From our first guest blogger: Lise Ellyin, Mozambique Country Director for the Clinton Foundation
Emanuele asked me to contribute to this great blog to discuss the Mhealth solutions being implemented in Mozambique, for which I am delighted to share on behalf of the Ministry of Health and partners. It seems fitting to be writing this while I am in China, a capital of technologies.
Innovative solutions are changing the way health services are delivered these days in Mozambique. The country has become one of the leaders in this area: in evaluating and implementing new diagnostic technologies and mobile health solutions, sharing these experiences globally via conferences, publications and most recently showcased in the WHO July 2011 Implementation guidelines.
The need for improving access and improving treatment initiation rates is being fast tracked with new technologies. Fixed dose combinations of antiretrovirals were one of the first innovations, diagnostics are now the next wave of technologies to be tested. Mozambique under the leadership of the Instituto Nacional de Saude has been testing Point of Care CD4 devices where CD4 test results are available from a small mobile machine in as little as 15 minutes, national scale up is now on way.
Using mobile (GPRS)
When the CHER study results were released in 2008- it showed the world the urgency with which HIV positive infants under 2 years needed to be treated. There were so many areas to strengthen- but testing was a main point. Well today- health sites providing the infant testing have GPRS printers, where results from the reference labs are sent via GPRS within a few minutes to a printer at the health facility. Over 95% of the infant results are now being delivered this way and 50% of the samples are available at the health facility from the time of testing in as quick as 28 days. I remember in 2008 when 4-8 months was the norm for infant test results time and we were losing a lot of infants out of the system- it was taking just too long.
Point of care technologies
The point of care technologies are able to deliver test results in a short period of time: from 1 minute to 40 minutes, depending on the type of test conducted. Cobue – a district in the Northwest of Niassa is a great example of the impact that these technologies can have- not only in urban areas, but also remote areas. The Cobue community has embraced the CD4 machine (otherwise known to them as the “PIMA”) as it rapidly provides them with their health status, and right at their doorstep. On a recent visit earlier this year to Cobue with the Ministry, the community asked what other types of testing machines were coming their way!
All these technologies are able to reduce the burden on the patient in terms of travel, costs and time for multiple visits – which could translate in reducing loss to follow up where rates which can be as high as 30% for adults and over 50% for pediatrics.
This new generation of technologies are also providing key job tools and improving efficiency for the health care workers. These devices could perhaps be defined in the future as “virtual” task shifting.
More diagnostic devices and evaluations are in the pipeline for 2012 onwards, ranging from DNA PCR, Viral load to pneumonia and eclampsia. These initiatives driven by the Ministry of Health, and the team at the national Institute of Health have also been a great example of partner coordination on scaling these programs nationally. We have also leveraged pubic- private partnerships that will ensure these initiatives remain viable. Since 2010, Mcell has supported the GPRS initiative with technical assistance and funding of the transmission costs of the GPRS printers.
At the UNAIDS High level meeting in New York in June- it was discussed that new innovations are needed to accelerate progress in HIV/AIDS and other health areas to meet the global MDG goals and reduce mortality rates. Mozambique could be leading the way and this brings good news.
Here’s to a successful and innovative 2012!