Increase adherence to recommended vaccines and other therapies through reduced pain.  May also be more effective at drug delivery.  LA Times reports on the development of micro-needles.

Big Tobacco using YouTube to circumvent bans on tobacco advertising. We talk a great deal about technology enabling better health, but what about technology enabling bad health habits such as smoking.  Regulation cannot keep pace with the proliferation of new media channels,

Oldie but worth a revisit.  Games for health. Has your office started an internal big loser club for losing weight?  What if video games were developed to support such efforts and encourage good natured competition towards desirable ends, such as losing weight.

At Global Health Ideas, we are suckers for the anything related to developing new medical technologies.  New drug development is a costly process with an uncertain outcome.  This  is especially true when the underlying condition is poorly understood.  Stress can kill and it can exacerbate the negative consequences of other aspects of our health.   See this Wired article about the search for a cure to stress.

The West Wireless Health Institute is hosting a Health Care Innovation Day in Washington DC on October 12.   The event will highlight innovation at the Department of Veteran Affairs.  Click here for further details.

Texting for Emergency Room Wait Times:

MetroWest Medical Center has launched service that allows patients to receive emergency room wait times via text message.   Goal of the service is to improve patient volume and satisfaction.

iPhone/iPad in Medicine

San Francisco Chronicle explores the iPhone’s role in Medicine.  How will the release of the iPad extend or change the role of the iPhone in medicine.  Stanford Medical School gave 91 incoming med students an iPad as part of a new trail.  Several other universities are exploring the role of the iPad in education.

California launches telemedicine broadband network

As part of National Broadband Plan, FCC is providing $400 million a year to connect rural health providers.  Governor Arnold Schwarzenegger announced the nations largest “telehealth” system funded in large part by the FCC monies.

Discussion with Maria Belenky and Donika Dimovska of Results for Development

Results for Development (R4D) has recently founded the Center for Health Market Innovations (CMHI) in collaboration with three international partners–ACCESS Health International in India, Consultation of Investment in Health Promotion in Viet Nam, and BroadReach Healthcare in South Africa.  The center has a new take on the quest to improve global health – a focus on health markets rather than specific disease interventions or capacity building of health workers. Implicit in this approach is that properly functioning and innovative health markets can help governments deal with the challenges of delivering critical health services that are high quality and affordable for poor people.

At present, though, there are no comprehensive sources to learn about programs piloting health market innovations.  There are, however, no shortage of health service innovators in the developing world struggling with ways to improve their own health markets.  This is the space that healthmarketinnovations.org is trying to fill.

I discussed with Donika and Maria the recent public release of the website healthmarketinnovations.org.  The website is the public face of CMHI and is a tool to aggregate data, disseminate findings, and analyze health market innovations.

The definitive starting point at healthmarketinnovations.org is the about section.  It is here that we (the user) learn about the framework used to classify health market innovations.  This framework is the driver for everything else that happens at the website.

What is a Health Market?

Everything that allows health consumers to receive health services from health providers

What is the target market for healthmarketinnovations.org?

People running innovative programs in developing countries, what we call the implementer audience, will find our program database helpful to get the word out at the grassroots level about their approach and successes. They can learn from other implementers and join a community of practice.  And using the funder database, implementers can also learn about with potential funders who may help them scale up a health program. Funders can easily survey the different types of health market innovations that exist globally.  Through the database, funders can learn about programs’ approaches and needs.  Policymakers and researchers have access to a rich database of health market innovations that have been classified and tagged with pertinent metadata.

What is CHMI’s approach to health market innovation?

Identify innovations; Analyze market evolution, innovative models and measure performance; link programs to each other and to funders.

How does CHMI classify health market innovations?

1. By Innovation: Organizing Delivery, Financing Care, Regulating Performance, Changing Behaviors, and Enhancing Processes.  The categories are not mutually exclusive and certain programs exemplify multiple types of innovation.

2. By health focus: Classify each program by disease category (HIV/AIDS, tuberculosis, etc.) or level of health service delivery (primary, secondary, tertiary, etc.)

3. By geographical target for the program: rural, urban, peri-urban, etc.

4. By country of origin: The country of origin coupled with the location in country.

Who identifies and classifies the health market innovations?

Many of the existing programs were identified by CHMI’s staff and on-the-ground partners.  Our on-the-ground partners are currently located in India, Vietnam, and South Africa, but we are rapidly expanding our partner network.  In the next few months, we will add partners in an additional 6 countries.

Over time, CHMI would prefer most of the health market innovations to be entered directly by the organizations responsible for the underlying program via the healthmarketinnovations.org website.  Each program profile will be vetted by members of the CHMI staff, but the profile will be ultimately controlled and maintained by the organization that submitted it.

Can a program be added via mobile phone?

Not at present unless the phone is capable of interacting with normal websites.  CHMI is actively exploring adding his feature in the near future.

What is the incentive for organizations to use the healthmarketinnovation.org website?

Exposure to the global health community.  Learning from the innovative practices of other global health organizations.  Access to funders.  Building a community of practice with like-minded organizations all over the world.

What help do you need from the Global Health Ideas community?

Feedback, Feedback, Feedback! Currently, we are looking to build the programs database and to ensure an enjoyable user experience.  We would appreciate it if  Global Health Ideas readers could visit www.healthmarketinnovations.org; use healthmarketinnovations.org; and, provide feedback on their experience.

Please let us know:

1.  What were your positive and negative experiences working with database and other website features at healthmarketinnovations.org?

2.  How intuitive is the classification framework and what adjustments might you suggest?

3.  How useful is healthmarketinnovations.org to your own work? and how can the website be made more useful to you?

4.  How would you suggest that CHMI maintains the relevance of healthmarketinnovations.org to the global health community?

5.  What do you want to know more about regarding health market innovations?

We are keen to hear your feedback. Feel free to write a comment to this post, or email ddimovska@resultsfordevelopment.org.

This is a guest post by Preethi Sundararaman, summer associate working with the Healthcare for All team at Ashoka.

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It is a known fact that childhood obesity is on the rise, affecting one third of American children today. Alarmingly, researchers are predicting that for the first time in U.S. history, children may have a shorter life expectancy than their parents.

On July 13^th, I attended the “Innovation, Information and Technology for Better Health Outcomes” conversation event held at World Bank. Todd Park, the Chief Technology Officer of the U.S. Department of Health and Human Services (HHS) and co-founder of Athenahealth Inc., was one of three panelists at the event.

A key theme Park brought up was the impact technology and social media could have on healthcare for younger generations. “What if FarmVille were HealthVille?” Park asked. FarmVille, a real-time farm simulation game, has acquired 75 million Facebook users just within a year of being available. If games with the potential to reach this many were designed around health data, generations to come could grow up being more health conscious.

Park highlighted the 2010 Health 2.0 Developer Challenge, which is run by the company Health 2.0, and supported by HHS and its Community Health Data Initiative (CHDI), the new open government effort encouraging innovators to use health data made publicly available by HHS.  “Community Clash” is one of several new apps created to engage users in the health data available through CHDI.

“Community Clash” creatively incorporates HHS data in what Park calls “Healthcare Blackjack.” The online card game, launched by MeYouHealth, involves a comparison between your city and a “Rival City” on a number of health indicators from obesity rates to unemployment rates. Todd Park claimed he learned things he didn’t know by playing the game, adding “it’s incredibly addictive.” After trying the game myself, I would have to agree! I was surprised to learn that 68.1% of adults in Washington, DC eat on average less than the minimum daily recommendation of 5 servings of fruit and vegetables.

Charged by the excitement and new knowledge I had gained, I proceeded to search for initiatives on apps specifically for kids and found  that earlier this year, First Lady Michelle Obama had announced the Apps for Healthy Kids Challenge in conjunction with the USDA as part of the Let’s Move! campaign, asking innovators around the nation to develop video games and mobile applications to incite physical activity and promote healthy lifestyles.

One of the 95 final entries was developed by Alaka Sarangdhar, a Portland-based software engineer. Her application, called iNutri8, is an iPhone app designed to make nutritional information available at your finger-tips and show users how their daily eating compares to the food pyramid guidelines. This allows kids to be aware of the portions and food groups they are lacking or exceeding in, and how their eating habits can be improved. I was able to ask Mrs. Sarangdhar how she sees the tool affecting kids in the future, and she stated “I hope iNutri8 teaches the younger generation to be aware of what they are eating and its nutrition value. With this on-the-go tool, they can even try to evaluate their options before they eat to see what will give them an overall healthy diet…” You can vote online for iNutri8 and your other favorite entries in the Apps for Healthy Kids Challenge until August 14^th.

After browsing through the entries in the Apps for Healthy Kids Challenge, it became apparent that Todd Park was on to something. What if apps were created to engage kids in HHS health data? With something like “Community Clash” that is fun, appealing and adds a competitive element to useful information, kids could not only improve their own lives but be more aware of healthcare issues in the communities around them.

Enter: the “Why-Health?!?!” challenge. In this challenge – one of five on the Health 2.0 Developer Challenge platform – Whyville.net, a virtual gaming site with 6.3 million users aged 9 to 15, asks developers to design games and other interactive resources that cater to their young users and make health data “accessible, understandable and actionable.” You can submit your applications to the Whyville health challenge until September 15^th of this year.

Provided with the right tools to be more aware of health issues, today’s younger generations could build a better future for all of us.

*The quote used in the title is from the Talmud, and is displayed at the American Visionary Art Museum in Baltimore.

Who:

* Todd Park, Chief Technology Officer, U.S. Department of Health and Human Services
* Eric Rasmussen, President and Chief Executive Officer, InSTEDD
* Randi Susan Syterman, Director Governance and Innovation, World Bank Institute

What:

• The power of analytics in shifting the landscape of global health
• Stimulating the development of new applications for improved access to health-care
• Using competitions and challenge grants to motivate the public and private sectors, NGOs and communities to road-test ideas and solutions
• Open data, open innovation, and PPP to improve global health outcomes
• Using data and innovation to improve performance and spark action locally and globally
• Increasing transparency and accountability and greater citizen participation through innovation

When: July 13th, 9:30-11am

Where: World Bank J Building – 701 18th Street NW (Washington DC)

How: External Participants should RSVP to Selina Khan skhan8@worldbank.org

Todd Park (CTO, HSS) – using information to shift the landscape; empowering communities, enabling global action, improving lives

Todd Y. Park has been Chief Technology Officer (CTO) for the U.S. Department of Health and Human Services (HHS) since August 2009. Mr. Park Co-Founded Athenahealth Inc., in 1997 and served as its Chief Athenista from January 1, 2008 to August 31, 2008. Mr. Park served as Chief Development Officer and Executive Vice President of Athenahealth, Inc., since February 2004. He served as a Leading Management Consultant at Booz-Allen & Hamilton in New York. Mr. Park specialized in healthcare strategy, operations, and systems work at Booz-Allen, and served as a major thought leader on the evolving dynamics of the healthcare sector. Mr. Park’s accomplishments at Booz-Allen included: Development and implementation of “best practice” provider network, medical management, claims processing, operations, and systems infrastructure for multi-billion dollar clients; Design and rollout of innovative managed care products and services; Successful marketing and expansion planning efforts for high-growth healthcare networks and services; Development of groundbreaking strategic partnerships among major healthcare organizations. Before Booz-Allen, Mr. Park served as Director of Development for Summerbridge Cambridge, an Innovative Academic Enrichment Program serving gifted and underprivileged children. He served as Director of Athenahealth Inc. from January 1, 2008 to August 10, 2009. He focused on healthcare economics, business strategy and technological innovation at Harvard University. Mr. Park received his Bachelor of Arts degree in economics from Harvard University.

Eric Rasmussen (CEO, InSTEDD) – SMS to avert outbreaks, mobile technology, GIS and innovation for emergency response

Dr. Eric Rasmussen arrived as President and Chief Executive Officer of InSTEDD in October 2007. Previously, Dr. Rasmussen was both Chairman of the Department of Medicine within Naval Hospital Bremerton near Seattle, Washington, and an advisor in humanitarian informatics for the US Office of the Secretary of Defense. He holds academic positions at several institutions and has been a Principal Investigator for both the Defense Advanced Research Projects Agency (DARPA) and for the National Science Foundation. He sits on several advisory boards, including the Crisis Management Resources Board for the National Academy of Sciences and the US Crisis Response Working Group. He has a number of publications and has been awarded several personal, unit, and theater military decorations, including a Presidential Legion of Merit.

Dr. Rasmussen spent seven years enlisted in nuclear submarines before leaving the Navy to receive his undergraduate and medical degrees from Stanford University. After graduate work in molecular biology at Los Alamos National Laboratory and teaching in Haiti, he completed a Residency in Internal Medicine and re-entered the Navy as Chief Resident in Medicine at the Navy Medical Center in Oakland, California. Subsequent Navy positions included three years as Fleet Surgeon for the US Navy’s Third Fleet. Dr. Rasmussen served on the Afghanistan humanitarian support planning staff within US Central Command Headquarters (CENTCOM) in 2002, and later as a physician to the Iraq Disaster Assistance Response Team (DART) for the Iraq War in 2002-2003. As a member of the DART, he served as medical director within the International Humanitarian Operations Center in Kuwait and was later selected for the DARPA 2003 “Sustained Excellence in a Principal Investigator” award.

Further work as Director of the Strong Angel series of international humanitarian support demonstrations led to work in Afghanistan in 2004 and 2007, and in Indonesia as head of a Civil-Military Coordination Team for the tsunami response in Banda Aceh in early 2005. Later in 2005, he deployed with Joint Task Force Katrina in New Orleans, coordinating a small portion of the relief response after Hurricane Katrina. He was the medical lead for a UN mission to Tajikistan in 2009, and in 2010 he deployed to Haiti immediately after the earthquake for work within the UN’s Search and Rescue Dispatch Center on the Port au Prince airfield.

In addition to his responsibilities at InSTEDD, he currently serves as Permanent Advisor to the United Nations Secretary-General’s High-Level Forum on Water Disasters, as a member of the US Congressional Task Force on Global Biosurveillance, and as a member of Kofi Annan’s Global Humanitarian Forum in Geneva.

Randi Susan Ryterman, Director, Governance and Innovation, World Bank Institute
Ms. Ryterman, an American national, joined the Bank in 1998 as Senior. Public Sector Management Specialist in the Europe and Central Asia Region.  She has since held various positions, her most recent assignment being Sector Manager, Public Sector Governance, in the Poverty Reduction and Economic Management Network (PREM). Ms. Ryterman studied at Wharton, University of Pennsylvania, and received her PhD from University of Maryland.

Haiti was a big focus of this year’s Global Health Council conference.

In addition to a plenary featuring Haitian Minister of Health Alex Larsen, this year’s US$1 million Gates Award was presented to Haitian NGO GHESKIO. This award recognizes that GHESKIO belongs in the same company as the London School of Hygiene & Tropical Medicine (last year’s awardee) and the Aravind Eye Care System (2008 awardee).

Founded in Haiti in 1982, GHESKIO (French acronym for: Haitian Group for Studies in Kaposi’s Sarcoma and Opportunistic Infections) was the first institution in the world dedicated solely to the fight against HIV/AIDS. GHESKIO physicians were the first to describe the characteristics of HIV/AIDS in the developing world, with their 1983 article in the New England Journal of Medicine, Characteristics of the acquired immunodeficiency syndrome (AIDS) in Haiti.

Since then GHESKIO has grown to provide antiretroviral therapy (ART) to over 9,000 HIV-positive Haitian patients – and to treat more than 500,000 Haitian patients annually. GHESKIO was selected for the award because of “its years of ground-breaking clinical service, research, and training to treat and prevent the spread of the HIV/AIDS and other related illnesses, as well as its life-saving and swift response to treat the sick and injured in the aftermath of the January 12 earthquake that devastated Haiti.” This response included continued support of its network of ARV patients when all infrastructure had collapsed. On the ground, GHESKIO staff tracked down patients on foot, by radio, and by mobile phone. GHESKIO staff did this, as Dr. Jean Pape described, even though many of them had lost loved ones in the earthquake.

The earthquake was the motivation for discussing rebuilding the health system in the plenary, After the Earthquake: Towards Building a New Haitian Health System.

The plenary participants:

• Donna Barry, Advocacy and Policy Manager, Partners in Health
• Thomas Tighe, President & CEO, Direct Relief International
• Alex Larsen, Minister of Health, Ministry of Health, Haiti
• Andre Vulcain, Faculty Liaison of the Haiti Project, Department of Family Medicine, University of Miami, Miller School of Medicine
• Dianne Jean-Francois, Haiti Country Director, Catholic Medical Mission Board, Inc.
• Moderator: Susan Dentzer, Editor-in-Chief; GHC Chair, Health Affairs Journal

While other issues were addressed, the focus of rebuilding was definitely on human resources for health:

Health worker shortage made worse: The state of New York has more Haitian physicians than all of Haiti (Minister Larsen). But the doctor shortage is only part of the problem – the shortage of nurses and mid-level professionals is even more severe. The situation before the earthquake was bad, but it was much worse afterwards, as many health workers lost their lives or were seriously injured. Consider that, as a result of the earthquake, 200,000 people died, 1.2 million were made homeless, and 600,000 left Port-au-Prince. This is why organizations such as GHESKIO had to extend beyond their core services to provide emergency care and shelter after the earthquake. (For another example, read/listen to this NPR story about 400 Cuban health workers as first responders post-quake.)

Mid-level professionals, not buildings: Minister Larsen stressed the need to focus on the health workforce over infrastructure given how many health workers were lost in the earthquake. He said that you “don’t need a building”, but people – that a hospital was of little value without the health workers to work in it. He specifically indicated the need for mid-level community health workers, nurse-midwives, and anesthesiology nurses. Jean-Francois echoed this with a description of how CMMB is focused on training and task shifting. Vulcain’s metaphor was perhaps most memorable: You have to “land the ‘beautiful plan’ in the reality of the ecosystem”. Mid-level professionals are the key to a smooth landing. “You win and lose the battles at the mid-level”.

Mental health & other “needs of the past”: Vulcain spoke of how the earthquake “exacerbated needs of the past”. In other words, the need for specific health specialties has been made more apparent in the wake of the earthquake. The two specialties that he specifically discussed were mental health and physical medicine/rehabilitation. To mental health, Barry gave the Partners in Health perspective, that they are starting to address mental health issues and that these issues need to be better addressed in Haitian health facilities. Since the earthquake, Partners in Health has brought on 50 new social workers and 15 psychologists. They are also assisting with a national plan for mental health. To rehabilitation, Jean-Francois, an amputee herself, spoke of “the plight of the Haitian amputee”. The needs go well beyond healthcare and rehabilitation – there is a need to ensure opportunities for an “active and rewarding life”.

Retention: As with many other places, Haiti suffers from the poor retention of human resources. Minister Larsen spoke to this issue. He suggested that it sometimes it feels as if programs to train health workers are in place to develop talent for later recruitment (a bit like minor league baseball in the Americas). He mentioned the US, but specifically called out Canada for its excessive recruitment of Haitian health workers. It is not only a challenge to keep resources in-country, but also to keep people working in the public sector – those that do stay in-country are drawn to NGOs and the private sector. He argued that the best solution is to train a rural person. They will be more likely to stay since “they will see see this as social promotion”. (With the caveat that no two places are the same, my experience in rural Mongolia suggests that this strategy has mixed results. Many of the young, rural recruits into the community health workforce in Mongolia are eager to migrate to urban areas, and some of them have already moved.)

Mid-level schools of public health: One of the more intriguing suggestions moving forward was from Minister Larsen, who wants to see 3-4 schools of public health for mid-level professionals in Haiti. These were already existing in Haiti at some point in the past, when he was young. (I wonder if the Cubans may be of assistance here, given their capabilities along these lines.)

Minister Larsen began his plenary remarks by describing how grateful Haiti was for the international assistance they received. In the first few days after the earthquake, the Dominicans – despite their limited means – sent assistance. Following this, assistance came from everywhere, from the Israelis and the Palestinians, from the Russians, from the Americans, from the Europeans. He said that Haiti is “forever in debt for this assistance”. The challenge now will be to ensure that the assistance translates into meaningful contributions to helping Haiti develop its human resources to help it rebuild its health system. Sara Pacqué-Margolis, who reported on this plenary from the perspective of IntraHealth’s CapacityPlus project, speaks to this very need.

As Minister Larsen said, citing a French saying: “It’s never too late to do good”.

This is a report from the Global Health Council’s annual conference in Washington, DC. This year’s conference, Dateline 2010: Global Health Goals & Metrics, was held June 14-18, 2010. GHC37 is a reference to the Twitter hashtag used for the meeting. Make sure to check out the Council’s own conference blog coverage for more depth. This is our third year covering the meeting (2008 posts, 2009 posts).

Even though the focus of the Global Health Council conference was on metrics and evaluation, we at Global Health Ideas were particularly interested in learning about new service and technology innovations. “New”, as you might imagine, is a relative word. I discovered this when asking other conference attendees for their lists of new innovations. Late in the conference, I offered my working list to Peggy Parlato of AED. Every single item on my list was old hat to her. When I asked her for an innovation, she told me about voucher schemes – which we’ve covered extensively on Global Health Ideas for more than three years.

I’m focusing on ideas that were new to me, with the hopes that these will be new to some of our readers, too:

Export human resources, import ideology. This was the topic of Lord Nigel Crisp’s (NHS UK) lunchtime talk about his new book Turning The World Upside Down: The Search For Global Health In The 21st Century. He argued that we currently do the opposite in places like the UK, that we import human resources (brain drain) and export ideology (development aid). A wild idea on paper, but one that jives with the trend towards reverse innovation and addresses critical issues around human resources for health (HRH).

Micro-competitions. Spark MicroGrants “supports community-led development by giving small grants to community members to fund locally-generated solutions”. From the card that Neal Lesh gave me. He described a story of how his team was trying to develop an SMS-based system to increase the number of mothers giving births at health facilities in Tanzania. During this process, they asked community health workers for their ideas and one suggested a much simpler solution – that they simply provide free diapers and soap as an incentive to mothers to come to the clinics. They encouraged this health worker to write up the idea. She did and US$625 later, the idea was implemented, resulting in almost immediate increases in facility births (tens more facility-based births per month at one facility). This is how the Spark Microgrants idea was born. The grants they now provide are on the order of US$3,000. The Jhpiego PRIDE project in Pakistan similarly organized a competition for health centers to apply for facility development funds. With PRIDE, the amounts were greater – on the order of US$10,000 – and the focus was less on innovation and more on basic needs (e.g., clean water systems).

Avon Lady model, exported. If you’re not familiar with the US-originated Avon model, read up on it. It’s long been expanded to international markets, but now Solar Sisters has appropriated the model to sell solar-powered lamps to poor households in Uganda.

Ultra Rice. Ultra Rice has been around for a little while, but a couple folks brought this up to me as novel, including a JSI employee that I met at a cafe across the street from the conference. Ultra Rice is a food-based solution to micronutrient problems, well-suited to cultures with rice-heavy diets. We’ve covered this in a previous conference post.

Voucher programs. Since Peggy mentioned it, we’ll include it here. Now accepted as a way to implement results-based financing (RBF), though it wasn’t always that way – previously there was not always a tie-in between vouchers and outputs (thanks to Mursaleena Islam of Abt for the historical perspective). The voucher session description, doesn’t provide an entirely clear description of what voucher schemes are or why they’re important, so if you’re new to vouchers, check out the Population Council’s Reproductive Health Vouchers site.

This is a report from the Global Health Council’s annual conference in Washington, DC. This year’s conference, Dateline 2010: Global Health Goals & Metrics, was held June 14-18, 2010. GHC37 is a reference to the Twitter hashtag used for the meeting. Make sure to check out the Council’s own conference blog coverage for more depth. This is our third year covering the meeting (2008 posts, 2009 posts).

This morning I attended the Next Steps in Health Information Systems Applications panel.

The speakers:

• Johan Saebo, Health Metrics Network, Norway: A Global Analysis of Health Information System Assessments
• Gashaw Shiferaw, Supply Chain Management System (SCMS), Ethiopia: Ethiopia’s Innovative Approach for Bigger, Better, Faster Logistics Decisions
• Anwer Aqil, John Snow, Inc., United States: Strengthening Routine Health Information System (RHIS) for Better Health Systems Outputs
• Theo Lippeveld, John Snow, Inc., United States: Case Studies Illustrating Contributions of Health Information Systems
• Moderator: Dykki Settle, IntraHealth International, United States

Two aspects of the panel deserving special attention:

ARV supply chain management in Ethiopia: Gashaw Shiferaw presented a system developed by Ethiopia for tracking ARV supplies. The system is called HCTS, or Health Commodity Tracking System. It was motivated by Ethiopia’s extremely ambitious scale up/universal coverage program. For example, Ethiopia is aiming to scale up from 220,000 patients on ART to just under 2.4 million by the end of 2010. The technical system makes use of PDAs and offline desktop applications for data entry, and a centralized web service that aggregates data, performs analysis, and produces reports. And all this of course influences the behavior of the supply chain. It’s interesting to hear about a present-day PDA example, a seemingly successful one no less. In the past 1-2 years it seems PDAs have become passe in our mHealth community – it’s all about mobile phones these days. The system has been used by the Clinton Health Access Initiative (CHAI) and FMOH medical stores for five decision cycles. Results include the following: reporting turnarounds have been reduced from 1-2 months to 3-5 days; reporting is up to 99+%, well above the 80% target, from 70%; and emergency orders due to stock outs have been reduced to 0. It is now being implemented nationwide. More information is available from the HCTS website.

Quasi-experimental RHIS studies: In 2009, HMN contracted JSI to conduct case studies in four countries examining the impact of improving HMIS on health services: Ethiopia, Haiti, Cote d’Ivoire, and Pakistan. In Cote d’Ivoire, where the focus was on HIV/AIDS prevention, they observed dramatic increases in VCT rates between 2005 and 2008. During this period there had been significant RHIS efforts that could have led to this increase. Despite results such as these (Lippeveld also presented DHIS improvements from Pakistan), there is no clear causal link between RHIS efforts and system outcomes. Lippeveld conceded that there needs to be a stronger, “more structured, more scientific” link between RHIS performance and health system performance. The MEASURE evaluation team is now developing a “linking tool” and everal quasi-experimental studies are in the works, with results expected in three years.

This is a report from the Global Health Council’s annual conference in Washington, DC. This year’s conference, Dateline 2010: Global Health Goals & Metrics, was held June 14-18, 2010. GHC37 is a reference to the Twitter hashtag used for the meeting. Make sure to check out the Council’s own conference blog coverage for more depth. This is our third year covering the meeting (2008 posts, 2009 posts).