Lokii is a framework that simplfies the process of connecting an application to a cell phone. It does this by establishing a message queue and server to handle requests and responses, and connects the queue with existing SMS toolkits. Developers can focus on their area of expertise and application functionality rather than reinventing the wheel.

The framework is built using the Ruby programming language. To build a new application you download and install the package, generate the default application and add your application handlers. Once created, you can plug a cell phone into a laptop, run an existing SMS toolkit, and start your Lokii server to begin using the application. Incoming text messages will be routed to the server to be processed by your handlers. Simple commands like "say", "reply", and "complete" are used to encapsulate the details Short Message Service protocol and message queues.

The framework is open-source and currently available on the SocialRange site and is hosted on Github at http://github.com/jeffrafter/lokii.

Results

In November, 2008 a group of developers and volunteers in Lilongwe, Malawi were given a one hour presentation on how to create applications using Lokii. Following the presentation a contest was held to build fully functional SMS-based applications. Within 45 minutes, five new applications had been created:

• A BMI calculator
• An adherence calculator
• A patient identifier validation service
• A remote server control application
• A handler that could respond based on the incoming dialect

Two of these applications were connected to an existing electronic medical record system so that they could be used by Community Healthcare Workers.

Direction

With the initial framework complete, I am seeking to establish pilot projects in the developing world and continue adding functionality. This includes expanding the project to have more sample applications and a website containing tutorials, training manuals and field manuals.

Life-saving AIDS drugs have been provided for free to millions of people worldwide. With the cost of AIDS drugs reduced in developing countries, forgetting to take drugs is the next greatest barrier to pill-taking (called antiretroviral (ARV) adherence). AIDS patients require consistent ARV adherence to prevent drug resistance and death.

PROVEN METHODS

Any cell phone program for ARV adherence should build on past successes in ARV adherence and E-Health programs. Social support for AIDS patients is key method for improving adherence. Online programs have also shown that tailored messages are more likely to be read, remembered, saved, and perceived as interesting. Accordingly, messages that are individually-tailored messages and socially supportive could improve SMS reminders for AIDS medication.

PROGRAM DESCRIPTION

The SMS4AIDS program will send SMS reminders for AIDS medication, providing messages that are tailored and socially supportive for South African AIDS patients. SMS reminders will be timed according to individual pill schedules. Tailored messages will also address individual barriers to adherence with content written by ARV counselors. Participants can choose to receive messages in English or isiZulu. SMS4AIDS also offers supportive messages to AIDS patients, who often have trouble taking medication in isolating situations that stigmatize AIDS. This combination of reminders, tailored messages and social support addresses proven problems and solutions in technology and AIDS medication. The program is also designed for scale up with locally available resources. The cost per SMS is under 3¢ and no computer programming is required.  In uses Excel, one computer with Internet access, and a bulk SMS messaging service that is widely available in South Africa. South Africa is chosen for need and feasibility, because it has the world’s highest number of people living with HIV/AIDS and Africa’s highest percentage of cell phone subscribers (89%). PILOT PROGRAMA pilot of SMS4AIDS was recently tested at a Johannesburg AIDS clinic by the Reproductive Health & HIV Research Unit (RHRU). The pilot found high consistency of message reception, high patient satisfaction, and no accidental disclosure by SMS.   

SMS4AIDS will support AIDS medication in South Africa by addressing known problems with known solutions.  

In response to rising STD rates among African American youth in San Francisco, US, ISIS developed SEXINFO, a sexual health text messaging service. SEXINFO is an education, awareness, and referral service accessed by texting “SEXINFO” to a 5-digit number from U.S. based wireless phones. Community organizations, religious groups, and health agencies assisted with project development. Based upon simple SMS text messaging, the ability to impact large numbers of youth with referrals to local clinical and support services via something they "keep in their pocket" has tremendous potential for impact throughout the world -- economic impact, health impact on other disease areas (HIV/TB/Malaria), as well as health impact in the areas of reproductive health and gender violence.
SexINFO International will be able to locate and mobilize youth in the major urban areas of each continent to empower them to take charge of their own sexual health. Think of places like Kathmandu, Delhi, Mumbai, Kampala, Johannesburg, Nairobi, Lima, Buenos Aires, Mexico City. Each city has large numbers of sexually active urban youth at risk for HIV, STDs, unplanned pregnancies, and gender violence. While these youth may be disenfranchised in many ways, when they do have monies, the first thing they do is spend it on cell phones (SIM cards, mobile access). Cell phones are their connections, their life lines, their support. To scale SexINFO globally, ISIS will follow our best practices model of engaging the community, SexINFO will gather small groups of these youth to understand their particular needs, language, and cultural norms; engage the local health officials and important community members to discuss and advise; partner with technology carriers and providers (working through existing relationships with HipCricket - US Based - and AdIQ - London Based); develop a comprehensive social marketing plan, and partner with local academic researchers to develop and implement the evaluation plan.

For too long, we have conducted development without good information about our “customers” – the people whose lives we want to improve through our money and effort. We believe this is because developing countries often lack good statistical information on which policy-makers, donors, and private companies can base sound decisions. To date, our knowledge has mostly been limited to expensive door-to-door surveying techniques or difficult phone interviews. The proliferation of mobile phones in developing countries opens the exciting possibility of surveys reaching far fewer people for far less money and providing income for the beneficiaries themselves.

In this system, text messages would be sent to mobile phone users with one or two question surveys, perhaps about health care, education, or even consumer preferences. To provide an incentive to reply, mobile phone credits or mobile banking payments will be issued in exchange for complete surveys. Backend analysis will be used to improve credibility of the results, a task which will be made easier by the large number of people reachable using this system.

Those data can then be used by local, regional or national governments to improve service delivery, by donors and multilaterals for analysis and reporting and even by private companies interested in serving the bottom of the pyramid.

The data platform itself could also have the added benefit of spurring on the spread of cell phones and mobile banking to underserved populations. Instead of being a service they have to pay for, they can be paid to have access to these technologies and financial products.

We have conducted over one year of research to advance this concept and have determined that many of the tools already exist but have never been aligned in quite the right way. We are looking for seed capital and partners to help us launch this exciting venture.

Dana Worth and John Stephenson, the project directors, have extensive experience in both the private and public sectors. We both started our careers at private sector strategy consulting firms and now work at Dalberg Global Development Advisors, a firm that applies business approaches to the challenges of development. Through our involvement with healthcare and humanitarian response works, we have been struck by how little data district, province, national and international decision-makers have at their disposal, and consequently, how many critical decisions were made based on old numbers of just plain gut-feeling.

Making Cents International’s recently developed Value Chain Analysis and Market Opportunities curriculum brings the world of value chains into perspective for young entrepreneurs, helping them to discover market opportunities and business relationships that are critical to sustainable business growth.  This curriculum provides students with the knowledge and experience they need to take their learning beyond the classroom and into their communities.  As a result of this course young people are able to conduct market surveys on their own, know what a value chain is and why it matters for the growth and management of their business, as well as understand how to respond to changes in the market.  The curriculum has been piloted in Senegal, Niger, and Sierra- Leone.    Leveraging the power of cell phone technology, Making Cents International seeks to further engage newly trained youth by presenting them the opportunity to join a mobile business network of entrepreneurs and market opportunity seekers.  With an estimated 4.123 million cell phone subscribers in Senegal, and 776,000 in Sierra Leone, information can be shared and disseminated with relative ease.  Furthermore, youth have a strong proclivity to join networks and to effectively utilize new technology.  As members of the “Youth-Cell” network youth will exchange local market information with other members spread across the entire region to help broker new transactions, share innovative ideas, and create business partnerships that will lead to greater market penetration.        The type of information found on the network might include real-time prices of sector related goods and services, a marketplace, ideas forum, and tips and trades “from youth like you!”  As the network and demand for services grows, other features will be added organically to meet the specific needs of the member users.  The Youth-Cell Market Opportunities project would be piloted in Senegal and Sierra-Leone with the vision of going global.

Voxiva has been developing innovative mobile information solutions to help clients around the world address their most critical information challenges in Health and Public sectors.

 Because many of the users of the Voxiva solutions have not easy access to the Internet, they are accessible using multiple technologies (Web, PC Client, Mobile Phone Client, SMS, IVR) giving them a much broader reach than Internet-only solutions.

These solutions are built on the Voxiva platform and they support: Real-time, multi-channel data collection, Data management & analysis and Communication & information sharing.

OBJECTIVES OF THE CURRENT PROJECT

Strengthens the capacity of emergency and disaster management through the use of an innovative integral platform of information and communication that will facilitate the greater participation of the citizens  and the social organizations in the prevention and attention of disasters in the local or national level . 

THE PROBLEM

Before the worsening of the problems caused by the natural disasters and the ones generated by the action of the human being,  greater availability of direct and opportune information on dangers and vulnerabilities is required. This information must be produced nearby to the places at the risk of occurrence of a disaster.  In these usually rural areas in developing countries, the Internet access is still  scarce or nil and the flow of existing information is not automated, exceeding the available times for the need of answer and attention of the populations directly affected by the disasters. 

THE SOLUTION

The Voxiva platform will let the citizens and social organizations to send reports using any devices of information and communication as the pay phones, fixed phones, mobile phones, SMS  or computers connected to Internet  available in points close to the place at the risk of occurrence of a disaster.

These reports should include information to prevent risks (as climatic changes or increasing of water volume in the rivers), and information for Disaster management that help to the damages evaluation and analysis of needs.

The system saves the data, produce dashboards and summary reports in real-time to make decisions and send alerts to the authorities in charge.

BENEFITS

• Availability of greater and better information in a short time, to make more effective decisions and coordination through a simple tool. 

• Possibility to compile information and feed back,

• Significant Reduction in the times of answer before the occurrence of Emergencies and Disasters because local Command Centers  with access to data summarized in dashboards.

This project is aimed at serving the Tarahumara Indians of the Sierra Madre. These people live scattered in 200 square miles of an incredibly rugged, vast canyon system. With an infant mortality rate of 50%, they are in desperate need of holistic health care and education. The installation of new hardware will enable Mexico Medical and other groups to meet the endless needs here.
To improve our current system, a taller radio tower with full solar power will be installed near the hospital. This will increase the range and quality of all contact with all radio units. One radio unit with solar panels and batteries will be put in a remote village. Solar capacity will be increased on another village unit. The 50-watt units in our ambulance and a community health vehicle will be upgraded to 60-watt radios, which will increase their range of contact.
Communication will be more reliable, and the range will expand in all of the cases listed below. Important users will also be added to the network.

The ability to call for medical help will be enhanced in 8 villages, most of which have no electricity or other communication ability of any kind.
Several channels will be available, allowing for simultaneous conversations to take place.
The air ambulance will be able to talk to its destination before taking off.
A private line will be available for the air-ambulance and its home base.
The hospital and ambulance will have contact over larger distances.
Communication between the hospital and health workers who live in villages will be more reliable.
Itinerary health workers who travel to remote villages each week will have greater safety and ability to network with the hospital and all other radio units.
Communication needs for another organization that runs schools and boarding houses in Tarahumara villages will be improved.
All radio units will have increased contact with local law enforcement officials.
Communication with government health workers will be possible.
The impact of the improved system will grow as Mexico Medical expands its work in Tarahumara villages.

The Technology Partnership (Partnership) between the United Nations Foundation (UNF) and The Vodafone Foundation (VF) is a leading public-private alliance advancing the use of innovative mobile technology to support UN humanitarian efforts worldwide.

Health challenges present one of the most significant barriers to global economic development. In many developing countries, lack of timely and accurate health data is one of the greatest obstacles to overcoming these challenges.

The growing ubiquity of mobile phones presents new opportunities for meeting health data needs. Today, a full 64 percent of all mobile phone users are in developing countries[1]. To harness the power and utility of mobile technology to improve health and healthcare in resource-poor regions of the world, the UNF-VF Partnership created its Mobile Health (mHealth) for Development program.

The Partnership funded DataDyne.org’s development of EpiSurveyor—a free, open-source software that can be easily downloaded onto mobile devices. The software can be used by healthcare professionals anywhere to instantly record and aggregate essential health data.

By the end of 2008, the EpiSurveyor-based mHealth program will be operating in over 20 countries in sub-Saharan Africa, where the software is being used to track crucial data - from the availability of medical supplies to the coverage rates of immunization campaigns. And because these programs are owned and operated in-country, they build capacity at the local level.

The UNF-VF Technology Partnership, by partnering with groups like the WHO and DataDyne.org, is helping to bring together the people, ideas and capital that can help revolutionize public health.

GATHER is an open-source digital surveillance and reporting platform for the cost-effective development of electronic data collection, analysis, and reporting systems. With software modules for data validation, event detection, and reporting that can be used for a variety of applications addressing the full range of development issues, GATHER is designed for use by governments, NGOs, CBOs, and aid agencies Underlying GATHER is a standards-based architecture, designed to facilitate data collection using electronic forms with a mobile phone or PDA. Data can be reported using SMS, interactive voice recognition over wireless or land line telephones, or through a web-based interface. GATHER architecture incorporates established open-source components that, in addition to reducing upfront costs, reduce total cost of ownership because their accessibility allows local developers to extend applications to meet changing local needs, encouraging sustainable development.The GATHER backend implements the logic for the functional modules of the platform including a Data Processing and Storage Module that supplies functionality for authenticating user access rights, validating data, and interacting with the database; an Event Detection Module that handles evaluation of conditions over data in database tables in order to raise an alert when an event occurs. This module includes a GUI editor, enabling users to compose new event conditions; and a Reporting Module for generating reports based on data in database tables. Reports may include tables, graphs, and bar charts as display elements and be generated on demand or according to schedules.AED-SATELLIFE has developed a GATHER-based disease surveillance application for the collection, aggregation, analysis, and reporting of epidemiological data that was field tested in Uganda. Based on the paper-based forms and processes already in use by the Ministry of Health, health workers were able to fill in electronic forms using the keypads of mobile telephones and transmit the collected data directly to the central server. The GATHER backend aggregated the data, supported analysis and report generation, issued email and SMS alerts of (simulated) disease outbreaks, and automatically populated and disseminated charts and tables compiled from the data reported.

AED-SATELLIFE has been approached by organizations eager to use GATHER in Mali (education), Peru (public health), Sri Lanka (human rights), and other countries.

The standards based, open source, personal health record represents both an opportunity to make the power of health IT accessible to every individual anywhere and to avoid the fragmentation of medical records as low resource settings begin to adopt health information systems.The goal of the project is to create a mobile extension of a proven PHR, MyOSCAR, based on the successful Indivo open source project and establish an affordable, ubiqutous mobile phone based platform for recording health information and practicing self managed evidence based care. This generic "Lego block" architecture can be used to address any specific problem such as chronic disease or communicable diseases as well as general health. wellness and prevention. The standards based platform will also act as an integrating tool in fragmented or emerging health information technology ecosystems.

In addition to the technology, the project will more importantly focus on the collaborative, evidence based improvement of the knowledge and decision support that can best aid the individual in managing their own health.