1. 1Management Sciences for Health Stronger health systems. Greater health impact. Reaching Beyond the Grid: the K4Health Malawi Pilot Natalie Campbell

2. 2Management Sciences for Health www.k4health.org K4Health Malawi Pilot

3. 3Management Sciences for Health K4Health Malawi Challenge How can we support Community Health Workers to deliver effective FP/RH services at the community level though they are in remote locations, receive limited training and have limited access to resources available at the district and national level?

4. 4Management Sciences for Health K4Health Malawi SMS Goal Goal: Increase CHW’s access to FP/RH information through mobile telephone networking using FrontlineSMS in Salima and Nkohtakota Districts Desired Result: Timely and accurate Family Planning and Reproductive Health services provided to men and women in hard to reach areas, reducing incidences of maternal and neonatal mortality

5. 5Management Sciences for Health K4Health Malawi Design of the mHealth project Timeline: May 2010 – June 2011 Resources: $25 mobile phones and $7 solar chargers for 100 CHWs in each district Partnership: FrontlineSMS; MOH; BASICS; and other SMS network projects SMS system: 1.SMS alert system (i.e. notification of community vaccination dates, trainings, etc) 2.Peer-to-peer SMS network (ongoing support for CHWs) 3.On-demand automated FP/RH info and tips (immediate info on dosages or other automated responses to FAQ)

6. 6Management Sciences for Health K4Health Malawi Bridging knowledge exchange gaps National Level Ministry of Health Health Centers - Nurse - Medical Assistant Health Post - Health Surveillance Assistants - Community Based Distribution Agents (volunteers) District Health Facility (hub) - Medical Doctor - Clinical officers - Registered Nurses - Nurse & Midwives - Laboratory personnel - Pharmacy Technicians

7. 7Management Sciences for Health K4Health Malawi Knowledge and Information Flows

8. 8Management Sciences for Health K4Health Malawi How can FLSMS help CHWs like Rose? Report drug stock outs so that her clients never miss their monthly supplies Report any side effects of difficult conditions and assist her clients in time Get timely information about supervisory support visits Avoid longer walks (30km trip) to consult her supervisor on difficult cases – costs us 10 cents.

9. 9Management Sciences for Health K4Health Malawi Story from Nkhotakota It’s late at night in a hard-to-reach village in the Malawian District of Nkhotakota. There is no electricity in this village, nor in the Bua community health center that serves 11,280 people. A pregnant mother goes into pre-term labor. The local Health Surveillance Assistant (HSA) is called to provide help because the local maternity nurse is not at home.

10. 10Management Sciences for Health K4Health Malawi Story from Salima District of Mr. Almon Chimphepo 92km 32km Mr. Chimphepo, FP provider at village level Mr. Moyo, HAS At Health Center District Hospital Supplies

11. 11Management Sciences for Health K4Health Malawi Current Usage August: 175 messages received & 158 sent as group distribution

12. 12Management Sciences for Health K4Health Malawi What's next? Continue to track usage Continue training Increasing use of key word messaging Exploring expansion of program Exploring partnerships

13. 13Management Sciences for Health Natalie Campbell ncampbell@msh.org Thank You. www.k4health.org For further information or questions:

14. 14Management Sciences for Health Stronger health systems. Greater health impact. Saving lives and improving the health of the world’s poorest and most vulnerable people by closing the gap between knowledge and action in public health.