WHCC Affordable Health Innovations

Below is the text of a release by Freedom From Hunger, Indian Institute of Public Health Gandhinagar and Microcredit Summit Campaign  

Microfinance and health leaders will meet in Ahmedabad July 26–27 to explore opportunities for greater collaboration between the health and microfinance sectors to improve economic productivity, health practices and access to health services for millions of the Indian poor. 

Health shocks are among the biggest and least predictable forms of uncertainty that a poor family faces, with about 39 million additional people in India falling into poverty every year as a result. Ill health and the inability to access health care are key causes and consequences of poverty for millions of people in India, with the financial and time costs of illness representing a significant burden on households. 

Microfinance, the extension of small loans, has proven to be a valuable tool for poverty reduction.  Although access to financial services is undeniably important to poor families, it is insufficient on its own to address the multi-dimensional challenges of poverty.

To address this gap, and to explore the potential for integrated approaches, the Indian Institute of Public Health Gandhinagar, Freedom from Hunger, and the Microcredit Summit Campaign have organized the workshop, Linking Health and Microfinance in India:  Improving Incomes and Promoting Universal Health Care Access for the Poor (26–27 July), in Ahmedabad, India. This workshop brings together over 65 senior officials from microfinance, the self-help group (SHG) movement, the health sector, government, and donors and social investors for dialogue to explore intersecting objectives, services, and potential for synergy within what have been largely separate efforts towards reducing poverty and poor health.

The keynote address will be delivered by Ms. Ela Bhatt, founder of the Self-Employed Women’s Association (SEWA) of India.  A lawyer by training, Ms. Bhatt is a respected leader of the international labor, cooperative, women’s, and microfinance movements who has won several national and international awards.

Other key speakers include Sheila Leatherman, Research Professor, Gillings School of Global Public Health, University of North Carolina; Ms. Rita Teaotia, Commissioner and Principal Secretary Rural Development, State of Gujarat; Dr. Dileep Mavalankar, Dean, Indian Institute of Public Health, Gandhinagar; Mr. PK Saha, Chief General Manger, SIDBI; Mr. Chandra Sekhar Ghosh, Executive Director, Bandhan; and Ms. Vijaylaxmi Das, Executive Director, Ananya Finance.

The workshop dialogue will result in identification of innovative approaches to link microfinance clients and SHG members with health education, services and financing opportunities, which can  advance greater collaboration between health and microfinance services through experimentation, research, replication and expansion of innovations.

The event is co-sponsored by SIDBI, NABARD, Johnson & Johnson, Ananya Finance for Inclusive Growth, CSIR, Indian Institute of Public Health Gandhinagar, Microcredit Summit Campaign and Freedom from Hunger.

Friends from the press are invited to attend and cover the event at the Country Inn & Suites, Nr. SAL Hospital, Off Drive-in Road, Ahmedabad.

Contact:

Indian Institute of Public Health Gandhinagar is an initiative of Public Health Foundation of India to build institutional capacity in India for strengthening training, research and policy development in the area of public health. Contact: Somen Saha, ssaha@iiphg.org

Freedom from Hunger is an international development organization working in 19 countries across the globe. Its value-added microfinance programs are serving over 18 million people in some of the poorest countries on earth. Contact: Kathleen Stack, kstack@freedomfromhunger.org or Marcia Metcalfe, mmetcalfe@freedomfromhunger.org

Microcredit Summit Campaign is a global network of microfinance practitioners. Their Financing Healthier Lives Project aims to build a global group of MFIs capable of providing health education to their clients in a sustainable manner to reach over a half-million clients, affecting some 2.5 million family members. Contact: DSK Rao, dskrao@microcreditsummit.org

The World Congress 3rd Annual Leadership Summit on mHealth  (July 28-29 in Boston) is pleased to welcome several participants  a special poster exhibit featuring new mHealth innovations. The exhibit is part of the WHCC Health Innovations program.

As mobile phones and smartphones continue to saturate the global market, health care applications have become more prevalent. Below are the presenters scheduled to attend.

UCLA tests symptoms diary on smartphone for sickle cell diease pain and symptom tracking

Dr. Eufemia Jacob, assistant professor, of the UCLA School of Nursing will present on “Wireless Pain Intervention Program in Sickle Cell Disease.”

In the study, researchers used a handheld electronic multidimensional pain and symptoms diary accessed using a smartphone that can be monitored by an advanced practice registered nurse (APRN). The purpose is to examine symptom reporting in two groups of children with sickle cell disease. One group used a paper diary and the other a smartphone for self-monitoring pain and symptoms.

Consumer Reports’ first smartphone consumer app

 Tara Montgomery, director of Consumer Reports Health, will present on the organization’s launch of its first smartphone consumer health app. The first step will be direct to consumers on iPhone App Store. Consumer Reports is also interested in understanding how this type of product could be customized and made available to large employers, health plans, etc. for dissemination to their members.

The Symple Sympton Tracker

Diagnosed with a complex autoimmune disease in late 2010, Natasha Gajewski  searched for but could not find a portable, elegant, and relevant symptom tracking solution. So she designed her own, the Symple Symptom Tracker. The new company will beta test on the Lupus community beginning in August with an iPhone application. The best features of SympleSLE: user defined criteria, daily alert feature, limited data reporting to physician, ability to attach “tags” (a trigger recording feature).

RemoteID: A low-cost HIV information tracking and testing system  

In developing nations where HIV prevalence is greatest, there is no anonymous, confidential testing method that allows for collection, aggregation and analysis of behavioral and test result data. Developed by Triad Trust, RemoteID is a cost-effective, electricity independent remote information tracking and testing technology that enables health workers and educators to capture, upload, retrieve, and aggregate data from remote locations. The technology uses biometric identifiers and builds upon existing technologies using wireless networks. Brooke Wurst, Triad Trust executive director, will present the RemoteID poster.

Call this one the “eye’ phone.

MIT Media Lab has an interesting innovation called CATRA, which has the potential to efficiently and inexpensively diagnose cataracts in the developing world. Cataracts are the world’s leading cause of blindness. Built from off-the-shelf components and with no moving parts, CATRA employs an eyepiece that snaps onto a smartphone.

According to the developers’ abstract, here’s how CATRA works.

A cataract-affected eye scatters and refracts light before it reaches the retina, caused by a fogging or clouding of the lens. We measure this deformation or (clouding) by allowing one to compare a good light path with a light path blocked by the cataract. Current methods for cataract detection require costly equipment and highly trained clinicians. They utilize back-scattering which is observed and subjectively diagnosed. However, this does not address the early onset of cataract affected vision, as early opacities are difficult to detect. Back scattering can be misleading as it does not account for what the patient actually sees.  Existing techniques present a simple grading of severity, while our technique presents a full map of opacity and scattering.  Our technique allows for a coupling of quantifiable data with the users visual experience.

CATRA utilizes a forward scattering technique, which allows the user to respond to what they visually experience.  Our device scans the lens section by section. The user sees our projected patterns and presses a few buttons to map the light attenuation in each section of the eye.  This information is collected by the device creating an attenuation map of the entire lens.  This allows individuals to monitor the progression of the severity of the cataract.  Our maps capture a full point spread function of the lens, allowing us to simulate the visual perception of a cataract affected subject over time.  Early cataract onset is difficult to diagnose.  We present a device for measuring cataracts, which is highly portable and collects quantifiable data to help tackle a global health problem making it ideal for the developing world.

The Boston Globe ran a great article about Boston-based Prometheus Power Systems, which specializes in solar-powered refrigeration. A unit they desigened that employs solar energy to keep milk cool recently received a grant from the National Science Foundation.

According to the article, the technology is espeically useful in India, the world’s largest milk producer and consumer.  India is espeically vulnerable to spoiled milk because of high temperatures and frequent power blackouts. Other markets of interest include Africa and Latin America.

Sara Al-Lamki, an advocate for materal health progress in developing countries, recently spoke with WHCC Health Innovations regarding her work with  Young Champions of Maternal Health Program, a project organized in conjunction with Ashoka Fellows . For her project, Al-Lamki, a native of Oman, conducted a survey about the pregnancy habits of women who worked in or frequented one of the busiest markets in Denapasar, Bali, Indonesia. She will present a poster on her experience during the World Health Care Congress Middle East, this December in Abu Dhabi.

Q. What are the objectives of the Ashoka Maternal Health Fellowship?

A. The Young Champions of Maternal Health program was designed to produce the new generation of maternal health ideas and innovations, but hand picking 15 budding maternal health entrepreneurs aged 24-33 from various different backgrounds, and placing them in wholly new environments and countries to work with established Ashoka Fellows in the same field. The program was unique in that to be considered, the applicants had to submit a unique new idea on how to improve global maternal health, and how they were planning to implement that. These ideas were then matched with Fellows’ projects to ensure that the Young Champions had the best possible chance of developing and growing their ideas into pilot projects.

Q. The Reproductive Health Centre you worked in in Denapasar, Bali, Indonesia was located on the top floor of a market. Why?

A. Markets in Indonesia, and in South East Asia in general are the social and trading hub, where members of all levels of the community come together on a day to day. Indonesia is unique in it’s market structure: while the sprawling street market exists, it does so just outside the market building, where there is often also an office for the market management. The market where the RHC was located was the central market for all trading in Bali, the Pasar Badung. This market consisted of 2 large 4 story buildings, of which the top floor of one was reserved for the market management and offices. These markets are also almost exclusively run by, and frequented by women. From vendors to load bearers, shoppers to staff, it is estimated that 5-6000 women are in the market on a daily basis. For this reason, the YRS RHC was built on the top floor of the market building, to ensure the maximum number of women can be reached, and to also ensure that it is easily accessible for everyone, no matter their schedules.

Q. Part of your project addressed the lack of antenatal care for the population served by the market. Tell us about the program you implemented to study this.

A. The YRS centre is very focused on reproductive health care – Pap smears, contraceptive care, STI checks treatment and counselling. However, this is something that YRS has been wanting to expand to for some time, and since this is my focus I conducted qualitative research to investigate the pregnancy habits, maternal health status and beliefs concerning pregnancy and child birth among these women. I developed a questionnaire that broadly explored 4 key areas: Demographic, Pregnancy history, Maternal health status, Traditional beliefs and practices. There was an additional section that asked about the current pregnancy for the pregnancy respondents. This questionnaire was then translated to Bahasa Indonesia and the interviews conducted in a setting where the most information can be obtained. 156 women were interviewed, 40 of whom were pregnant, that encompassed all the various women that you encounter in the market, from those that work there to those that work in the offices or are shopping. This was all done to assess what these women really need, what are the risk behaviours that are prevalent in the community, and what services can YRS begin to offer to better serve pregnant women. These results were then analysed and discussed with those at YRS so we could figure out the best way to begin offering more thorough prenatal care. I also sought out a natural birthing centre located near by and set up referrals for the women that YRS serve to receive free or low-cost birthing facilities and postnatal care, in return the women they serve were referred to YRS for contraceptive care and Pap smears, this way the community receives a more holistic reproductive health care.

Q. What are you doing with the results of your study?

A. After discussions with the staff at YRS or what the results mean, and how studies like this one work and how this same study model and questionnaire can be adapted for their use in other similar studies, I wrote a proposal of how to incorporate the findings for developing new targeting educational material, what kinds of services they can offer for pregnant women, and how to ensure that these women are more aware of the services and the need for them to seek it. There is much information that can be extracted from the study, and I am also splitting them up into mini studies and sending them for publication, and hoping to present at international events an meetings. The work that is being done by YRS is very unique in so many ways, and I feel the results are interesting to a broader audience.

 Q. You are interested in getting more involved in the Middle East. What is it about the region that interests you?

A. Being from Oman, the region is my home, and I would love to serve my population. I feel that the Middle East is often overlooked when it comes to global health issues especially those concerning women’s and reproductive health, and I feel that there is much scope for this to be developed and for there to be more international interest in the region. I hope that I can contribute to this, and I can adapt everything that I have learnt in my travels and work in Indonesia to the region, with a fresh eye, and a new perspective.

QuickCheck Health, which develops home diagnostic tests for a variety of ailments, was recently featured in Technology Review, a publication from MIT. The Minnesota-based company was among the organizations in attendance at the World Health Care Congress in Washington D.C. last April. QuickCheck’s testing device, which would be sold in drug stores and other similar outlets, reveals a code the user can enter online or give by phone after contucting a self-test. Some of the array of tests QuickCheck produces include strep throat and urinary tract infections. If the test is positive, the user is directed to an online health care provider who can prescribe treatment. Click here to read the article.

Below is a guest post from E+Co, which makes clean energy investments in developing countries. With 15 years of experience and offices in 8 locations, E+Co’s innovative business model provides lasting solutions to climate change and poverty.

Energy Access Meets mHealth: Monitoring Efficient Household Cookstoves using Mobile Devices

Michael Benedict, Founder, Carbon Keeper
Erik Wurster, Manager, Carbon Finance, E+Co

At about 7AM on May 25, 2011, Victoria Aloyce bought a new stove for her home outside of Moshi, Tanzania. Her stove will last longer and burn cleaner than other models on the market, and use about 40% less firewood for cooking. It will not only save Victoria money on fuel and help avoid deforestation in her community, but also reduce her family’s exposure to the smoke and other health-damaging pollutants produced from cooking with biomass. Victoria’s household is one of thousands in Tanzania to purchase modern, efficient stoves through a project run by E+Co, a US-based clean energy investor that is developing similar initiatives throughout Sub-Saharan Africa.  

I’ve never met Victoria, but I know about her new stove because the salesman who sold it sent an SMS (text message) documenting the sale to a local number. The information was immediately verified, entered into a project database, and made available to Tanzanian and US-based project staff over the web. E+Co and their Tanzanian partners are using Carbon Keeper, a suite of open source software tools designed for monitoring energy access projects using mobile devices and the web. The software provides aggregate business information to entrepreneurs in Tanzania and managers at E+Co, along with detailed sale records that facilitate follow-up monitoring at the household level.

Monitoring is broadly important for E+Co to understand their projects’ impact and provide information to funders and the public, but it is particularly vital for their stove programs. In collaboration with E+Carbon, E+Co’s partner carbon finance company, scale up of cookstove sales in Tanzania is funded through international carbon markets. Efficient stoves produce fewer greenhouse gas emissions than traditional models, and carbon credits associated with these emission reductions can be sold to organizations in the developed world that want, or are required, to offset their environmental impact. Cookstoves stand out among household energy technologies for the quantity and value of emission reductions produced, but accessing carbon funding is not easy. It requires maintenance of a detailed sales database used to generate a sample of households for periodic in-home monitoring of stove use and performance. Project developers need to know who is purchasing their stoves and how to find them in the field, and the process must be validated by third party auditors. Carbon Keeper helps streamline this previously laborious, paper-only system, by allowing individual stove sellers to update the project database from the field using standard mobile phones.

The need for an end user database and follow-up monitoring is not unique to carbon finance projects. Indoor air pollution (IAP) from biomass stoves contributes to a wide range of health problems, including respiratory infections, burns, and perinatal conditions, primarily impacting women and children. Medical researchers working to better understand these health effects have a need to track stove users, and evaluate cooking behavior and IAP exposure at the household level. Carbon Keeper is being expanded to incorporate follow-up surveys administered on PDAs, and eventually data from electronic cookstove use sensors, directly into the point of sale database. Over time health researchers and carbon project developers will be able to build rich profiles of individual stove users from sale records and day to day stove usage.

E+Co and other cookstove project developers are investing in Carbon Keeper to build the monitoring infrastructure needed for their projects, but the benefits of modern, open source data management extend beyond carbon finance. The same tools and datasets can be modified to support studies of stoves and their impact on health outcomes, alongside or independent from carbon finance projects. As the field matures, such studies will continue to inform household energy policy and device design, ultimately resulting in more, higher quality stoves in the homes of people like Victoria Aloyce.

Click  here to learn more about E+Co’s cookstove projects, and other investments in clean energy entrepreneurs throughout the developing world. For more about Carbon Keeper, including how to get started using the software in your project, visit http://carbonkeeper.org.

Freedom from Hunger’s breakthrough white paper, “Human Faces of Microfinance Impact,” presents the impact story methodology of carefully collecting and analyzing stories of randomly selected microfinance clients, which has proven to be a meaningful tool for evaluating impact. The paper, authored by Lynne Jarrell, Bobbi Gray, Megan Gash and Christopher Dunford, describes both the methodology and preliminary findings from Freedom from Hunger’s use of the tool with partner organizations in eight countries.

Offering insightful results and a distinctive contribution to the narrative about the impact of microfinance, “Human Faces of Microfinance Impact” provides a noteworthy combination of rigorous method and storytelling. In so doing, this approach involves open-ended questions, careful listening, and free-flowing follow-up of the answers to capture a more complete picture of a client’s experience than can be achieved by standard interview techniques.

Since 2007, Freedom from Hunger has been developing and testing the impact stories methodology to discover client experiences that are representative of the whole clientele of a microfinance institution or even multiple institutions. A variety of methods is available to measure impact, including randomized controlled trials with highly structured interviews, but each is deficient for providing a holistic view of impact. To complement other techniques, the impact story approach enables a researcher to hear the bigger story of the individual or family and tries to find out what else is happening that might not have been anticipated.

The stories collected in “Human Faces of Microfinance Impact” paint a picture of the hope that participants bring to their microfinance experiences. The 274 individuals who participated in this study, representing both incoming and long-term clients in Freedom from Hunger’s programs around the world, entered their local microfinance program from a variety of backgrounds and family situations. This significant white paper highlights the importance of relying on multiple qualitative and quantitative methods to help researchers understand the full range of possible benefits of a value-added microfinance program.

Bobbi Gray, Freedom from Hunger’s Research and Evaluation Specialist and co-author, said, “We thought implementing organizations and our research evaluation peers, as well as donors, would find this paper interesting because it contributes to the ongoing public debate about the impact of microfinance and gives more of a client perspective about their lives in general and how microfinance fits into that picture—as well as what it tells us about successful microfinance clients.”

One of the highligths of the WHCC Health Innovations Exhibit at the 2010 World Health Care Congress was GE’s Vscan ultrasound. A demonstrator showcased the pocket-sized device on an actual person who was laying on an exam table on the WHCC exhibit hall floor.

The product, which allows doctors to conduct an ultrasound more quickly and less expensively than with a traditional ultrasound test, also holds promise for the developing world, where access to traditional ultrasound machines in limited.

The Vscan is part of GE’s healthymagination program, which was launched two years ago with the goal of “revolutionizing the world’s healthcare by focusing on high costs, disperate quality and inadequate access.” In its recently released second annual global report, GE offers that healthymagination has exceeded its Year 2 goals with $2.2 billion invested and 43 innovative technologies validated.

The WHCC Health Innovations YouTube Channel features several new videos conducted at the The 2011 World Health Care Congress. the innovations are part of the WHCC Health Innovations program. Featured innovtions include an ECG device that recquires no electrodres, a $2 clean birthing kit than can reduce maternal and infant mortality and how to market health insurance and other producsts to poor populations in developing countries.