Mobile Technology for Improved Malaria Community Mobilization and Project Supervision Beth Brennan and Elana Fiekowsky, Africa Indoor Residual Spray Program M&E Specialists March 2, 2015

Africa Indoor Residual Spraying (AIRS) President’s Malaria Initiative (PMI) 15 countries in Africa Aug 2014-2017 AIRS protects 36 million and hires 88,000 people

IRS and Mobile-based Tools In 2014, AIRS piloted: Mobilization with voice and SMS messages Campaign operations progress via SMS data Staff performance supervisory tools

Mobilization on an IRS Project Traditionally IRS programs hire local residents as mobilizers to visit each house in a target village How to prepare for spraying and the timing

Mali Mobilization Pilot In 2014, piloted using mobile phones in place of mobilizers to prepare households in 3 villages in Koulikoro district

Cell Phone Number Collection One month before spraying, staff collected 2+ phone numbers from every concession (n=673 nos.) Also collected: preferred language and time of day to receive messages literacy level

Enumeration Data Pilot Villages: Fougadougou (n=148 phone numbers), Tienfala Village (n=181), and Tienfala Gare (n=344)

Mobile Message Testing Two weeks later, sent a test text message to a random sample of 10% of the total phone numbers 68 test messages Follow up interview to 20 of those 68 subscribers

Implementation Text messages sent to beneficiaries in all three villages before, day of, and following IRS « Monsieur, madame contribuez à la réussite de la campagne PID financée par l’USAID en préparant vos fiche PID et en sortant vos meubles le jour de la pulvérisation. Les insecticides utilisés sont testés et n’ont aucun effet nuisible à la santé »

Implementation -2 Voice messages sent to beneficiaries in Fougadougou and Tienfala Gare, along with text messages

Pilot Evaluation Spray operators indicated household preparedness on their data collection form Enumerators asked households their perceptions of mobilization

Findings: Household Preparedness Comparison of Spray Coverage and HH Preparedness during the First Week of Spray Pilot Villages Most common reason un- sprayed Spray coverage IRS Card available Structures prepared FOUGADOUGOU Refusal 81% 25% 48% TIENFALA GARE 77% 45% 59% TIENFALA VILLAGE (text only) 92% 24% 50% Total   83% 31% 52% Comparison Villages Most common reason un- sprayed Spray coverage IRS Card available Structures prepared FASSA Structure Closed 97% 74% 75% WOLONGOTOBA SOCORO 91% 81% 68% WOLONGOTOBA SOCOURA Refusal 100% Total   94% 85%

Findings: Survey Results Beneficiaries were very curious about the messages and wanted more information on IRS

Findings: Survey Results -2 Mobile messages led to an unexpected shift in gender participation with mobilization

What’s the cost difference? Mobile messaging was more expensive in Mali Mobilization Method Total Costs $USD Percentage Cost Mobile messages 2,529.48 72.1% Traditional mobilization 978.89 27.9% Total Cost 3,508.37 100.0%

Future Applications Are other countries better suited for this? Can we use text message only? What does replacing personal contact with a mobile message do to the community?

IRS Supervision using mobile platforms

Mobile Supervisory Approaches SMS-based Operational data for quick program progress Smartphone-based: Staff performance data for real-time program quality

Operational Data for IRS Progress Are we meeting the campaign goals? Are we on track to finish by X date? Where do we need to address/fix issues?

Operational Data Collection/Reporting

Staff Performance Data for IRS Quality Are homes prepared for IRS? Are operators spraying per IRS protocol? Are we in compliance with environmental standards? Are spray quality issues being addressed immediately?

Staff Performance Supervisory Checklist - Implementation Start of day check Household prep for IRS Spray quality End of day check

Staff Performance Supervisory Checklist - Data Collection

Colors represent performance quality Staff Performance Supervisory Checklist - Reporting Colors represent performance quality Issues by area

Staff Performance Supervisory Checklist – Reporting -2 Lists teams members

Staff Performance Checklist – Stats Country Total # Forms Avg # Forms/ Day Avg % Red Flags Common Issues Reported Angola 531 18 5.0% Inadequate PPE Insecticides mixing Spray speed Spray coverage HH messaging: Do not paint walls Go to HF if rash appears Senegal 522 2.2%

Staff Performance Checklist – Stats -2

Benefits of Mobile Supervisory Tools Real-time data to address issues Accountability and skill building of seasonal staff Improvement in spray quality Consistent & standardized supervision Daily campaign reporting to partners

Mobile System Challenges/Solutions Low mobile technical skills among seasonal staff Increase the number of training days to allow for more practice Perform close supervision the first week of spraying Poor network coverage in some areas Submit data when back in area with good network coverage Difficulty running software updates for mobile tool edits Train supervisors to process the updates themselves Undefined roles for AIRS team members Outline the roles for all project staff (M&E, IT, operations)

Way Forward for Mobile Supervision Mass-rollout in all AIRS countries in FY2015 Expand mobile-based platform to other IRS areas: Epidemiological surveillance Household enumeration with GIS mapping Gender norms survey Entomological research Mobile banking

Questions? Beth Brennan, Abt Associates Beth_Brennan@abtassoc.com Elana Fiekowsky, Abt Associates Elana_Fiekowsky@abtassoc.com http://www.africairs.net/