Thinking of Solutions on a Continuum

K4Health Highlights

Lisa Mwaikambo

JHU∙CCP | eLearning Coordinator & KM Officer

Last week, I attended IntraHealth’s SwitchPoint 2013. It was an energizing event that brought together technologists, public health professionals, entrepreneurs, health workers, and artists to discuss innovations and partnerships for social change. I personally took away three key messages.

  1. Making is contextual

Erik Hersman, a Nairobi-based technologist and blogger, opened the event with the statement “if it works in Africa, it will work elsewhere.” He shared the many creative solutions that can be found across the continent. Creativity and inventiveness are often by-products of having little. In Africa, if you can’t fix something, then you’re just stuck. You can’t just throw something away and buy a new version if something doesn’t work. You need to improvise, recycle, reuse, and find creative solutions.

  1. A solution is defined by its user

Speaking of solutions, Josh Nesbit, CEO of Medic Mobile, challenged the technologists and reminded the public health folks in the audience that a solution is only a solution when it is used by the people for what they need. That is, once it solves a problem that the user is facing. Although technology offers all sorts of cool solutions, practical innovations are often low-tech as they must meet the needs of the end user without creating more problems for them.

  1. Trial and error is key

Sometimes, the best solutions aren’t the high-tech or “sexy” ones. It’s critical to think about and, more importantly, collaborate with intended users to make sure that the solutions meet their needs. This process often requires a willingness among all parties to learn from trial and error. Assess the needs and what is currently be used or done to address the needs (if anything), develop a solution, monitor and learn from its implementation, and then reassess and refine or develop something else.

Matt Berg, director of the Modi Research Group’s Africa Lab, was courageous in sharing with us an example of an app that was beautifully developed and worked flawlessly functionality-wise but failed as a solution since it did not meet the needs of the end user. It provided a complete profile of patient information; however, the nurses and midwives in the health facility were used to seeing a log of all patient information, not just the details of one patient at a time. As a result, they redesigned the app to allow this log-view option.

I especially appreciated this example because I work in the field of eLearning where there is constantly new interactivity and flashiness and I sometimes feel a little old school in my recommendations. But, then I’m reminded by learners that access to the latest, evidence-based information/training is what they value the most. So, when possible, we explore multiple delivery options so that we can reach as much of our audience as possible. What this often means is that we need to critically and creatively think about offering offline options along with online options.

The redesign of the Global Health eLearning Center (GHeL) platform is a great example of this. The courses are not only available online but you can also download a PDF version of a course or download a course to your iPad or eReader and read it anytime, anywhere at your convenience.  

Another example is the National Open University of Nigeria’s (NOUN’s) Open Courseware; the first of its kind in the West African sub-region. To meet the demand for tertiary education in light of the limited number of physical spaces available, NOUN offers a platform where learning is not only easily accessible, but also affordable. It offers over 50 programs and 750 courses, from certificate to diploma and degree levels, with study centers spread across the nation. Students have access to download course material into PDF form and self-study and then sit for the final exam at one of the study centers across the country.

IntraHealth’s CapacityPlus Project offers yet another example. They are currently pilot testing an interactive voice response (IVR) mLearning platform that delivers training to health workers, who previously attended a face-to-face training, on their mobile phones. The IVR training uses spaced education (PDF) methodology, a question-and-answer learning approach that repeats content in a way that has been scientifically proven to help students more effectively retain information and change their behaviors than traditional methods of learning.

Whenever participants are ready, they can listen to the questions and type back the number corresponding with their answers. Participants receive prerecorded feedback right away. Once they have answered all the questions correctly twice in a row, the course is complete. After finishing the course, the health workers receive certificates along with packets of all the course content.

Bringing this all back to my background in family planning and reproductive health, I’m reminded of the importance of expanding the range of contraceptive methods offered by family planning programs because the reproductive health needs of women vary greatly. This idea of options or choices is also true for the introduction and expansion of IT solutions for health and development outcomes; there is a continuum of options and often no one solution is perfect for everyone.