AIDS 2012Mobile tech in PMTCT programme evaluation

Purpose of presentation

• Protocol recap

• Technology implementation

• Benefits: Data quality, availability & security

• Technology costs

Protocol recap

• Baseline (6w)Facility based interview + DBS sample taken

• EnrolmentHIV+ reported or tested enroled for follow-up

• Follow upInterviews and tests at 10-14w, 6m, 9m, 12m, 15m & 18m

Mobile interfaceData collectors

Basic logic determines whether a participant should be considered for the baseline and follow-up cohorts

Eligibility & screening logic

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Interviews take place at 7 time points (in SAPMTCT 1,100 fields captured)

Data collection

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Respondents appear on each follow-up list automatically

Follow-up management

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Web interfaceData managers, DC coordinators, principal investigators

Existing forms developed for SAPMTCT can be used as base and adapted for local application

Design & deploy forms from the web

Easily configure reports for supervisors and coordinators

Published reports

Detailed meta-data, granular permissions control and full audit history

Control data access and cleaning

Integrated SMS, activity logs and location lookups

Monitor & communicate

Backend & reportsProtocol support

Backend

• Longitudinal record-keepingRespondent record built up over multiple interviews

• Automated merging of lab resultsLab results received from NHLS automatically matched & merged to update respondent records

• Appointment remindersReminders sent ahead of each follow-up

Automated reports

• Progress reportsRolling 7-day report distributed via email

• Operational reportsDaily export of key tracking data for active respondents

• Analysis data setsMerged longitudinal export for analysis

Support, logistics & capacity building

• TrainingTraining provided to cover survey design, data collection & management

• LogisticsAssistance with handset procurement, setup & airtime monitoring

• Local capacity buildingHandover of core support activities to local resources

Data qualityHow can data integrity be ensured and on-going participant engagement encouraged?

Data quality benefits

• Improved data integrityPrevent input errors with relevant skip logic and validation

• Check digitsIssue and validate participant identifiers

• Tried-and-tested instrumentsUtilise tested base of questionnaires and protocols

• No separate data captureNo secondary data entry stage eliminates transcription errors

Data quality benefits

• Server-side heuristicsAlerts issued when sanity/integrity checks fail

• Data auditingAutomatic auditing of data modifications by authorised personnel

• Data authenticityVerify data authenticity through meta data & respondent mobile follow-up

• Reduced attritionSupport for visit scheduling, automated SMS appointment reminders and respondent airtime incentives reduce attrition rates

Data availabilityHow easy will it be to access, analyse and use data?

Data availability benefits

• Cloud architectureNo server-side hardware required

• Offline usageCaptured data cached on handset until network available

• Real-timeReal-time access to review, export, chart and map responses

Data availability benefits

• Data controlComplete control and ownership of data collected

• Automated progress reportsProgress reports generated and distributed automatically on daily basis to team leaders and coordinators

• ExtensibleGeneric and open API allows data to be integrated into any other system

Data securityHow can respondent confidentiality be ensured?

Data security benefits

• Confidentiality"Store-and-forward" and encrypted transmission

• Controlled sharingAbility to define dynamic data sets and provide access to limited user group

• Field visibility controlHide specific fields from selected users (e.g. mobile number)

CostIs it affordable and financially sustainable?

Cost

• Remove paper process costsNo printing, data entry, document transportation and storage

• Reduce errors and associated costsDetect and correct errors in the field

• Low cost handsetsChoose from over 500 handset options, including entry-level feature phones (around $50 each)

• ScalableSelect appropriate scale – a phased approach is possible

Cost

• Technology• Assuming large-scale sample (e.g. SA = 12k baseline, 3k

follow-up, 1,100 fields)• Hardware, software, hosting, training & consulting• Budget $90k initially• Budget $45k per annum for annual evaluation• Capacity building of local resources included

Concluding Remarks

• Using mobiles, data flow can be simplified and improved significantly

• Mobile technology provides a real alternative to paper

• Migration from evaluation to surveillance

Thank you

Questions Direct email: andi@mobenzi.com Support: support@mobenzi.com Twitter: andi_friedman / mobenzi_r