1. Neal Lesh, D-tree International, Dimagi Inc In search of effective mHealth.

2. Phones won’t save the world but we can build some great tools deliberately.

3. Roadmap Introductions and overview CommCare Five cautionary suggestions 1.Open source is a deep concept 2.Design under the mango tree 3.Don’t automate broken systems 4.Beware unused data 5.Building capacity takes time

4. 91-97: PhD computer science, UW 97-04: Artificial Intelligence & HCI 04-05: MPH global health, Harvard 05-08: Vagabond eHealther… ◦ Tanzania (Harvard PEPFAR, D-tree, MVP) ◦ Rwanda (Partners in Health, Columbia) ◦ South Africa (D-tree, MRC ) ◦ Bangladesh (BRAC, Dimagi) ◦ Malawi (Baobab) Me 4 Many other collaborations: IRC, Ifakara, OpenMRS, OpenROSA, Intrahealth, DataDyne, UW, PATH, Cell Life, …

5. Almost everywhere, somebody local has a phone.

6. mHealth Areas Outreach Data Collection Decision Support Tele- Medicine OpenROSA Consortium

7. Cell LifeMakerereDataDyne SSID-treeDimagi ….. …. UW CommCare To strengthen and monitor community health programs JavaROSA open source software

8. Growth Spurt for D-tree Office in Dar es Salaam, TZ Five pilot projects, ~55 users Two controlled studies Starting to standardize our practices

9. Roadmap Introductions and overview CommCare Five cautionary suggestions 1.Open source is a deep concept 2.Design under the mango tree 3.Don’t automate broken systems 4.Beware unused data 5.Work glocally

10. CommCare 10 HEALTHY PREGNANCY Vitamin A, Iron Started tetanus Finished tetanus Started IPT (Malaria) Finished IPT (Malaria) Deworming tablet Has birth plan Tested for HIV

11. Child Mortality in Tanzania (per 1000 births) The Lancet, Volume 371, Issue 9620, Pages 1276 - 1283, 12 April 200 11

12. Video

13. Population health data Implementation monitoring Process improvement Evidence-based change Supervision Checklists, Protocols Scheduling Job satisfaction Benefits of CommCare 13 Field Office Community Health Organization Government, other development efforts

14. Roadmap Introductions and overview CommCare Five cautionary suggestions 1.Open source is a deep concept 2.Design under the mango tree 3.Don’t automate broken systems 4.Beware unused data 5.Building capacity takes time

15. Open source is a deep concept Not free (total cost of ownership) Get by giving, but giving can be uncomfortable for many organizations Much open source code is not collaboratively built, some not even released Conducive to local ownership Not conducive to good tech support

16. Design under the mango tree 16

17. Don’t automate broken systems CommCare doesn’t save lives, CHWs do. Tech won’t get health workers to take temperatures, but it might help supervisors to get them to. mHealth is tools, so find places where better tools will have impact. 17

18. Map it before you automate it 18

19. Beware unused data

20. Successful Report

21. Unsuccessful Report

22. Building capacity takes time So start now! Don’t expect a lot right away. Invest in local capacity and give opportunities to local innovators Coded in Country – Akin to FairTrade label for software

23. What are we going to do today, Brain? The same thing we do every day, Pinky…. Make a plan to TAKE OVER THE WORLD!!!!! neal@equalarea.com