Health at Hand
By Aarti Dhar
India can learn some lessons from Uganda where social media and technology are being harnessed to assist health care and education systems
“No drugs in clinic?” People can just SMS the complaint to 8200 -- a free health service complaints hotline. Any citizen in Uganda can report a health service delivery complaint to this toll-free SMS hotline.
India can learn a lesson or two from Uganda. This small African country is making the best use of technology and social media to improve health care and education systems by bringing in transparency and technology. Instead of depending wholly on traditional methods like audits, annual reports, special surveys and inspections for outcomes, Uganda is now using some innovative methods to get instant feedback from end beneficiaries. This also ensures community participation in drafting and implementation of health and education-related schemes. Additionally, it brings in transparency and accountability at the level of resource providers, including development partners, resource expenders and beneficiaries.
mTrac and EduTrac are two schemes at the delivery level based on the use of mobile phones to strengthen existing government Health Management Information Systems and community reporting. Launched in December 2011, mTrac covers the whole of Uganda connecting 2,500 health facilities, 7,000 village health team workers and 15,000 health workers. All mTrac data is compiled on online dashboards customised for each stakeholder (including district and Ministry of Health officials), providing easy access to information and creating a “chain of accountability” for response and action.
mTrac takes advantage of the unprecedented growth of telecommunications infrastructure that includes network coverage and high rates of mobile phone penetration in Uganda to strengthen health sector reporting. It takes a unique approach by designing a system that works on any mobile phone. Health workers use their own phones to send in reports to a toll free SMS/USSD short code. Project implementation costs are kept to a minimum, and long term sustainability is enhanced. It is supported by UKAid, UNICEF and WHO.
Almost 50,000 complaints have been reported on 8200 hotline covering a wide range of issues such as absenteeism, drug theft, impersonation and abuse. Over 250 priority cases were being followed up and 75 per cent have been successfully closed.
“Over 85 per cent of those reporting and seeking information are women,” says Dr Sharad Sapra, country representative of UNICEF. “In India we are told language is an issue. But even basic phones have SMS facilities and Facebook is now available in 18 Indian languages. Video content can help break the language barrier,” Dr Sapra explains.
Similarly, EduTrac gives real time information on attendance, violence, budget allocation and managing critical school issues. Currently it is being tested in 19 districts with 6,000 reporters from 1,600 schools. The reporters include teachers, headmasters, school management committee and trained youth groups. The scheme is being run by the Ugandan Ministry of Education in collaboration with UNICEF.
Importantly, U-Report is a social monitoring tool that gives young Ugandans on issues that matter to them the most. Every Ugandan has a right to be heard and this right can be exercised by SMSing toll-free 8500. More than 1,80,000 young Ugandans have self-enrolled as reporters representing all 112 districts. Those enrolled have an average age of 24 years and 51 per cent of them are women. The system is being run by 11 partners including faith-based organisations like the Church of Uganda, Muslim Supreme Council, Catholic Secretary, Youth Department and World Vision among others. The reporters conduct a poll twice a week where questions are decided by partner groups and u-reporters. Once a feedback is received, the data is automatically analysed and subsequently shared with the media and concerned departments.
“I intend to work with social media groups. Power of social media is something we have not yet explored. We just fear it. But once we get over this fear, we can also succeed,” says Anuradha Gupta, Mission Director, National Rural Health Mission. She feels that it is just a mindset to think that information is needed by rural masses alone. It is needed equally by the urban, particularly for information on non-communicable diseases and adolescent nutrition, which are major issues of the future.