Geneva, Switzerland, 25-26 September 2012 Narrowing the Evidence gap for informed policy and regulations in mHealth Dr. Shariq Khoja MD. PhD (eHealth)

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


2

Roadmap

Understanding mHealth EcosystemWhat are the needs and gapsImportance of strengthening Evidence base for mHealthRole of mHealth AllianceBuilding Partnerships


3

mHealth Ecosystem


4

Intervention Points across H/system


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

5

Framework for mHealth Impact


6

Gaps in Evidence


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


• 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

Results Framework: mHealth community1 intermediate targets

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method

Evidence base

• 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

Results Framework: mHealth Alliance1 intermediate targets

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method

Evidence base

• 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

Membership model:

Source: Dalberg benchmarking analysis (six sector-building organizations) 2011; Vital Wave “mHealth Alliance Operating Plan” 2009

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Cross-sectoralSingle actor focus

GSMA GBC Health ANDE CGAP Roll Back Malaria

Stop TB

Mem

bers

hip

Part

ners

Fu

nd

ing

• Funding institutions

• ~50

• Implementers, technical support

• Grants• Membership

fees

• Intermediaries (investors, tech assistance)

• ~60 members

• Funders

• Members dues• Occasional

fee-for-service

• Private sector• ~250

members

• Implementing actors / general supporters

• Members dues• Occasional

fee-for-service

• Open • 700+

• Same as members

• Donations from large funders

• Private sector mobile companies

• Implementing actors

• Members dues

• Multi-sector institutions

• Light screening

• 1000+

• Implementers, technical support

• Grants• Membership

fees

Org

an

izati

on

Role

• Research, policy building

• Member services

• Member services

• Movement building

• Member services

• Movement building

Conclusions

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

14Geneva, Switzerland, 25-26 September 2012

Thank you

Dr. Shariq Khoja

[email protected]

15Geneva, Switzerland, 25-26 September 2012

Documents

Geneva, Switzerland, 25-26 September 2012 Narrowing the Evidence gap for informed policy and regulations in mHealth Dr. Shariq Khoja MD. PhD (eHealth)