Geneva, Switzerland, 25-26 September 2012 Narrowing the ‘Evidence gap’ for informed policy and regulations in mHealth Dr. Shariq Khoja MD. PhD (eHealth) Technical Advisor – Evidence, Financing and Policy mHealth Alliance ITU Experts Group Meeting on m-Health: Towards Better Care, Cure and Prevention in Europe Geneva, Switzerland, 25-26 September 2012
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Geneva, Switzerland, 25-26 September 2012 Narrowing the Evidence gap for informed policy and regulations in mHealth Dr. Shariq Khoja MD. PhD (eHealth)
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Geneva, Switzerland, 25-26 September 2012
Narrowing the ‘Evidence gap’ for informed policy and regulations in
mHealth
Dr. Shariq Khoja MD. PhD (eHealth)Technical Advisor –
Evidence, Financing and PolicymHealth Alliance
ITU Experts Group Meeting on m-Health: Towards Better Care, Cure and Prevention in Europe
Geneva, Switzerland, 25-26 September 2012
2
Roadmap
Understanding mHealth EcosystemWhat are the needs and gapsImportance of strengthening Evidence base for mHealthRole of mHealth AllianceBuilding Partnerships
Geneva, Switzerland, 25-26 September 2012
3
mHealth Ecosystem
Geneva, Switzerland, 25-26 September 2012
4
Intervention Points across H/system
Geneva, Switzerland, 25-26 September 2012
Research and Development
Leadership and Governance
Financing
Procurement and Supply chain
Communication and Education
Service Delivery
Information Management
Enablers
Health Work force
Medicines, Vaccines, Supplies
Facilities/Infrastructure
Health SystemData
Collection / Disease
surveillance
Emergency Medical
Response System
Disease Prevention and Health Promotion
Health Financing
HIS and Support tools
for Health Providers
Treatment Adherence / Appointment
reminders
Supply Chain Management
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Framework for mHealth Impact
Geneva, Switzerland, 25-26 September 2012
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Gaps in Evidence
Geneva, Switzerland, 25-26 September 2012
Examples of Operational Effectiveness Examples of Improved health OutcomesEmergency
Response in Haiti
1000% Increase in number of people reached through sms
Benefits:
Expanded geographic reach to remote areas
HIV Testing, Kenya
97% decrease in processing time
Benefits:
Increased speed of Information delivery & Efficient supply chain
Patient Registration, India
300% Increase in volume of data captured
Benefits:
Promotion of healthy behaviour
Increased accuracy of information
Patient Reminders, Kenya
Significant Increase in adherence to care plans
Benefits:
Improved quality of care
Improved capacity of health Providers
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Gaps constraining mHealth Ecosystem
Geneva, Switzerland, 25-26 September 2012
• Lack of mHealth Policy or alignment with the eHealth policy at National level
• Limited connection between global North and South• Lack of standards to enable interoperability• Low level of coordination between players at national level• Low level of cross-sectoral understanding b/w communities
• Lack of second-phase funding to scale projects• Limited understanding of full cost of implementation• Low engagement of major health funders (GAVI, GF etc)• Limited willingness and capacity to pay among end-users• Lack of Inter-operability with enabling systems & tech• Challenges of delivering services in rural areas• Lack of evidence-based studies to support business case
• Lack of rigorous evaluations to demonstrate health impact and learn about what works
• Low end-user and health worker technology literacy• Siloed relationship with other mServices (mMoney etc)• Lack of effective dissemination platform for knowledge • Weak technology support markets
Impact Areas Gaps and Barriers
mHealth Alliance
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Mission:
Goal:
Strategic priorities:
Catalyze the power of mobile technologies to advance health and well-being throughout the world, with a focus on low income countries
Mobilize the effective integration of mHealth into global health practices, programs, and policies by building the mobile health commons
Evidence base linking mHealth to operational benefits and
improved health
Health community
with capacity to design and
deploy
Alliance’s activities:
Catalyze the Alliance’s partners and members to build “the commons”
Set the agenda to build the commons
Build the mHealth
knowledge base &
communicate/ advocate
Connect, convene, and facilitate the community
Provide catalytic
funding to accelerate
building of the commons
Results Framework: mHealth community long term targets
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Strategy Target IndicatorMeasurement
method
Catalyze the power of mobile
technologies to advance health and well-being throughout the world, with a focus on low
income countries
•Measurable progress made against MDGs 4,5,6 (DHS/ MDG indicators)
•UN MDG indicators for MDG 4, 5, & 6
•Refer to publically available research and data
Notes: 1. Community refers to the broader mHealth community that the Alliance targets. Source: Dalberg analysis
Results Framework: mHealth community long term targets
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Strategy Target IndicatorMeasurement method
Mobilize the
effective integration of mHealth into global
health practices, programs,
and policies by building the mobile
health commons
•Health community is aware of mHealth and effectively use•mHealth uses commonly accepted health & technology standards; policies apply to and account for mHealth •Programming and funding of health initiatives & services include mobile component•mHealth is scaled and sustainable due to common challenges addressed
• # of Ministries with mHealth incorporated in national programming • # of global
health funders with explicit mHealth programming or strategic priority• # of health
practitioners and individuals who report using mHealth
•Refer to publically available research and data •Partner feedback survey•Member survey
• Larger and higher quality evidence base linking mHealth to operational benefits and improved health
•# and proliferation of comparative studies across countries•# of scaled projects producing rigorous M&E results•# and proliferation of comparative costs/benefit studies
•Refer to publically available data•HUB surveys2
Policy
• Global & national policies support the use of mobile for health
•# of countries adopting mobile policies in national health programs (policies explicitly mention “mHealth”)
•Member survey•Refer to publically available research and data
Capacity
• Health community with capacity to design and deploy
•# of health practitioners using mobile, •# of readers of M&E reports (i.e. # of downloads, distribution)
•Member survey •Website / social media tracking tools
• 2-3 key research questions answered in one use case at national level by 2014
• # of studies conducted on key research gaps – either commissioned or brokered by the Alliance and its WG•# of existing studies which have integrated key questions in line with those identified by the WG
•Refer to publically available data•Working group performance measurement process (TBD by working group)
Policy• TBD when working group is formed
•# of countries adopting mobile policies in national health programs (policies explicitly mention “mHealth”)
•Member survey•Refer to publically available research and data
Capacity• TBD when working group is formed
•% positive responses of target cohort in member survey•# of readers of mHealth reports & tools (# of downloads)
•Member survey •Website / social media tracking tools
mHealth ecosystem needs evidence on successful business models and health related outcomesmHealth Alliance is playing an important role in creating enabling environment for mHealthmHealth Alliance is looking to engage partners at different levels to engage in each of the priority areas