Scaling mHealth for Community-Based Health Information Systems: Lessons and Best Practices

Despite the availability of low-cost technology and decreased Internet access costs, few programs have successfully scaled and sustained mHealth solutions. The MEASURE Evaluation project, funded by the United States Agency for International Development (USAID), aimed to explore the feasibility of scaling mHealth projects to effectively manage community health information and improve data use. The project selected two mHealth implementations that had moved beyond the pilot phase: the partnership of Medic Mobile with Living Goods in Uganda and the partnership of Dimagi with mothers2mothers (m2m) in South Africa. The project involved informant interviews with senior managers, finance staff, project managers, M&E staff, designers, technical program advisors, software developers, and information technology staff from the implementing partners and technology companies. The interviews focused on successes and challenges encountered in designing and implementing mHealth programs, including the use of M&E data to inform scaling decisions, potential cost savings, key lessons learned, and best practices for taking a community health information system to scale. Medic Mobile and Living Goods partnered to develop an mHealth application that facilitates care coordination among CHWs. The application enables CHWs to diagnose, distribute medicine, and provide health information to clients. The partnership has shown promising results, with CHWs using the application to improve data collection and transfer community data into the HMIS. The partnership of Dimagi and m2m in South Africa also implemented an mHealth solution to support CHWs in collecting data and providing health services. The solution included a mobile application that enabled CHWs to collect data, receive feedback, and transfer data into the HMIS. The partnership faced challenges in scaling the solution, including limited resources, training, and support for long-term sustainability. The MEASURE Evaluation project identified several lessons and best practices for scaling mHealth projects, including the importance of integrating mHealth solutions into existing health systems, designing for users, keeping it simple, and having offline options. The project also highlighted the need for partnerships, training, and data use to ensure the sustainability and scalability of mHealth solutions. The project's findings suggest that mHealth projects can be scaled to effectively manage community health information and improve data use, but it requires careful planning, design, and implementation. The MEASURE Evaluation project's lessons and best practices can inform the development and scaling of mHealth solutions in community-based health information systems.