1. Bobby Jefferson, Senior Health Informatics Advisor, Futures Group
• Principal Investigator CDC HMIS Grant Kenya
• Senior HMIS Advisor - AIDSRelief
Abby Clay, Senior Business Development Associate, Futures Group

2. Global Organizational Structure
• Founded in 1971 Futures Group Global, LLC
• Headquartered in Chris LeGrand, MS
Chief Executive Officer
Washington, DC
USA
• 467 staff Operations
worldwide Ed Abel, MPA
Senior Vice President &
Chief Operating Officer Human Resources Organizational Dev
Benefits
• Operating in 30+ Recruiting
countries Finance & Administration Employee Relations
Timothy Schur
Chief Financial Officer
• Largest country
presence,
USA Technical
India
Farley R. Cleghorn, MD, MPH
Afghanistan Senior Vice President &
Kenya Chief Technical Officer
South Africa
Tanzania
Center for Policy & Center for Health
Advocacy Systems & Solutions
Sarah Clark, PhD Shannon Hader, MD, MPH
Vice President Vice President

3. mHealth Informatics Challenge
Nigeria, Kenya, Uganda, Tanzania, Rwanda, Zambia, South Africa, Haiti
Guyana, Ethiopia , 10 Countries, 244 Hospital Facilities + 112 Satellites
Clinics , 535 Antenatal Care - PMTCT sites
Supporting rural, remote, faith based mission hospitals “serving poorest of
poor”
Lack power, intermittent power, No IT staff, No internet, Sparse mobile
coverage
Nurses, Health workers need to report health indicators, M&E program data on
monthly basis
Cost effectiveness and sustainability -- no funds for proprietary licenses, or
yearly maintenance fees

5. Health IT Solutions
Collectively referred to as IQSolutions
1. Electronic medical records
1. IQCare - Reviewed by CDC, WHO, USAID
2. IQChart - French language
2. Mobile Phone solution (SMS technology)
3. Site Capacity Assessment Dashboard (SCA)
4. Monitoring & Evaluation Electronic reporting
5. GIS and GPS related IQGeo
6. SQL Training, Virus Remediation Training

6. Health IT Solutions
Use of freely available, reusable, tools, “coded in
country” Creative commons approach
Reusable software and technology across countries and
programs
Offline Solutions, Disconnected model
Local programmers, all IT staff in country (Africa)
Low costs, Inexpensive $200-$350 Netbooks
Samsung Solar netbooks
Solar mobile phones, SMS instead of Smartphones
Use of inverters to address power

8. demo
http://173.203.65.108/iqcare/frmLogin.aspx
 Username: user1
 Password: 1
 Facility/Satellite: 001-01-01-Demo Site

9. IQSMS – Mobile Phone Reporting by Health Workers

11. IQSMS PMTCT Reports
PMTCT Currently consists of 4 types of monthly reports
1. PMTCT Antenatal Clinic (ANC) Monthly Summary Form
2. PMTCT Care Register Monthly Summary Form
3. PMTCT Maternity (L&D) Monthly Summary Form
4. PMTCT Mother - Child followup SummarForm

12. PMTCT Report
Data Quality Checks
Must Pass All Data Quality Rules,
District Office
Monthly and Quarterly
Reports

13. NUMBER OF CLIENT HAD HIV TEST AT ANC

14. technology isn’t the barrier to scale up
• Nurses and community health worker receive per diem or transports costs
for picking up or bringing their list and reports back and forth to health
facilities, district offices, etc.,– they’re not interested in losing out in
reimbursement;
• After early adopters, health care workers not keen sending message unless
they have free airtime and toll free number available from their mobile
telecom provider ; we increase use by 50% when toll free is available
• The older staff have more difficulty using mobile for messaging and
reporting;
• Often other people have access to the phones (25% share phone vs. Own)
and often those text message can be forwarded to others
• Staff in rural areas want their SMS messages in Swahili or local language;
Detailed instructions in Swahili to how to do reporting and use phones for
reporting

15. Tanzania
Distance from Time spent to
Facility Name District Facility to Deliver PMTCT Bus Fare (Tsh)
District (KM) Report (Hrs)
MWANZA Region
NYAMAGANA DISTRICT
Mwamashimba Health Centre Kwimba 50 1.30hrs 10000
Malya Health Centre Kwimba 25 1hr 5000
Kikubiji Dispensary Kwimba 102 4hrs 20000
Kiliwi Dispensary Kwimba 100 4hrs 20000
KWIMBA DISTRICT
Nyakalilo Health Center Sengerema 46 2 HRS 8000
Mwangika Health Centre Sengerema 98 4 HRS 10000
Sengerema Health Centre Sengerema 10 20MIN 3000
SENGEREMA DISTRICT
Kharumwa Health Centre Geita 115 3HRS 20000
Nzera Health Centre Geita 48 2HRS 8000
Katoro Health Centre Geita 50 45MIN 6000
Nkome Dispensary Geita 80 2HRS 6000
Nyang'hwale Health Center Geita 85 2HRS 7000
Kasamwa Health Centre Geita 25 30MIN 4000
Bukori Health Centre Geita 60 1:30HRS 6000

16. • Delays with data flow and information reporting from the District and
Regional level to the National level
• Inaccuracy of reports being received thus requiring further on site data
verification
• High cost of supervision and sending report to district in regards to travel
costs to access the 535 health facilities
• Ever used the phone
for SMS services
No 52.17%
Yes 47.83%
Total 100
– All staff own the
telephone handset and
share it in daily personal
uses

17.  Instruction on
 Any problems with
Swahili critical to
small buttons on the
using IQSMS
phone?
 Response Freq %
 Response Freq %
 No 6 17.14
 No 30 85.71
 Yes 29 82.86
 Yes 5 14.29
 Total 35 100
 Total 35 100
• Reasons For Not Sending Monthly Report
– Majority said they don’t understand English
language
– Need message understandable in Swahili language

18. IQSMS Instructions in Swahili

19.  Barriers to implementing • Anything that can be
mobile phone reporting for improved on report
submitting all four reports submission to make
each month report to be on time
 Mobile Network Problem/failure • Response Freq %
 Server don’t respond on time • No 14 40.00
 PCR report type is hard • Yes 21 60.00
 It have been found that free • Total 35 100
Airtime is critical for scale up

20. Health IT Solutions
*EMRS – Electronic Medical Records System

21. Health IT Solutions
Tanzania mobile phone coverage and mobile penetration
Vpdacom Tanzania
•
*EMRS – Electronic Medical Records System

22. M&E Electronic Reporting System
Solar Power Cell phones
Orphans Vulnerable Children
PDA device
(OVC), Most At Risk
Population (MARPS),
Maternal Child Health (MNH)
Ms Access Database
Excel
PMTCT MONTHLY REPORT
PMTCT Antenatal Clinic (ANC) Monthly
Excel Only Summary Form Web Internet
118 Desktop
ANC 01. New ANC clients this month 8
ANC 02. Previously known to be HIV
positive 17
ANC 03. Total number tasted 574
ANC 04. Number of new client had HIV test
at ANC 277
ANC 05. Tested HIV-Positive 37
ANC 06. Post-test counseled for positive
and negative 574
ANC 07. Number of partners tested for HIV 16
ANC 08. Tested HIV-Positive 4

23. For more information
 Contact
 Bjefferson at futuresgroup.com
 Lburrows at futuresgroup.com
For more information please contact Centers for Disease Control and
Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.atsdr.cdc.gov