Mobile Phone Technology Helps to Monitor Disease Outbreaks and Health Behaviors in Lao PDR

Cecile Lantican reports on the Lao SMS experience

Use of mobile phones to communicate with family, friends and coworkers, especially in the provincial capitals and some district towns, is becoming more the norm in Lao PDR. Now, thanks to the Mekong Behavior Change and Communication (MID-BCC) project funded by USAID the application of mobile phones application has gone a step further, helping health officials to monitor public health initiatives and disease outbreaks.

Beginning in November 2010, AED (and its partner, Rapid Asia) set up a rapid response mechanism to monitor health programs atcross-border sites. MID-BCC capitalized on its existing partnership with the Lao Women's Union (LWU), whose members had previously been involved with efforts to prevent avian flu and deploy vaccines for the H1N1 influenza virus. A total of 17 LWU members from several villages in and around Vientiane, Savannakhet, Luang Namtha and Bokeo were recruited and trained to use the mobile phone/SMS-based program. They would serve as "master trainers" who would then, in turn, return to their cities and towns and train additional members. Overall, 71 participants were successfully recruited and trained.

recent seminar of Handicap International The main criteria for involvement were relatively simple: participants had to have a GPRS-enabled mobile phone with service by either LTC, ETL or TIGO -- the three largest mobile service providers in Lao. They also had to be willing to help monitor public health initiatives both for human and animal health, monitor animal deaths and cases of sick animals, and provide input on health-seeking and health-reporting behaviors, as well as which types of support materials they deemed most useful.

During their training workshops, the women were educated about infectious diseases in general, the role of LWU in managing emerging infectious diseases, the mechanics of the mobile phone panel, and for master trainers, how to recruit others. After the participants' mobile phones had been successfully connected to the internet, they had to register to the panel online and complete a test survey. During registration, essential panel member information was collected for the panel database including name, phone number, service provider and location. They then worked through the process of data capture to ensure that they could gather and report back information without a hitch.

Four "waves" of data collection were conducted. For each wave, the first SMS link was sent out early on Monday morning, and additional panel participants were recruited by the Master Trainers after each wave, as needed.

Each wave was devoted to either human or animal health. Some of the questions posed during the various waves included the following:

Which of the following symptoms have you noticed among your friends, family or other villagers during the past week, if any?
How do people in your village normally treat illnesses?
Which of the following symptoms have you noticed among your friends, family or other villagers during the past week, if any?
How do people in your village normally treat illnesses?
What do Lao Women's Union members currently find most useful in order to help address health problems?
To whom does the Lao Women's Union share events of disease outbreaks?
Which animals have you observed DEAD in your village this past week, if any?
What did the owners do regarding their animals that were sick?
What do the LWU members currently find most useful in order to help address health problems?
What did you personally do last week in your village regarding animal diseases?
To whom does the Lao Women's Union generally report in case of an animal disease outbreak in your village?

Overall, the data collection worked well, albeit with several areas for improvement, especially in terms of improving recruitment criteria and recruitment process. In addition, internet connectivity posed a problem, although over time, panel members learned to recognize when they had a good signal and to time their responses accordingly.