Presentation from our recent event held in London, UK "Mobile Technologies for Social Transformation"

1. Mobile technologies for social changeDavid Deakin Tearfund “People's behaviour makes sense if you think about it in terms of their goals, needs, and motives” Thomas Mann

2. Outline Introduction - A personal story Mobiles in HIV/healthcare development Tearfund programmes Previous experience Existing projects Future

3. Tearfund www.tearfund.org Christian Relief Development Advocacy Holistic Transformation 10 yr Vision 50 million people released from poverty Church & Communitymobilisation

4. Berta Belinha A story of 2 mothers…

5. Why a story about HIV/AIDS? “Through its impacts on the labour force, households and enterprises, AIDS has played a more significant role in the reversal of human development than any other single factor.”

6. Chimoio, Gondola, Mozambique GNI ; c. $600 per person HIV prevalence: 14-21% 1.5m living with HIV 100,000 deaths 400,000 orphans

7. Belinha A story of 2 mothers…

13. Orphan burden - 12m orphans in Africa

16. Donor Follow-up visit – March 2010

17. What’s the difference?

19. Trained volunteer

20. Communication challenges Training information ‘Classic Home based Care’ versus ‘Access to treatment’ Volunteer attitude & behaviour change Local services availability Nearest availability of testing, treatment & monitoring Transport support Mentoring & encouragement Overcoming stigma Challenging sexual norms

21. Tearfund – ‘Task shifting’ Operating model Mobilise Volunteers to impact Clients Community Local Partner Volunteers Recruitment Local Tearfund Clients Training MOH

22. Mobile technology in healthcare/HIV World AIDS Conference 2010 Task shifting Task-shifting of antiretroviral delivery from health care workers to persons living with HIV/AIDS: clinical outcomes of a community-based program in Kenya Community-based care delivered to adults living with HIV by people living with HIV using mobile technologies provided care as safe and effective as clinic-based care Reaching vulnerable groups Opportunities to reach residence based female sex workers (RBFSW) through cell phones - an experience from Bangladesh About 50% RBFSW possess and use cell phones to contact clients Many peer educators use cell phones to contact RBFSW Sexual Behaviour change Brief cellphone-delivered counselling as a novel strategy to enhance the maintenance of HIV behavioural intervention efficacy: results from a supplemental treatment effectiveness trial Lower chlamydia infections Reduction in frequency of sex & Increase in condom protected sex Improving adherence Facilitators'-on-wheels: a model for HIV/AIDS education for people with disabilities by people with disabilities ‘uses cellphone technology to improve adherence rates and communicate relevant information’ Overview from Cell-life Exploring the potential of mobile phone technology for prevention, care and treatment of HIV in South Africa: the case study of Cell-Life they have great use in increasing the uptake of health services, providing information needed by people affected by HIV and linking patients and clinics largely ineffective in direct behaviour change (e.g. changing someone´s mind to use a condom by sending an SMS)

23. Tearfund Malawi Pilot study – published in M4D 2008 Improving Home Based Care Through Mobile Phones in Malawi Objectives 1 yr project in 2 areas of Malawi Improve communication between rural home based care and hospital centres Financially sustain the volunteers’ use of a mobile phone as an income generating activity Results Mixed success Communication & referral helpful but phones used more for business Income generating activities not sustained (coinciding with handset penetration) Learning Take account of rapidly changing market Enable cost free access to pre-logged hospital numbers

24. Film clip

25. Prevention of Parent to Child Transmission of HIV (PPTCT) 1 in 5 maternal deaths due to HIV 90% of children living with HIV are infected by their mother Without intervention 40% of babies will be HIV +ve Intervention can reduce vertical transmission to <5%

26. Guardians of our Children’s Health (GOOCH) Toolkit for community mobilisation Focus on parents Reduce transmission of HIV Reduce maternal & child mortality(MDGs 4, 5 & 6) Tearfund Partner Master Trainers Volunteers Church & Community

27. Nimbus project objectives Does the JamiiX/Nimbus system: improve the effectiveness & efficiency of achieving target outcomes through coaching & mentoring of volunteers? Improve data collection efficiency to facilitate attribution of activities to outcomes?

29. Volunteers develop mentoring skills

30. Mobile only data collection Tearfund Partner Positive outcome = Living your beliefs(Successful patients maychoose to become volunteers and ‘Mother buddies’ Education, Mentoring and Data Collection

32. Best practice

33. Q&A

35. Data Collection Application sends off required numberof SMS’s with data to JamiiX web portal Web Application populates database Confirmation SMS Excel spreadsheet reportsand trend charts sent monthlyto Tearfund

36. System Overview JamiiX web application Monthly Excel report for each country (emailed to country rep) Clickertel Link to JamiiX platform Data sent to in countrySMS code Nimbus collate monthly country reports to produce consolidated view with trend charts that can beaccessed online SMS forms appon mobiles Page 31

37. Possible future applications (1) Sexual Behaviour Change Accountability Groups 4 theories of behaviour change Health Belief model AIDS Risk Reduction Model Stages of Change Theory of Reasoned Action