1. Programme Mwana:
A Zambian mHealth Initiative

2. Programme Mwana
• Piloted in Zambia by MoH with support
from UNICEF, ZCAHRD, CHAI & ZPCT II
• Addresses Early Infant Diagnosis of HIV and
post-natal follow-up and care

3. Programme Mwana
• Piloted in 31 clinics across 13 districts in 6 provinces
for over a year, delivering thousands of results
• Scale-up approach pre-tested in 30 facilities in
Kalomo District in Southern Province
• Built on RapidSMS, an open source framework
• Designed to be as a MoH owned and operated
enterprise mHealth platform

4. Locations of Pilot Sites
Luapula Province:
• 11 Sites
• Across 3 Districts
• Implementer: UNICEF
Southern Province:
• 10 sites
• Across 2 Districts
• Implementer: BU
Central Province:
• 3 Site
• Across 3 Districts
• Implementer: CHAI & ZPCTII
Copperbelt Province:
• 3 Sites
• Across 2 Districts
• Implementer: CHAI &
ZPCT II
Northern Province:
• 2 Sites
• Across 1 District
• Implementer: CHAI
& ZPCT II
North-Western
Province:
• 2 Sites
• Across 2 Districts
• Implementer: CHAI &
ZPCT II

5. Programme Mwana
• There is an mHealth Technical Working
Group that coordinates Programme Mwana
activities and other mHealth initiatives
• The TWG is holds meetings every month
and has sub committees that look address
the day to day activities
• The TWG is chaired by MoH

7. Locations of PCR Labs
Provinces the Labs Serve:
• Arthur Davison
• Northern
• Northwestern
• Copperbelt
• Luapula
• Central
• UTH
• UTH facility
• Southern
• Kalingalinga
• Lusaka
• Eastern
• Western

8. Early Infant Diagnosis Results Cycle
ref - Early Infant Diagnosis: System Summary (2008) – MoH & Clinton H/A Initiative
National average of 2008 including rural and urban

9. Programme Questions
• Can we use mobile technology to
significantly speed up getting infants
HIV results to their caregivers?
• Can we use mobile technology to
increase post-natal visits of mothers
to health facilities?

10. • Delivers infant HIV results from Lab to
Facilities via SMS and SMS Printers
• Tracks samples through the logistics system
• Provides government monitoring tools

11. HUB

12. From:Results160
Hello Maria,
there are 3 DBS
results for your
clinic.
Please reply with
your PIN to
retrieve
these results
When results are ready the central SMS System sends a
message alerting the clinic workers results are ready.
Workflow: Phone: Results Retrieval 1

13. Kanyihampa Clinic.
Patient ID: XXXXXX-
0001-1.
HIV-DNAPCR Result:
NotDetected.
Approved by ADH
DNA-PCR LAB.
When a result is ready it is sent by SMS to the printer at
the facility it the sample was collected at.
Workflow: Printer: Results Retrieval 1

14. • Patient tracing by Community
Health Workers
• SMS Reminders for post-natal
visits
• Specific traces for DBS results
being returned

16. Quantitative: Pre-SMS System v Post-SMS System
On average results were
56% faster
between sample collection and
delivery to caregiver

17. Quantitative: Pre-SMS System v Post-SMS System
45.5
21
0
5
10
15
20
25
30
35
40
45
50
Pre-SMS Post-SMS
TurnaroundTime(days)
Pre-SMS and Post-SMS
Aggregated Turnaround Time to Facility, Pre- vs. Post-SMS
system, Central, Copperbelt, Northern, North-western Provinces

18. Quantitative: Hardcopy v SMS Results
While urban facilities saw only a 5%
improvement rural facilities received results
46% faster
between sample collection and delivery
facility using SMS

19. Quantitative: Hardcopy v SMS Results
Luapula Province
60
42
0
10
20
30
40
50
60
70
SMS (N=146) Hard Copy (N=103)
Percent
Method of Result Receipt
SMS vs. Hard Copy, Volume of Results Received, Luapula Province

20. Quantitative: Hardcopy v SMS Results
On average
30% more
results arrived by SMS than by
hardcopy

21. Triangle of Management
Health
Facility
District
Medical Office
Provincial
Medical
Office
National IT
Management
Team
Implementing
Partner
Lab
Team
Software
Develop
ment
Team
Secondary Support
Primary Support

22. Aggregated Web Reports

23. Real-time Alerts

24. Way Forward
• Scaling Up the system nationally with
the help of partners
• Each year we set scale up targets
• This year we have a target of 300 sites.
We are on course to meet this target.
•To date we have scaled up Programme
Mwana to over 462 sites.

25. Way Forward
• Scaling the system nationally between now
and 2015
• To date we have scaled up Programme
Mwana to over 400 sites.

26. Thank You