THE POTENTIAL ROLE OF MHEALTH IN MEETING THE NEEDS OF YOUNG PAC CLIENTS

Transcription

1 THE POTENTIAL ROLE OF MHEALTH IN MEETING THE NEEDS OF YOUNG PAC CLIENTS

2 WHAT IS MHEALTH?

3 WHY MOBILE PHONES? HIGH PENETRATION

4

5 FIVE ESSENTIAL ELEMENTS OF PAC

6 WHY MHEALTH FOR PAC FOR YOUTH?

7 USES OF MHEALTH TO MEET THE NEEDS OF YOUTH

8 PAC- MHEALTH

9 MHEALTH FOR PAC GOING FORWARD How do we expect Mhealth improve PAC services? What outcomes to we hope to achieve? Message development Determine if mhealth acceptable to PAC patients Adapt modify existing mhealth materials Modify Global PAC messages for mhealth Pilot messages including user interface Literacy of target population SMS vs. Interactive Voice Response (IVR) Ownership & privacy of mobile phones For youth Cost Challenge of sustainability of systems Cost of phone calls or text messages

10 SUMMARY TABLE: ORGANIZATIONS DOING MHEALTH FOR ABORTION Organization Description Type of mhealth Countries Time frame Cell Life & University of Cape Town (UCT) & Ipas M-Assist: WHO funded RCT by UCT & Cell-Life to evaluate the use of mobile phones in medical abortion (MA). SMSs coaching women through MA Self-assessment of abortion completion via mobile phone FP info (via SMSs, MXit and a mobisite) SMS and mobi-site (website accessed by mobile phone or internet) South Africa ; study completed Cell Life & Ipas Women can text to get more info on abortion Women who have an MA can choose to receive automated text messages every day/every few days for 11 days with info on abortion complications and self-assessment of completion, and also messages encouraging her to use FP (messages similar to Cell Life) SMS and mobi-site South Africa May 2012 in 1 st province; currently rolling out to 3 rd and 4 th provinces Venture Strategies for Health (VSHD) Women will receive text message offering opportunity to obtain info; dedicated toll-free number -select language, then choose RH messages:: contraception, prevention of PPH, and safe medical abortion. Interactive Voice Response (IVR) Mozambique, Kenya, Tanzania, Nigeria; MAYBE Zambia & India Starting spring, 2013 Women on Waves Hotlines: straightforward, practical information how to induce an abortion with misoprostol, as well as talk to women that have already done an abortion; give info about safe options and RH. Aunty Jane hotline in Kenya uses an IVR system. It is a recording available 24/7 and callers can choose from a menu of messages. Hotline (both IVR and Indonesia, Thailand, Pakistan, Poland, Kenya (with an IVR component), Argentina, Chile, Ecuador, Peru and Venezuela Started in Portugal in 2004, ongoing Women on Web Telemedicine : people request info by on abortion. After a medical consultation online can actually receive mife and miso to their home address (provided they are less than 9 weeks pregnant, and live in a country where access to safe abortion is restricted). Telemedicine (internetbased) Worldwide Started 2006, ongoing Marie Stopes Intl. Hotlines and IVR for abortion and SRH messages (no further details available) Hotlines and IVR Zambia, Uganda, Cambodia, South Africa, TZ and Kenya?

11 MEDICAL ABORTION IN SOUTH AFRICA

12 ADDITIONAL SLIDES

13 I CHOOSE WHEN MOBISITE

14 I CHOOSE WHEN MOBISITE ABORTION INFO

15 MEDICAL ABORTION IN SOUTH AFRICA, CONT.

16 M4RH

17 I CHOOSE WHEN MOBISITE

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19 M4RH FOR YOUTH IN RWANDA

20 M4RH FOR YOUTH RWANDA Info for youth aged FP Puberty Sex and pregnancy HIV STIs Starting in June, 2013

21 Looking for other sex ed mhealth example.. Place holder

22 SMS MESSAGES: DEVELOPMENT

23 LOGISTICS OF DOING MHEALTH

24 M4RH: INCREASED FP KNOWLEDGE AND BEHAVIOR CHANGE REITERATED BY SMS RESPONSES

25 SUMMARY TABLE: ORGANIZATIONS DOING MHEALTH FOR ABORTION Organization Description Type of mhealth Countries Time frame Cell Life & University of Cape Town (UCT) & Ipas M-Assist: WHO funded RCT by UCT & Cell-Life to evaluate the use of mobile phones in medical abortion (MA). SMSs coaching women through MA Self-assessment of abortion completion via mobile phone FP info (via SMSs, MXit and a mobisite) SMS and mobi-site (website accessed by mobile phone or internet) South Africa ; study completed Cell Life & Ipas Women can text to get more info on abortion Women who have an MA can choose to receive automated text messages every day/every few days for 11 days with info on abortion complications and self-assessment of completion, and also messages encouraging her to use FP (messages similar to Cell Life) SMS and mobi-site South Africa May 2012 in 1 st province; currently rolling out to 3 rd and 4 th provinces Venture Strategies for Health (VSHD) Women will receive text message offering opportunity to obtain info; dedicated toll-free number -select language, then choose RH messages:: contraception, prevention of PPH, and safe medical abortion. Interactive Voice Response (IVR) Mozambique, Kenya, Tanzania, Nigeria; MAYBE Zambia & India Starting spring, 2013 Women on Waves Hotlines: straightforward, practical information how to induce an abortion with misoprostol, as well as talk to women that have already done an abortion; give info about safe options and RH. Aunty Jane hotline in Kenya uses an IVR system. It is a recording available 24/7 and callers can choose from a menu of messages. Hotline (both IVR and Indonesia, Thailand, Pakistan, Poland, Kenya (with an IVR component), Argentina, Chile, Ecuador, Peru and Venezuela Started in Portugal in 2004, ongoing Women on Web Telemedicine : people request info by on abortion. After a medical consultation online can actually receive mife and miso to their home address (provided they are less than 9 weeks pregnant, and live in a country where access to safe abortion is restricted). Telemedicine (internetbased) Worldwide Started 2006, ongoing Marie Stopes Intl. Hotlines and IVR for abortion and SRH messages (no further details available) Hotlines and IVR Zambia, Uganda, FHI's m4rh worked with MSI in TZ and Kenya?

26 SMS MESSAGES FOR MA CLIENTS FROM CELL LIFE & UCT Message text Message text Message Day Counseling on side effects Hi there, the pills u took at the clinic may make u bleed. If u do, it can be light, normal or heavy. But don't worry if u don't bleed. The pills you take at home tomorrow will make you bleed. Make sure u have pads and painkillers (Ibuprofen is good. Aspirin is bad so no Disprin or Grandpa). Directions on taking second dose of medication and counseling on side effects 0 18:00 Hello! Just a reminder to take the pills you were given, hours (1-2 days) after u took the pills at the clinic. Put a pill in each cheek and 2 under the tongue, and let them dissolve (break down) there. Take them without water! U can drink 30 min after. When u take them, bleeding may start after 20 minutes (but later is OK too). If u vomit within 30 minutes of taking the pills, go back to the clinic for more. Hey more info on the pills: if u get cramps, use heat or take pain killers. It can be pretty sore - don't be scared. U may feel sick, vomit, or get a runny tummy. It's not a problem. 1 9:00 1 9: :00 Remember bleeding can be heavy! It's only a problem if u soak more than 6 maxi pads in 2 hours. Call or go to the clinic immediately if that happens. You may or may not see clots (lumps in blood) - it's OK. 1 18:04 Hi just checking on u! If u haven't taken the pills at home yet, do it straight away. It's NOT safe to miss the pills u were given to take at home. Remember that the pills are more than 95% successful. We're helping you to take them right - so don't stress. Hi just a reminder that bleeding can be heavier than a normal period, and cramping can be worse. It's OK! Look after yourself :-) If you haven't started to bleed, don't worry. It's only a problem if bleeding didn't start within 2 days after you took the pills at home. 2 9: :00 Good evening! With the bleeding, please take a note of whether it's heavier than a normal period, the same or lighter. You'll need to know that when you answer some questions on your phone in about a week. 3 18:00

27 SMS MESSAGES FOR MA CLIENTS FROM CELL LIFE & UCT CONT. Message text Message text Message Day Counseling on side effects Counseling on potential abortion complications and reassurance Hi just a note that if you get a fever more than a day after you took the pills at home, and the fever lasts over 6 hours, please call or go to the clinic. You may still be bleeding. That's OK. It's just a problem if you soak more than 6 maxi pads in 2 hours - then call or go to the clinic. Hi good morning hope you're feeling OK. We're going to SMS you less now, and there will be days without SMSs. Have a good day! Remember that after the pills, bleeding usually lasts a week, but it can go on for as long as a month (that's unusual though!). Family Planning messages 4 9:00 5 9:00 6 9:00 Hi there, it's time to start thinking about what contraception you're going to use. Pill? Injection? IUD? Condoms? Condoms are great cause you don't get any side-effects, and they're small enough for a little bag or pocket. Best of all, they protect against HIV and STIs. Get LOTS at the clinic! 8 9:00 Morning, there's info you can read on your phone to help you decide about family planning. To read on MXit, go to Tradepost>MXit Reach>Ask Doc>I Choose When. Or visit m.ichoosewhen.org.za on your phone or computer. It will cost about 5c to see 15 pages so u can use a friend's phone :-) Hi, more contraception info! The pill is great cos it can help with bad skin and if u have facial hair or if u have heavy painful periods. But you HAVE to take it EVERY DAY, at the same time. Free at the clinic! 9 9: :00

28 SMS MESSAGES FOR MA CLIENTS FROM CELL LIFE & UCT CONT. Message text Message text Message Day Request to do self-assessment of abortion completion on mobile phone Plz check now if things went OK. It's really important! Dial *120*74781# on ur phone. There's only about 5 questions and it's totally private. We've sent R10 to ur phone so u can do this. If it doesn't work plz try again! And if u make a mistake, wait a bit and dial that number again. 11 9:00 Just a reminder that u can check if things went OK. Dial *120*74781# on ur phone & answer the questions there. Don't worry it's private. Remember we sent airtime this morning for that :-) And tx if you've already done it! Counseling on side effects Hi hope you're good. You may still be spotting (a bit of bleeding or brown bits). If you're bleeding like a normal period or more, make sure you tell them this at your clinic appointment. Reminder to come in for study follow-up appointment Hi hope you're well. Don't forget your clinic appointment! It's really important that you go as the nurse needs to check that everything is OK, and you will get R50 to say thanx for being in the study : : :00

29 SMS MESSAGES FOR MA CLIENTS FROM CELL LIFE & UCT, CONT. Message text More Family Planning messages Message day Message time Hi there! The injection is a great kind of family planning cause you only have to get it every 2 or 3 months. It can make your periods lighter, and for some they decrease period pains. Some find they gain weight at first, then that stops. Get it free at your clinic - it's just not worth getting pregnant again. 14 9:00 Morning, there's info you can read on your phone to help you decide about family planning. To read on MXit, go to Tradepost>MXit Reach>Ask Doc>I Choose When. Or visit m.ichoosewhen.org.za on your phone or computer. It will cost about 5c to see 15 pages so u can use a friend's phone :-) 16 9:00 Hi more on avoiding pregnancy :-). The IUD is a small device placed inside the womb. It may increase monthly bleeding and cramps at 1st. It's called 'forgettable contraception' cos it lasts for 5-12 years! U just have it removed if u don't want it anymore. Ask the clinic about it. 18 9:00 Family planning tip of the day! Some think that it's OK for the man to pull out of the vagina before he comes. NO! There can be sperm in the fluid that comes out any time before he comes leading to pregnancy or infection. Protect yourself please go to the clinic and get contraception! 20 9:00 Final reminder to go to study follow-up appointment Just checking: if you didn't go to your clinic appointment, you should cause it's important, and you'll get R50 after your interview to say thanks for being in the study. The SMSs will end now. Time to say goodbye & we hope you stay well :-) 21 9:00

30 SMS MESSAGES: EXAMPLES M4RH BASIC, M4RH EXPANDED, AND YOUTH CONTENT: Basic Message: Implants are small rods placed under the skin of a woman s arm. Highly effective 3-5 years. For married and singles. May cause light irregular bleeding. When removed can become pregnant with no delay. No infertility or birth defects. Expanded Message: IUD Side Effects: Few side affects. Monthly bleeding may be irregular, heavy and longer during the first 3 to 6 months. May have painful cramps. Wounding of the uterus is rare. Youth Message: Early signs of pregnancy can include: a missed period, tender breasts, nausea, and change in appetite and emotions. Avoid using tobacco, drugs or alcohol when pregnant. If you are HIV positive, make sure to take your HIV medication during pregnancy, go to the health center for advice. See directory.

31 M4RH HAS BROAD REACH Kenya Tanzania

32 SUMMARY

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