1. m4QI: SMS for Learning, Assessment
and Performance Support
James Bon Tempo, Jhpiego
Pamela Riley, Abt Associates
March 23, 2011
SHOPS is funded by the U.S. Agency for International Development.
Abt Associates leads the project in collaboration with
Banyan Global
Jhpiego
Abt Associates Inc. Marie Stopes International
Monitor Group
O’Hanlon Health Consulting

2. Contents: m4QI
• m4QI Overview and Objectives
• m4QI Implementing Partners
• m4QI Background: Why was tool developed
• m4QI Implementation: What is being done
• Content development
• Platform development
• Delivery
• Evaluation
• m4QI Replication: How others can use

3. m4QI = Mobiles for Quality Improvement

4. m4QI Overview and Objectives
• Objectives are to design, deploy and evaluate a mobile
phone-based learning platform for FP providers
• Increase adherence to clinical protocols
• Affect positive behavioral change in service delivery
• Identify competencies in need of strengthening
• Improve effectiveness of supportive supervision and follow-up.
• The application is intended to be scalable and replicable,
targeting users of low-end phone and those without
access to internet
• Core-funded through USAID’s Strengthening Health
Outcomes through the Private Sector (SHOPS)

5. m4QI Implementing Partners
• Abt Associates: Project management
• Jhpiego: Design and implementation
• Marie Stopes Uganda: Deployment, monitoring
• Appfrica: Software developer
• FrontlineSMS: Technical support

7. m4QI Background
• Problem statement: need for a cost-effective means for
reinforcing training of field staff, improve quality of FP
service delivery
• Solution: mhealth application to send SMS tips and
quizzes
• Leverage ubiquitous access to mobile phones, low cost SMS
• Text messages provide timely and targetted training content,
works with low end phones, “no internet” settings
• Adapt FrontlineSMS platform to add functionality
targetting identified groups of “learners”
• FrontlineSMS platform is free, easy to use, widely available
• Assessment feature allows supervisors to provide targeted
remediation, follow-up training

9. m4QI Implementation: Content development
• Assess the gaps: m4QI team met with Marie
Stopes clinical team, trainers, and M&E staff to
identify indicators
• Target behaviors with inconsistent adherence to
clinical guidelines
• Applicable to broad cross-section of staff (e.g. client
care, infection prevention)
• Develop content: Utilize language from training
manuals, in 160 characters
• First step is identifying why behavior not routinely
done, why important to provider and client

10. m4QI Platform: FrontlineSMS:Learn
• RFP process to identify local programmer
• Local capacity building with support from FrontlineSMS
global organization
• FrontlineSMS plug-in to add features:
• Bank of messages to be delivered by topic
• Quizzes (multiple choice, T/F) with automated
responses
• Reports on messages delivered, received, questions
answered correctly
• Future functionality will include peer-to-peer
platform

11. m4QI Delivery and Evaluation
• Six locations Marie Stopes Uganda
• Total 30 pilot users including all staff functions from
doctors to receptionists
• Three Outreach Teams, three Health Centres
• Pilot will be conducted over 8 week period April –
June, 2011
• Pre-testing with users to address technical bugs, ease
of use, content comprehension
• Qualitative research to be conducted for process
evaluation
• Final report July 2011

12. Replicability
• Final report will detail process steps for
implementation by other programs
• FrontlineSMS:Learn is open source, free
• SHOPS plans in future to apply in context of non-
networker private sector providers
• Address challenges of isolation, limited training,
support for quality improvement
• Will include quantitative impact evaluation

13. jbontempo@jhpiego.net
pamela_riley@abtassoc.com
www.shopsproject.org
SHOPS is funded by the U.S. Agency for International Development.
Abt Associates leads the project in collaboration with
Banyan Global
Jhpiego
Abt Associates Inc. Marie Stopes International
Monitor Group
O’Hanlon Health Consulting