Detailed Mechanism Funding and Narrative

Years of mechanism: 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 17043
Country/Region: South Africa
Year: 2013
Main Partner: University of the Witwatersrand
Main Partner Program: Wits Reproductive Health and HIV Institute
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $0

This program uses mobile technology to address the challenges that HIV and AIDS pose in South Africa. It is a collaborative partnership between the Vodacom Foundation, and partners who have experience in developing and implementing mHealth interventions.

The aim of the programme is to implement at national scale a small number of mHealth applications to make a significant impact in HIV prevention, testing, treatment support and in general health systems strengthening. The development of the programme will be evidence based only applications that have been shown to be effective will be taken to scale. The new field of mHealth is only just discovering what is and is not effective. Despite dozens of mHealth projects around the world,and a great deal of enthusiasm and hype, only a handful of interventions had demonstrated medical benefit, and almost no systems were being run at national scale, let alone with a comprehensive cost-benefit analysis.

The programme directly responds to the health priorities of the national Department of Health (NDOH), as well as the South African National AIDS Council (SANAC), both of which have been consulted. Over the course of the programme, it will be reviewed; we will assess the experience learnt, and determine which interventions should be taken to scale. It is these meetings that will make the decisions on which interventions to take to scale, continue testing, or finish.

Evaluations will be key to this programme, with interventions examined for:

Medical impact: are patient outcomes improved;

Operational appropriateness: does the health system have the capacity for this intervention;

Cost-benefit: do the benefits in medical outcomes, operational efficiency or savings justify the expense.

Funding for Care: Adult Care and Support (HBHC): $0

Leveraging support and funding from Vodacom Foundation, WRHI is providing text message-based services to HIV-positive individuals receiving care in public health care facilities. Three related services are offered; CD4 count by SMS, clinic appointment, and adherence/support messages. The CD4 count messages are offered to newly diagnosed HIV-positive individuals who provide their phone number. Clinic appointment reminders are offered to stable HIV-positive patients who are on ARV medication. The reminders come as a batch of three text messages; one two weeks before the appointment, one the day before the appointment, and a final message the day after the appointment. The final message is either a 'thank you' message if the person has attended the appointment, while, if they did not attend the message reminds them that they should return to the clinic as soon as possible. The adherence/support messages are sent once a week, also to stable HIV-positive patients on ARV's and contains psycho-social and healthy living support content, such as healthy eating, where to find community support, etc. The goal of the project is increase retention in care for those who are HIV-positive.

WRHI is also conducting detailed M&E on the systems described above. We will be sharing our research outputs with our partners as soon as they are made public.

This project utilizes FY 2009, 2010 and 2011 funds.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

Leveraging support and funding from MAMA South Africa, which is indirectly funded by Johnson & Johnson, the mHealth Alliance, UN Foundation and USAID, WRHI is providing text message-based to pregnant women in public health care facilities. The messages are free to receive (after a R1 signup fee), can start as soon as the woman has found out she is pregnant and continue twice a week for a year after the birth of the baby. At signup the woman enters her expected due date which allows the message content to be customised to her pregnancy stage, providing her with relevant and timely information about her pregnancy and infant care. Women who are HIV-positive have the option of receiving additional information relating to being pregnant while HIV-positive. These messages are geared towards supporting the woman in following healthy behaviours which minimise maternal to child transmission of HIV, such as ARV adherence reminders, PCR testing information, and recommendations around exclusive breastfeeding.

WRHI is also conducting monitoring and evaluation duties on other communication channels of the MAMA South Africa project. These M&E activities include analysing the SMS, MXit, mobi, USSD and voice channels to gauge usage and uptake of the services. Additionally, health and behaviour outcomes will be tracked and measured as much as possible. This includes a research trial to measure the effect of the SMS's on HIV-positive pregnant women from signup to 18 months post-delivery, as well as tracking knowledge acquisition in registered users of the MAMA mobi web site.

This project utilizes FY 2009, 2010 and 2011 funds.

Subpartners Total: $0
Cell Life: NA
GeoMed: NA
Praekelt Foundation: NA
Key Issues Identified in Mechanism
Child Survival Activities
Safe Motherhood