1. Health: Hype or Hope? Cell-Life on mHealth 101 Dr Peter Benjamin peter@cell-life.org Skype ID: peterbenjamin #PeterB_CellLife www.cell-life.org.za

2. What is Cell-Life is? Not-for-profit making tech & services accessible to improve health & meet social challenges Started 2010, UCT & CPUT Cape Town, SA 10 African countries (mainly SA) 25 staff (mainly techies) Open Source © Cell-Life 2011

3. What do we do? Applying eHealth (especially mHealth): 1. Social & behaviour change communications 2. Primary health system strengthening We are one of the few mHealth organisations active in Technical development Proof-of-concept pilots at sites Larger health system implementations Developing business models Research and Policy Lots of things ‘work’ as pilot, issue is  S C A L E

4. Intelligent ARV Dispensing, Stock Management, and Reporting Data collection, Monitoring & Evaluation using mobile phones Mass HIV and health messaging using mobile phones © Cell-Life 2011 Contributing to the mHealth evidence base Main Services

6. Intelligent Dispensing of Antiretroviral Treatment Software solution designed to support pharmacists dispense ARV & related drugs Improved reporting, data quality, stock control 300+ sites (92 main clinics, 211 down-referral) 350,000 patients receive ARVs © Cell-Life 2011

7. iDART in action

9. Mobile Data Collection © Cell-Life 2011

10. Dept of Health cellphone rollout 12,000 phones Data collection for all 4,332 health facilities First application: monitoring of HCT Project awarded to Cell-Life and HISP Initial rollout in 950 facilities June 2012 Full rollout from Sept - Nov 2012 Infrastructure for clinical mHealth Clinical data collection in SA public sector © Cell-Life 2011

13. Basic phones25% mobiles in SA Voice, SMS, Text menus (USSD) “Feature phones”65% mobiles in SA Basic internet connection (GPRS) WAP / Mobi-sites, MXit, Java Apps Smartphones10% UP  Apps (Est 13,000 iPhone health Apps) Tools for mass mobile communication © Cell-Life 2011

14. Messaging for prevention & testing Soul City, SANAC, Brothers for Life, RTC, Just positive Mass information for positive living TAC Adherence Clubs, Siyayinqoba Linking patients & clinicsECHO, Kidz +ve, DTHF, RHRU CounsellingNational AIDS Helpline Building capacity of HIV- related organisations CARIS, HIVAN, TAC... – over 100 organisations Maternal healthMobile Alliance for Maternal Action Communicate applications

15. mHealth Research SMS to test RCT 2,400 enrolled. Control; ‘Information’/‘Motivation’; 3 / 10 Stat significant only with 10 ‘Motivational’ PMTCT (ECHO @ Coronationville Hosp) RCT 320 mothers (½ test, ½ control). SMS info & reminders. Msgs help women deal with status, ‘psycho-social’ support. Better retention @ 10 weeks. 2 Adherence trials MXit text counselling (RedChat) MXit link with National AIDS Helpline. 55,000 conversations Good access to youth, anonymity, multiuser © Cell-Life 2011

16. © Cell-Life 2010 “These tools don’t get socially interesting until they get technologically boring” (Clay Shirky, 2010)

17. © Cell-Life 2011 Formal health system inaccessible, inadequate or abusive to many mHealth can reduce the barrier to accessing healthcare The cellphone can be the first point of contact with the health system Like mBanking provide better financial services with users outside banks … Towards mobile primary care

18. © Cell-Life 2011 1.Promotive & Preventive 2.General health info 3.Triage services 4.CHW assistance 5.Clinical referral 6.Treatment support 7.Maternal & child health focus 8.School-based Towards primary mHealth

19. Communicate Web based software solution/ Platform that Provides communication and information services through cell phone channels. SMS, USSD, WAP, MXIT

20. Nkosi Siyabonga Ke a leboga Dankie Thank you Dr Peter Benjamin peter@cell-life.org Skype ID: peterbenjamin @PeterB_CellLife `