mobil phones/telephonie mobile

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Mobile phone use for integrated health servicesin Guinea- Experience of Guinea

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Jacqueline ARIBOT

GMHC2013, Arusha-Tanzanieq15-17 January 2013


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Goal and objectives

Describe the implementation strategy of themobile phone fleet

Describe results and lessons learned

Discuss problems encountered

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The goal of this presentation isto share Guineaexperience on the use of mobile phonetechnology for integrated health services :

A head of rural health center with

phone , Kouroussa (12/10/2011)


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BACKGROUND 1

Country indicators TFR : 5,7

CPR : 9%(6% modernes

methods) MMR : 980/100 000 NV

infant mortality : 91/1000

(39/1000 before 1 month) Coverage :

20 districts (606 healths facilities and

et 1700 CHW villages)

Family planning

Emergency obstetric and newborn care

Quality improvement through Standards-BasedManagement and Recognition

Child Health: Integrated Management ofNewborn and Childhood Illness, communitycase management

Malaria

Community outreach and community-basedservice delivery

Pre-service education (doctors ,midwives)

Infection prevention

MCHIP/Guinea Majors Activities


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BACKGROUND2

Almost total absence of means of communicationbetween facilities of the health system

Low reference rate of pregnant women (4.6%)

Frequent Contraceptives stock out

Emerging technology services such as mobile phonehelped to communicate in various sectors, including

health.


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BACKGROUND3

# Companies: 5 (4 privates)

Two Orange fleets:

WHO/Guinea & MCHIP/Jhpiego

Cost: $2-$4/month/line

Unlimited voice services

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Deployment of a fleet of 264 Mobile phones :

Signing of an agreement to use the phone

Provision of management tools, guidanceand supervision of the staff

Keys staff of the health system

Key project personnel

Health services providers

INTEGRATION STRATEGIES2 : PROCESS


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Data collection & reporting

Request for

technical assistance

Planning &

Management offield activities

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Communication between MCHIP staff and field

PURPOSE OF MOBIL PHONE USE 1

MH Advisor(MCHIP)

Midwife(HealthCentre)

SBMR Advisor(MCHIP)


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Referral of cases (FP, MCH, IMNCI)

Drug/contraceptive stock

management Consulting colleagues

Coordination of health activities

Transmission of epidemiologicalsurveillance data

Communication among field staff

PURPOSE OF MOBIL PHONE USE 2


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KEYS RESULTS 1 : GLOBAL USE OF PHONE

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(Janvier Dcembre 2012)

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

Number of calls done by providers/managers/supervisor of health system


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KEYS RESULTS2 : REFERRAL CASES

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Fever and

malaria are

76% of thereferred

children

(January to December 2012)


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ACHIEVEMENTS

The phones are used not only for data collection andreferral of cases

Fast communication, fewer trips to carry out (andreducing travel costs) between remote and central

facilities/districts/region

Help providers to timely refer and to address somecomplications of pregnancy and childbirth on site

Sending the ambulance where available to transfer thewoman quickly

Used for bench marking from successful SBMR sites


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CHALLENGES / CONSTRAINTS

Loss and recurrent breakdown of phones; Challenge byhealth providers to replace lost phones

Low retention capacity of the battery creates frequentand recurring costs of charging (scarcity of energysources to recharge phones and poor quality)

Limitation of services (text messaging services are not

included yet)


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LESSONS LEARNED

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

improves the availability of health services and technicalassistance in remote Geographical Locations

The timeliness and completeness of data collected greatlyimproved

Mandatory replacement of lost phone by the holder reduce

losses

Providing new sturdy phones reduce breakdowns


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PROVIDERS AND HEALTHSSYSTEM MANAGERS TALK ABOUT

PROVIDERS:

Fewer trips for medical evacuations;

Easier reference (the reference center is immediately informed of thecase)

In MH: Support of Pre Eclampsia and Eclampsia management bycommunicating the protocol by telephone;

FP: the management of side effects of contraceptives is oftendiscussed

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


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WAY FORWARD

Use the phone for mentoring

Evaluate the impact of use of telephone forreferences 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 toprevent stock-outs

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


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RECOMMANDATIONS

Improve the management of the phone (mode of use,security) in health facilities for a better accessibility to allproviders

Expand the availability of other services to fleets inhealth facilities (emergency, pharmacy)

Support the Ministry of Health for a sustainedappropriation of mobile phones for health system

Find more robust/sturdy Phones & Accessories


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THANK YOU !

MERCI !ASHANTI !

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