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Interview with Donald Thea: Professor of International Health at Boston University. Thea purses a full time career in both domestic and international clinical and epidemiological research in infectious diseases. He is currently the program director of the Boston University preventing mother-to-child transmission of HIV (PMTCT) integration project, which seeks to improve the implementation of PMTCT services and early infant diagnosis services in Southern Zambia.

 

Background: Thea has spent 25 years in Africa starting in 1989 when he was first went to Congo. He was been working in Zambia since 1999 mostly on HIV and PMTCT. Thea (2012) mentions that this is really the first study that he knows of using mobile technology to improve the health of rural communities and prevent HIV.

–       1st phase is article he wrote.

–       2ned phase will be community health agent who live in the community have an interest in health and doing some work for some pay and volunteer and a lot of them have cell phones. (5 years increase in cell phones). We are these communities with cell phones to register pregnancies and births and maternal and infant deaths. Once the pregnancy is entered and expected date of delivery is entered into the database. The community health workers then get text messages to remind women to come in for visits to the local clinic. This encourages mothers to come in for their first, second and third trimester visits whom may be coming from long distances away. During these visits to the clinic the mother is reminded about the impotence of taking her ARVs for her and her child to encourage a healthy pregnancy and childbirth with the help of prophlaxisis.  The community health workers are also using cell phone for maternal morbidity using community counselors in setting up trios center to text health related questions to the clinic to determine if an ambulance is needed for further medical attention.

–       Started implementing it and getting (5 health centers) impressive results. 800 pregnancies, deliveries registered in 2 months.

–       System was failing from mother to bring in child to get tested for HIV and often mothers would not come back, now women get child tested and get the results quickly which is import as children’s HIV progresses much quicker then adults ARVs are essential.

–       What Role is the Government playing? MOH supportive, local ministry of health at the district health was enthusiastic and the national government immediately decided to scale up a national campaign. The National Government is currently seeking non-governmental organizations that are willing to help. Most of the costs come in the training of the people using the system for example the nurses in health facilities and the community workers (whom might already have cell phones) register blood spots and teaching them how to enter pregnancies, expected delivery dates, and text clinics for health related questions.

–       Ministry needs to find people to take responsibly for oversight of the program. Organizations and NGOs come in and think of innovative ideas and pilot projects but they often do not go anywhere and becomes inefficient. If there is someone in the MOH that can be the central coordinator then maybe these projects can obtain the correct resources and funding to be implemented properly. They can also attract other resources (if they put it on their list and go to Gates Foundation (who support technology innovations), Norway donates a lot of money to publish health) Implementing guidelines Thea feels is also incredibly important.

–       Data collection are also used as well, on tablet

 

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