussa (12/10/2011)

BACKGROUND 1
MCHIP/Guinea Majors Activities
Family planning

Emergency obstetric and newborn care

Quality improvement through Standards-Based Management and Recognition Child Health: Integrated Management of Newborn and Childhood Illness, community case management Country indicators TFR : 5,7 CPR : 9% (6% modernes methods) MMR : 980/100 000 NV infant mortality : 91/1000 (39/1000 before 1 month) Malaria Community outreach and community-based service delivery

Pre-service education (doctors ,midwives)

Infection prevention

Coverage : 20 districts (606 healths facilities and et 1700 CHW villages)

BACKGROUND2
Almost total absence of means of communication between facilities of the health system Low reference rate of pregnant women (4.6%)

Frequent Contraceptives stock out

Emerging technology services such as mobile phone helped to communicate in various sectors, including health.

BACKGROUND3
# Companies: 5 (4 privates) Two Orange fleets: WHO/Guinea & MCHIP/Jhpiego Cost: $2-$4/month/line

Unlimited voice services

INTEGRATION STRATEGIES2 : PROCESS

Deployment of a fleet of 264 Mobile phones :

Health services providers Keys staff of the health system

Key project personnel

Signing of an agreement to use the phone Provision of management tools, guidance and supervision of the staff

PURPOSE OF MOBIL PHONE USE 1

Communication between MCHIP staff and field

Data collection & reporting

Request for technical assistance Planning & Management of
MH Advisor (MCHIP) SBMR Advisor (MCHIP)

Midwife(Health Centre)

field activities

PURPOSE OF MOBIL PHONE USE 2

Communication among field staff Referral of cases (FP, MCH, IMNCI) Drug/contraceptive stock management Consulting colleagues

Coordination of health activities

Transmission of epidemiological surveillance data

KEYS RESULTS 1 : GLOBAL USE OF PHONE

(Janvier Dcembre 2012)
Number of calls done by providers/managers/supervisor of health system

Use by Region in descending order: Nzrkor, Conakry, Kankan and Faranah

9

KEYS RESULTS2 : REFERRAL CASES

(January to December 2012)

Fever and malaria are 76% of the referred children

10

ACHIEVEMENTS
The phones are used not only for data collection and referral of cases Fast communication, fewer trips to carry out (and reducing travel costs) between remote and central facilities/districts/region

Help providers to timely refer and to address some complications of pregnancy and childbirth on site
Sending the ambulance where available to transfer the woman quickly Used for bench marking from successful SBMR sites

11

CHALLENGES / CONSTRAINTS
Loss and recurrent breakdown of phones; Challenge by health providers to replace lost phones Low retention capacity of the battery creates frequent and recurring costs of charging (scarcity of energy sources to recharge phones and poor quality) Limitation of services (text messaging services are not included yet)

12

LESSONS LEARNED
Networking providers and managers of the health system:
facilitates the information flow

improves the availability of health services and technical

assistance in remote Geographical Locations

The timeliness and completeness of data collected greatly improved Mandatory replacement of lost phone by the holder reduce losses Providing new sturdy phones reduce breakdowns
13

PROVIDERS AND HEALTHS SYSTEM MANAGERS TALK ABOUT

PROVIDERS: Fewer trips for medical evacuations; Easier reference (the reference center is immediately informed of the case) In MH: Support of Pre Eclampsia and Eclampsia management by communicating the protocol by telephone; FP: the management of side effects of contraceptives is often discussed MANAGERS/SUPERVISORS: Reducing travel from health centers to districts, Reduced call charges to health facilities in our area or district Improving the system of making referrals from health centers to district hospitals Faster coordination of an ambulance in case of referrals from health centers to the district/regional hospitals Improved drug/contraceptive stock management

14

WAY FORWARD
Use the phone for mentoring Evaluate the impact of use of telephone for references and data collection Support the Ministry of Health for a sustained appropriation of mobile phones for health system

Expanding the fleet to new project areas

Improve the communication system at all levels in order to prevent stock-outs

Plan refresher courses for FP providers and make available Jobs aids (management of side effects)

15

RECOMMANDATIONS
Improve the management of the phone (mode of use, security) in health facilities for a better accessibility to all providers Expand the availability of other services to fleets in health facilities (emergency, pharmacy) Support the Ministry of Health for a sustained appropriation of mobile phones for health system

Find more robust/sturdy Phones & Accessories

16

THANK YOU ! MERCI ! ASHANTI !

17