Reality TV shows of the home improvement and restaurant/bar business makeover variety have become a popular entertainment staple in the United States recently. Media for Education and Development, in partnership with global extension, health and international aid agencies, have taken this expert “rescue” concept and applied it to help struggling farmers in rural East Africa with the “Shamba Shape Up” series. (“Shamba” is a Swahili term for farm.) Instead of a renowned chef helping a struggling restaurant owner identify the flaws in his or her menu or staff, the Shamba Shape Up features their media team as well as invited experts in veterinary medicine, for instance, or beekeeping or pest control visiting small farmers in Kenya, Tanzania and Uganda to help them address specific farming problems that may be affecting their crops or farm animals. Show hosts and experts are from the region, and their recommendations reflect the culture of East African countries and practices.
The program estimates that in its first seasons the uptake of the evidence-based agricultural practices from the show resulted in an increase of over $24 million (US) net gain for just two of the farming enterprises, dairy and maize. The audience is estimated at over 10 million farmers.
The program is available on television and radio. A special “iShamba” text messaging service is available to receive farming tips from the show specific to the subscribers’ crops, livestock and location. Full episodes and clips are available on the Shamba Shape Up web site. Viewers of the series are also encouraged to text requests for relevant informational leaflets or download them from the site.
The World Bank recognized Shamba Shape Up during its Harvest Nutrition Contest in 2013.
The fact that 70% of cell phone subscribers are in the developing world has not been lost on global health innovators. A case in point is that of the creators of SAWBO, or Scientific Animations Without Borders (http://sawbo-illinois.org/main.htm), under the auspices of the University of Illinois at Urbana-Champaign. This project aims to bridge the gap between evidence-based global health interventions and those who need this knowledge the most. Unfortunately, those most in need of these interventions are often unable to access the information or understand it if they can access it due to literacy or language considerations. The SAWBO project team, in collaboration with local health, development and agricultural education agencies around the world, creates brief – about 2 minutes each – animated videos focusing on such local health issues as How to Remove Poison from Cassava Flour or Construction of a Solar Oven Using Simple Materials. These animated educational vignettes are available in multiple languages (using local accents where possible) and available for download to cell phones using Bluetooth technology. This initiative is cost-effective, scalable, and searchable using the affiliated SusDeViKi database available at http://susdeviki.illinois.edu/. Much of the work is done by volunteers, but the project receives some funding from the University, private foundations and individuals. For more information, contact the organizers at http://sawbo-illinois.org/contactus.htm.
The author wishes to thank SAWBO Director, Dr. Barry Pittendrigh, for his input for this blog entry.
In an earlier post, I described a few text messaging public health initiatives under way in the United States. These efforts are part of a global trend in the practice of “mHealth,” involving mobile and wireless technology as a means of promoting health objectives. The “explosive growth” of mHealth programs, particularly in developing countries were described in a recent draft brief on Emerging High-Impact Practices for Family Planning, produced by USAID, FHI 360, Progress in Family Planning and the Johns Hopkins School of Public Health Knowledge 4 Health project. This document notes the driving forces behind the popularization of mHealth projects, including the mobile phone market penetration worldwide (especially in developing countries – from 2005 to 2010 mobile technology subscriptions grew in developing countries 221%), the shortage of health workers, and technological improvements. Together these forces provide a perfect breeding ground for innovative, mHealth solutions to health challenges in resource poor countries. The main difficulty at this point is in moving these projects beyond the pilot phase and sustaining them for the long run. The document authors also observe that, as far as reproductive health mHealth projects are concerned, there isn’t even substantial evidence available documenting the effectiveness of mobile technology in promoting family planning in developing countries at this point.
Perhaps the most important part of the draft brief is its “How To Do It” tips to guide developers of new mHealth programs in limited resource areas. The tips are divided into five sections, including Planning & Design, Technological Considerations, Scale-Up, Sustainability, and Evaluation. Some key points include:
• Involving end-users and other stakeholders in the design and testing of the program will increase buy-in and promote sustainability. In particular, the target population’s technological understanding and common usage should be accounted for in order to avoid a steep learning curve and/or expensive outlays for new equipment.
• Likewise, it is important to involve government officials early in the process so that projects aren’t derailed by unexpected regulatory challenges. Government buy-in also helps in scaling up and sustaining projects for the long-term.
• Long-term costs should be considered from the outset, as well as the possibility of private sector support for the project. Open mHealth systems encourage sharing data standards and modifiable system functionality, which may also promote scalability and sustainability.
Of course, it’s important to review existing mHealth projects and those under development before striking a new – and perhaps redundant – path. Check out these resources for global mHealth projects: