Category: Blog

Text to Change’s Chief Technology Officer, Marcus Wagenaar, sat down with me yesterday to discuss new projects on the horizon and innovations in the mHealth field.  Text to Change is an international NGO which uses technology for social change, or as Marcus puts it, “not just a tech company.”  Instead, outreach is where Text to Change works. As the knowledge bearers about mHealth systems and needs, they help design, conceptualize, manage and analyze outreach and projects with their implementing partners to address gaps in healthcare systems and information.

I asked Marcus to talk a bit about some of his favorite projects:

m4rh

Mobiles for Reproductive Health (m4rh), in collaboration with FHI, uses SMS and web based software to send targeted messages about reproductive health.  The user gets their first message and is given 1-3 options for response, such as “if you want more information about condoms, text back 001.” They are then inside a tree of responses win which they can navigate back and forth and discover new information.  The project has been running in Kenya and Tanzania for over a year with pilots in Ghana and Rwanda underway. FHI provides the content and updates, Text to Change runs the IT backend in each country, all from Kampala.

m4rh is one of Marcus’ favorites because it’s “inherently scalable, once it’s set up anyone can access it for free by texting the first keyword to get the main menu” and it’s the “perfect example of Text to -Change because it provides people with information to make informed choices about their lives. In situations where information is lacking or inaccurate around sensitive issues of reproductive health, m4rh allows people to access information that can give them more control over their lives.  They still make their own decisions but at least they have all necessary information to make an informed choice.”

As example of its popularity; in May 2012 more than 40 thousand people have accessed the M4RH information service in Kenya alone. The specific information people access in the system is analyzed. Also, SMS surveys amongst users are carried out to enable deeper analysis of behavioral patterns. By combining this information various things can be deduced. Examples are: which contraceptives are popular in which age groups, what are the differences in male and female use of the system, are the choices people make influenced by the system, etc. These research results or not yet in the public domain but have been shared at various mHealth conferences and we hope to be able to share the results with a wider audience in the near future.

Medical Male Circumcision

The Medical Male Circumcision project, in partnership with Jhpiego in Tanzania and potentially Uganda, is a service hat sends information, similar to m4rh, as well as supporting patient recovery.  Individuals in the beneficiary population get messages regarding where they can receive Medical Male Circumcision and why it’s important, such as “Male circumcision can reduce the risk of female-to-male HIV transmission by 60%”.  After surgery, patients receive messages as soon as the surgery is complete regarding what to expect during their recovery. The Medical Male Circumcision project provides a Virtual Nurse who advises patients: “Make sure that you do not have sex for the first two days,” for example, or later on in the recovery “if your urine is discolored, visit the clinic.” The messages are “specific but lighthearted” with quiz questions every week to engage the patients and to assess how much they know about Medical Male Circumcision. Messages are meant to be encouraging and a “positive way to ensure recovery,” reduce stress, and “decrease health costs overall” by addressing concerns before they become serious health issues.

Text to Change monitors how many people they reach with their messages, how often they are reached, and how much it costs to reach a person. Researchers were able to show a statistically significant association between those men who texted in to the toll-free number asking where male circumcision was available and those who actually followed through and got circumcised. This is a good example of providing people with information to help them making informed decisions about their own health.

Data Collection

The data collection project is in the pilot phase with the Center for Disease Control in Tanzania within the mHealth Alliance. The project targets mothers after they have delivered and will speed up data collection about Vertical or Mother-to-Child-Transmission (MTCT) of HIV.  Currently, midwives and nurses fill in registers for mothers and babies to track their data by hand.  The individual patient data is rarely analyzed and often inaccessible to researchers and government representatives so that today there is no reliable number for the transmission rate for MTCT in Tanzania.  This Data Collection tool pilots a new form for tracking MTCT data, where healthcare workers take data from the standard register, write it on a worksheet and then copy it line by line and send it to a central location using SMS.  The data collected will allow the CDC to calculate the transmission rate for the first time in Tanzania and will enable impact evaluation of interventions that aim to lower the number of Mother to Child Transmission of HI, which is part of the Millennium Development Goals.

I also asked Marcus to give a window into exciting innovations in the pipeline:

FormHub              

FormHub is an Open Source initiative by Columbia University.  Text to Change is working with Columbia to develop and use their platform in the field. Text to Change is currently implementing this technology with one of their partners. The partner will conduct a survey in Uganda’s Luwero District, interviewing 1000s of teachers and students in secondary school about physical abuse, sexual abuse, living conditions, and emotional and physical wellbeing of children.  This is the first ever large-scale survey about these sensitive issues performed in Uganda. The partner designs the survey questions, Text to Change enables easy data collection using mobile technology and the formhub platform. Using cheap Android phones, 60 trained Ugandans will carry out the survey using FormHub.

Marcus also wants to use FormHub to automate data gathering in health and medical setting in remote clinics because it’s simple to use for the designer, data collector and data analist and it’s open source.  Many more interesting projects to come!

Vusion

Vusion is a new SMS open source platform development by Text to Change. The backend is based on the Vumi system developed by the Praekelt Foundation.  Marcus sees Vusion as the next big thing in SMS messaging, and here’s why:

  • Vusion is focused on providing a scalable enterprise messaging platform
  • It can connects to multiple telecom companies and aggregators in multiple countries and multiple shortcodes
  • Once Vusion is set up, you won’t need a programmer to design campaigns or access data so it’s easy for non-technical project managers to use without programming skills
  • An API enables access to SMS data from external applications, which enables easy development of for example; advanced real-time data visualizations, website-widgets, twitter integration, etc.
  • Vusion has different access levels and enables organizations to implement and manage multiple SMS programs in parallel from one central platform.

Programmer? You can download Vusion from github and see what the skeleton looks like.

Some of the cost implications of SMS projects are annual dedicated shortcode fees and aggregator costs.  Vusion reduces this by enabling shortcode sharing. Users can use the same shortcode for small projects to share infrastructure and still be in full control over their campagins and projects  This is the approach Text to Change has been pioneering for years but Vusion will make it easier for organizations to be more involved in their own campaigns by having full access to their projects and the associated data.

Vusion was launched with an extensive demo on the 15th of June in Amsterdam. There is no recording of real-live demo but an accompanying presentation is available on slideshare.

Interested in learning about Mobiles for International Development? Check out our upcoming course, mHealth: Mobile Phones for Public Health, starting in November. 

The TechChange course on Mobiles for International Development starts on June 18. Sign up now!

Have you ever been stuck on the mobile version of a website and were unable to go where you wanted just because you were surfing on your smartphone? One solution gaining prominence is called responsive design, which uses proportional measurements and other techniques to display appropriately-sized content on any device from large displays to smartphones. We are pleased to announce that we have launched our new fully-responsive website with the mobile device in mind. Not sure what responsive design is? Try resizing this window wider and narrower and watch what happens, or if you have a smartphone, try loading our site on it.

1. Mobiles matter and your audience uses them

It’s no secret that we’re big fans of mobile tech (re: Blog Posts of ours: Thoughts on Mobile Money for Development, FrontlineSMS and Technological Responsibility, Risk and Rewards of Mobile Technology in Governance Deployment), and mobile internet users are projected to surpass desktop users by 2015. Furthermore, Jon Evans of TechCrunch predicted that in five years most Sub-Saharan Africans will have smartphones and Vodafone recently announced that they will make a high-end low cost smartphone specifically designed for consumers in developing economies. We tweet more than a dozen articles every day on new innovations in mobile tech, from the developing world to higher education. That’s why when we redesigned our website to represent our online identity, we designed it with mobile in mind. This isn’t just on principle; we’ve seen our mobile traffic increase 175% from the same period last year.

2. Because it can save your organization time and money over the long run

There are many ways to approach mobile, and in the end we decided that a responsive design approach made the most sense for our needs. Building a responsive site based off a common codebase limits the hours needed to update code for each mobile platform out there (iOS, Android, Blackberry, Windows Phone 7, and more). While tools exist to streamline these processes and create cross-platform mobile apps, like PhoneGap and Appcelerator, this approach seemed overkill for our site. Furthermore, even if you do develop a native app, with the increase of mobile web use,  your site will be much easier to find, navigate, and utilized by web searchers.

We’re obviously not the first organization to do this (and we’re a little embarrassed it took us this long to catch up), but we are huge believers in the potential for responsive design to broaden reach and shorten development times (over the long run) and we are happy to be a resource for others considering a move in this direction.

3. Because it forces you to re-evaluate your priorities

We decided to take a “mobile first” approach to responsive design, which emphasizes designing for the smallest and most constrained canvas and then building upwards. We felt that this would be a good way to sift through the many pages and multitudes of text on our former site and pull out what was absolutely necessary and most relevant to our users. There are many many reasons to go mobile first, but we found that this process helped clarify our mission and focus.

The last point is that we didn’t do it alone. We read forums, checked ideas, circulated betas, and then asked for feedback from tech communities to help us keep building our model. That’s why we’d like to close with asking you, the reader, for your feedback if/when you get a chance to check out our site — either on a mobile device or otherwise. Also feel free to ask us any questions by emailing info@techchange.org!

After all, any technology is only as powerful as the community that uses it.

by Chrissy Martin, cross-posted from her blog, innovate.inclusively. She was a moderator for our Mobiles for International Development course that ran last month. A new session will be starting June 18th and you can apply here to join us. 

 

A few weeks ago, I had the pleasure of supporting the TechChange Mobiles for Development (TC105) course as a moderator. I was interviewed for the course by co-founder Nick Martin, which stimulated a interesting conversation with many of the highly experienced and knowledgeable course participants. Excerpts from that interviews are below.

The course itself was an amazing opporunity to interact with experts across the ICT for development field, and to dive into specific areas of interest including mobile financial services, mobile health, and mobile education. I highly recommend checking out their upcoming course on the same topics – early registration is now open on their website. (more…)

Anyone who has planned a conference knows that they’re a lot of work. Lining up speakers. Coordinating room schedules. Coming up with discussion topics. Promoting the event so that people show up. And, oh yeah… learning stuff! That’s important too.

The event we’re talking about here is TechWeek@DU, which ran from April 16th – 19th at the Josef Korbel School of International Studies in Denver, Colorado, and was brought together by the school’s Global Health Affairs Program,  Humanitarian Assistance Program, and the Center for Sustainable Development and International Peace. Five events in four days involving experts from Denver, Washington DC, and the greater Boston area, and discussing some of the most pressing issues in and around ICT4D. From crisis mapping to mHealth – for a week the Korbel School had tech on its mind.

But what began as an effort to bring this conversation to the DU community quickly become a realization as to the incredible amount of work being done in Denver, and that sometimes it takes the mere act of getting people into a room together for the whole to become greater than the sum of their parts. With that said, here are four lessons that I learned during TechWeek:

Lesson 1: Tech is only ten percent.

Tech is, and should be, for everyone. However, there are no silver bullets that will magically kill the beast that is complex operations and make our work easy. The reality is that the solutions we’re talking about here are 10% technological innovation and 90% people power. While advances in information and communication technologies can be leveraged to enhance the efficiency or effectiveness of one’s work – at the end of the day, the user remains responsible for the success (or failure) of any program or operation. What truly matters is how you use these new tools- so education is, and must remain, a priority.

 

On a personal note – this is ultimately one of the reasons why I joined the TechChange team. Having learned the value of leveraging technology for my own work in peacebuilding and development, it is my belief that our community writ large would be well served to remain informed as to the latest and greatest tools to suit our individual needs. And by learning not only how to use these emerging tools in our own work, but also how other organizations apply them in new and innovative ways, we can work together to strengthen the community as a whole.

Lesson 2: Ethics matter, especially as tech puts us all on the battlefield.

What does it mean that we can now access new levels of information about people in crisis zones? What are the potential risks that come along with this new opportunity for data collection, management, analysis, and response? As we learned from Nathaniel Raymond, Director of the Satellite Sentinel Project (SSP) at the Harvard Humanitarian Initiative – we’re all in the war because tech makes it global. Putting dots on a map may seem harmless, but any and all sensitive information can be used in previously unforeseen ways. As such, the question of ethics are paramount, and must be regularly addressed as we continue to intake and output large quantities of data and information.

Lesson 3: Technology isn’t as important as how we put it together.

Satellites existed before SSP, education before TechChange, maps before HealthMap. It’s not always about inventing new things, but rather putting them together in innovative ways that add value.

This lesson is especially apropos to the work of Dr. David Scales and his team at HealthMap. Using their data aggregation system to show where outbreaks are occurring around the world – which is based on the news feeds of major health organizations and a number of other sources – global health practitioners are able to track health emergencies in real-time, take steps to prevent the further spread of disease, and ultimately save lives.

Lesson 4: Denver is already on the cutting edge!

When we started TechWeek, I hoped to bring in outside tech experts, but also showcase DU. It wasn’t until I had a chance to meet the team at pirate tracker, hear more about KP’s work with access.mobile, learn about the upcoming launch of the TIPS program through the work of Professor Debbie Avant, engage in discussions with Korbel PhD students Roni Kay O’Dell, Keith Gehring, and Jonathan Moyer on how ICT has evolved over time, and see the overwhelming enthusiasm of the student body at DU on ICT4D, that I really learned how amazing DU is already in this field. We’re not only active, but even on the cutting edge!

So if the goal of this year’s TechWeek was to bridge the divide between different types of experts working in complex operations, then thinking about the ways we can showcase more of Denver’s amazing talent at the next round of conversations may just be the best place to begin.

 

 

 

Conclusion: For TechWeek, like in technology, it’s not about the tools but about the people.

At the end, I learned more about the tools than I thought I would. But the most valuable parts of TechWeek happened in the conversations between the presentations. Once again – it’s not just about the technology, but about the people. Thanks to our speakers for bringing these tools to life and to the students who showed up. And thanks to all of the amazing members of the core team who made everything go off without a hitch. While TechWeek is over (at least for this year), it is my hope that this is just the beginning of a larger conversation we can continue in years to come.

During the tense electoral standoff in Cote d’Ivoire after incumbent Laurent Gbagbo refused to vacate office following his defeat, the hashtag #civic2010 was used to report abuses by dissident forces as well as refugees’ movements and needs. In Malawi, the #July20 hashtag and facebook groups were used to organize the country’s civil society during the eponymous protests which drew international condemnation of the Mutharika government’s crackdown on freedom of speech and press. And, at the time of writing in Mali, activists, civil society and ordinary citizens were using the #mali hashtag to organize the safeguard of Mali’s antiquities held in rebel occupied Timbuktu.

While many associate the events surrounding the ‘Arab Spring’ with the use of digital communication for social movements and political organizing, this truism ignores the real pioneering work done three years prior and south of the Sahara. In 2008, Ushahidi, an open-source platform, was first used in Kenya to map the post-election fallout at the beginning of 2008. Ushahidi, along with SMS applications and social media platforms collectively known as Information Communications Technology (ICTs) have since spread across the continent and have put the tools to build democracy and good governance into the hands of millions of civilians.

As a result, crowdsourced information has empowered ordinary citizens as never before. A villager in a rural area can report corruption and broadcast to the world instances of injustice — adding a new and exciting angle to human rights, democracy, governance, and civil society development across the continent. At the same time, ICTs have increased the burden on governments to be more accountable and connect with their own citizens.

On the heels of the exciting expansion of ICTs throughout Africa, The African Studies program at the Johns Hopkins School of Advanced International Studies in Washington DC, will be hosting a conference on May 1-2 entitled The New African Democracy: Information Technology and Political Participation. The conference’s primary objective is to join African Studies experts with policy makers and practitioners to discuss challenges and opportunities for African politics in the digital age.

Speaking at the conference are representatives from a variety of institutions including: WANGONet, NDI Tech, Frontline SMS, Accender Africa, African Technology & Transparency Initiative, Afrimap, MacArthur Foundation, Michigan State and Cambridge Universities, Ushahidi, The World Bank, Alpha Strategy, and USAID.

At the beginning of the conference’s second day, TechChange, will deploy a small local simulation for attendees to emphasize the possibilities for integrating crowdsourced information with institutional processes to improve democratic participation and governance function. The simulation which will be lead by TechChange’s Rob Baker, Christopher Neu and Kevin Malone  provides a glimpse into some of the substance covered in the organization’s online certificate course, TC104 Global Innovations for Digital Organizing.

 

Those interested in attending the conference should RSVP to Jessica Carsten at jcarste1@jhu.edu.

Interested in participating in TC104? Apply directly on the TechChange website

Description: The campaign to #StopKony is approaching a critical transition. On April 20th Invisible Children will launch its Cover the Night campaign on the heels of one of the most successful viral videos of all time.

Moving forward from online ‘awareness-raising’, in which over 85 million people viewed their video Kony 2012, Invisible Children is now asking their supporters for something more – offline action. Regardless of your position on the efficacy and appropriateness of the campaign, the upcoming Cover the Night will be an important event in the short history of digital activism. How will Invisible Children translate a resounding marketing success into tangible action? What does this mean for the greater advocacy community?

As a precursor to our course on digital organizing and good governance, TechChange plans to host an open twitter chat to reflect on the campaign and its successes and approaches to date.

Date: Friday 27th at 1:00pm EDT

Key Questions:

1.  One of the biggest criticisms of Kony2012 was that it oversimplified the history of conflict in central africa and the mechanisms needed to create change in the region. How do organizations handle conflicting demands of delivering a message in an accessible way vs attending to complexity and nuance of an issue?

2.  Invisible children was clear that Kony2012 Cover the Night was not intended for policymakers or for affected communities in central africa, it was targeted towards US based activists. Should organizations/campaigns segment or customize messages and actions for different target audiences and how might they do this effectively?

3. Kony2012 proved the power of viral video in getting the attention of tens of millions of people. How do organizations successfully translate online activity into meaningful offline action? how do they sustain success?

 

Hashtag: #TCTalk

Be sure to participate in the chat by logging on twitter on Friday April 27th between 1 and 2pm EDT. Please remember: use the #TCTalk hashtag, introduce yourself, stay on topic, be respectful and have fun. This discussion will be part of TechChange’s monthly twitter chat, which are real-time conversations structured around specific themes.

Have a question but can’t attend the chat?
Mention @TechChange before the chat with any questions you have or issues you are interested in exploring – or just comment right here on TechChange Blog. We’ll do our best to include this feedback in the chat.

Sample Tweet: Join @TechChange for a twitter chat discussing #Kony2012  and Digital #activism on April 27th 1-2pm. Use #TCTalk http://bit.ly/JcwMm9

Interested in continuing the conversation further and engaging with other activists across the globe? Be sure to check out TechChange’s upcoming online certificate course, TC104 Global Innovations for Digital Organizing: open data, good governance, and online/offline advocacy. This course will evaluate case studies where new technologies have been employed for effective change and what factors and contexts are most influential on outcomes. More information can be found at TC104 course description page on the TechChange website.

Zombies have started to make their way into the DC Metropolitan Area! Yesterday the TechChange team delivered another FrontlineSMS simulation, this time set against the backdrop of a Zombie Apocalypse. The training was part of Challenge Accepted 2012 a weekend conference for undergraduates hosted by Americans for Informed Democracy.

Participants were divided up into teams of the Zombie Control Task Force  (ZCTF) and tasked with responding to the sudden appearance and spread of zombies in the city. They then had to set up the FrontlineSMS platform and determine a strategy for communication between  field workers and HQ, and civilians in need of treatment (all while avoiding a roaming Zombie).

Participants were asked to consider workflow questions such as:

  • How will you alert civilians when new information becomes available?
  • Should all civilians receive the same information? How will they be grouped?
  • What types of information will you need to gather from you field workers? What strategy will you use to ensure adequate communication between HQ and the field?
  • How will you verify the integrity of information from the field?
We’ve found that this is a great way to learn the potential and pitfalls of a tool like FrontlineSMS while keeping things engaging and fun. We’re excited about running more of these in the months to come (especially now that we have all kinds of new zombie equipment:)
If you’re interested in learning more about our courses and simulations consider signing up for our next online course TC104: Global Innovations for Digital Organizing. The course starts May 14th and there are sure to a few zombie scenarios in that one as well:)

This article was first published on the The Asia Foundation’s blog, In Asia.

By 

 “Just because they are poor and isolated doesn’t mean they don’t have the potential to be the next Bill Gates,” said Shahed Kayes, the founder of Subornogram Foundation in Bangladesh, while introducing me to lively students at a school he started on the remote island of Mayadip. Located in the Meghna River, the island’s 1,100 residents don’t have access to public services such as safe drinking water, public schools, or health care. The residents rely on the river’s catch of fish for their livelihood, and 97 percent live below the poverty line. Although the school doesn’t own a single computer and the island has no electricity, Shahed couldn’t resist taking out his personal laptop and showing the children how to use it, giving them at least a small glimpse of the world beyond their shores.

(more…)

Until recently, most health clinics in Uganda, and indeed across the continent of Africa, transmitted all of their data manually, sometimes by phone, but in most cases by sending messengers overland to each clinic — big, small, urban and rural — to collect paper records for analysis. This process is critical to verifying that medications are stocked on site and can be distributed in a timely fashion to patients most in need. It is also imperative in ensuring that Uganda’s health policy decisions are made based on the most up to date and accurate information.

But the journey of a paper record from doctor’s pad to the Ministry of Health in Kampala was treacherous at best. From extreme distances to challenging terrain and unpredictable transportation – collecting data the old fashioned way proved to be a time consuming, inefficient and expensive endeavor. This scenario caused health providers to learn about supply shortages only after it had become a relative emergency, hindering efforts to effectively respond to diseases prevalent in the region, such as malaria, HIV, and TB, among others.

One Healthcare implementer facing such data collection problems was the consulting group Cardno, and their Uganda Health Initiatives for the Private Sector (HIPS) project – a program funded by USAID, and administered through partnerships with over 100 private sector health clinics across the country. According to HIPS’ director of partnerships Barbara Addy-Witte, “[data collection] was a very cumbersome process for us. HIPS tracks data from 112 clinics and this often necessitated partner staff to travel to the project office in Kampala to deliver the data forms each quarter.

Working closely with USAID, HIPS faced the challenge of collecting upwards of 90 data points from each health clinic every quarter. With manual data collection and paper management, the HIPS program found these processes to lead to low collection numbers. And as any good project manager knows, low data collection numbers and compromised records can lead to the lack of ability to maintain the most efficient and effective operations. However, a recent partnership with the Denver based mobile technology group access.mobile has the potential to change the operational capacity of health providers in the region, with one of the most basic modern communication devices at the center of operations – cell phones.

The access.mobile team, led by Founder Kaakpema Yelpaala (KP), an American social entrepreneur of Ghanaian descent, has designed a mobile data collection and analytics system based on an SMS platform to electronically track priority health indicators, monitor stock levels of antiretroviral drugs and support organizations in understanding their data. This m-Health initiative, which uses full keyboard feature phones to send and receive information, has been rapidly scaled up for piloting in 70 health clinics in just three months.  It was determined by HIPS that just over 30 of their clinics, mainly urban sites, had sufficient connectivity to send their reports electronically, though the overwhelming majority were not in that position.

But not only is access.mobile working to develop scalable technologies for improved communications in the region, the model of development is one based on local ownership and long-term sustainability. According to KP, “Uganda particularly is a place with a ton of talent in the technology sector. All of our employees in Uganda are from Uganda. They’re trained in mobile technology, computer science, and medicine. They’re the linchpin to our company’s success because they understand the context. They understand how Ugandans think about technology. It’s when you blend a local team like that with a global team like ours – that’s when you get innovation.”

Dr. Dithan Kiragga, the Chief of Party of the HIPS initiative: “The commodity supply chain in particular for ARVs has been a challenge. This partnership presents an opportunity to improve the commodity flow, to develop an alert system that triggers a request when the stocks are low. This ensures that there are no stock outs for priority drugs.”

With Cardno’s Uganda HIPS working towards the end of the fully-scaled pilot phase of the access.mobile solution, results of the financial and social impact of their work will be generated in the coming months and a better picture of their work will emerge.  Furthermore, as the Ministry of Health in Uganda sets standards for data integration at the national level, solutions like access.mobile’s will also be an important element in helping engage the private sector with national health information management efforts.

As it stands however, the nascent m-Health industry has made significant headway toward strengthening supply chains, better depicting public health scenarios on the ground, informing good policy, and ultimately helping to improve the health of millions of Ugandans.

Post authors Kevin Malone and Greg Maly are working with TechChange for the online course: Global Innovations for Digital Organizing. They are happy to continue the discussion @TechChange.