MERL Tech DC 2019

Nepal Health Sector Strategy (NHSS) 2015-2020 aspires to leverage mHealth and eHealth to improve health outcomes for Nepalese citizens. At present, there is a paucity in evidence on the mHealth and eHealth interventions that have been implemented in Nepal and their effectiveness. Our study mapped technology-enabled projects in Nepal using Arksey and O’Malley’s scoping design framework and assessed the projects using WHO Building Blocks of a Health System framework. In total, 20 technology-enabled health solutions implemented between 1993 to 2016 were identified. The momentum for technology-enabled projects in Nepal is sporadic but continuous and largely donor driven. Technology-enabled health solutions in Nepal are limited in scope, focus areas, target audiences, and sustainability potential. Prevalent target audience for identified projects were front-line workers in rural areas, women of reproductive age, and adolescents. Evaluation or sustainability were not within the scope of most projects. Technology-enabled solutions are frayed, issue and organization centric, and primarily driven by donor or non-governmental organizations. Engaging the private sector, especially telecommunications companies, is an underutilized strategy to address barriers related to evaluating, scaling and integrating effective solutions in the health system. Existing pioneers in this space (government, national and international NGOs) must engage in strategic planning on how to increase collaborative partnerships with the private sector or incentivize independent commercial health technology ventures. Our session will shed light on opportunities and challenges for national and international governing bodies and health systems to chart a course for technology-enabled health solutions to move beyond “pilotitis” in low-resource settings.

Every1Mobile’s U Afya programme is a digital community for young mothers and prospective mothers in low-income areas of Nairobi to learn, share and connect on a variety of topics related to health, nutrition, hygiene and motherhood.

In an effort to leverage the technology that our target audience possesses, Every1Mobile created the U Afya 10-Day Handwashing Challenge - a mobile habit-tracking solution optimised for the most basic web-enabled feature phone.

The technology leveraged self-reported actions, where users were required to perform a daily activity, then complete a single-question survey to log their challenge as completed. The challenges varied but were all rooted in the WHO “5 Moments” model.

The habit-tracker adopted the behaviour change approach employed by Unilever and Lifebouy in their “Way of Life” campaign, namely Awareness, Commitment, Reinforcement and Reward.

This lighting talk will share specific advice and guidance for audience members who have experienced tech clutter, untidy data, or too many integrations. Our M&E house is tidy because we have a few tools and we know how to use them well. Through trial and much error, we've learned that a lean tech approach to MERL is incredibly powerful, and can create the time and space we need for data use. The lean tech approach gives us room to innovate with new tech like drones, blockchain, machine learning. I'll share what we've learned about when to keep it simple and when to invest in something new.

In this talk, we will present Integrity's work to implement ‘Aqoonta’, a web-based platform for DFID’s Learning and Monitoring Program – Somalia (LAMPS, 2016-2020). The LAMPS program verifies DFID Somalia’s Governance, Health, and Economic Development portfolios to improve DFID’s understanding of how the activities it funds are performing, the challenges faced, and ways to identify, mitigate and learn from risks affecting programming. Integrity and partners developed Aqoonta (Somali for “knowledge”) – as a space where DFID and partners interact with concise, visual LAMPS reports, photographs, management dashboards and learning resources. Aqoonta is a vehicle through which DFID and its implementing partners can learn from and improve their delivery. This talk will outline lessons learned through all stages of Aqoonta’s life, challenges during the process. Participants will gain an understanding of how even in challenging contexts such as Somalia, digital solutions can support efficient processes in monitoring, evaluation, and learning provided they follow an agile methodology and are grounded in a strong understanding of users, context, and needs.