palladium 2015 10 february 2016 financial forecasting for mhealth partnerships for behavior change

© Palladium 2015

10 February 2016

Financial forecasting for mHealth partnerships for behavior change

© Palladium 2015 2

• mHealth – “mobile health;” applying mobile technology to achieve or assist health goals; a subset of eHealth

• SMS – “short message service;” text messaging

• IVR – “interactive voice response;” automated voice messaging system with the ability to respond to voice commands

• USSD – “unstructured supplementary service data;” interactive way to communicate with mobile users via text; does not save to phone

Financial forecasting for mHealth partnerships

Definitions

Financial forecasting for mHealth partnerships 3© Palladium 2015

BACKGROUNDmHealth and the GSMA initiative

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• Global trade association representing over 800 mobile network operators worldwide

• Mobile for Development Foundation

- Partnering with African mobile network operators

- Trying to create a sustainable, scalable mHealth program

- Targeting vulnerable women and children with nutrition BCC messages


The GSM Association

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCIy5roCT7cYCFUppPgodHT8Fog&url=https://www.flickr.com/photos/kiwanja/3169439393&ei=A7euVcyrCMrS-QGd_pSQCg&bvm=bv.98197061,d.cWw&psig=AFQjCNEw4Y_XmvlVk0fiysFC8mG6hqVGnw&ust=1437599848490380

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCO64gcOT7cYCFQnJPgodF78Eog&url=https://pixabay.com/en/mother-daughter-love-family-happy-434355/&ei=jreuVe65N4mS-wGX_pKQCg&bvm=bv.98197061,d.cWw&psig=AFQjCNFazkQ_TUAXZ8aQBF0GtSOKsSivSg&ust=1437600005731548

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJGRk56U7cYCFUhVPgodWAAJrw&url=https://www.flickr.com/photos/georgiap/4011932303&ei=TriuVZGyAsiq-QHYgKT4Cg&bvm=bv.98197061,d.cWw&psig=AFQjCNEucgMKlFzu1y7-gtQHvrTJcreS4A&ust=1437600194452294

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• In the eight target countries, there are over 250 mHealth initiatives in operation1

• Few operate at the national scale

• Few are financially sustainable

• Most stakeholders in the health sector recognize the potential of mHealth for SBCC and other health interventions


Ghana, Malawi, Mozambique, Nigeria, Rwanda, Tanzania, Uganda, Zambia

mHealth pilots are widespread

1GSMA mHealth Tracker

© Palladium 2015 6Financial forecasting for mHealth partnerships

• GSMA is collaborating with DfID and research partners to promote “mNutrition,” a model of using mobile messaging for health (nutrition) BCC messages

• Creating a model that is sustainable

- Involving mobile network operators from the beginning

- Developing a business case for delivering free or reduced cost health BCC messages via mobile

- Free messages serve as a lead-in for other products and services and improves user satisfaction

• Scalable to the national level

Developing a model for sustainability

$

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mNutrition model

Voluntary registration• Dial or SMS a dedicated shortcode to subscribe to

mNutrition messages

• Provide basic information, including expected date of delivery or age of the child

• Indicate preference for text or voice

*123#

SMS or IVR

Nutrition information and

tips

Stage-based messaging• Receive regular (e.g. weekly) SMS or IVR BCC

messages

• Tailored to gestational or child age (until child is two years old)

• Free (or very reduced cost ) to end user



Government

• Legitimacy• Validation of

content• Interface with

health system

Mobile network operators

• Communication channel

• CSR or other funds

• Brand recognition

Non-governmental organizations

• On-the-ground experience

• Expansion of existing programs

International funders

• Convening power

• Start-up funding• Sharing of best

practices

Potential partners for mNutrition


PALLADIUM’S ROLE IN mNUTRITION

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Industry Engagement

Research

Technical Assistance

Content development

and localization

Product concept

Advocacy

MEL

• Engage stakeholders in the 8 countries, assessing attitudes, buy-in, and opportunities

• Provide “health and economic proof points” in support of mNutrition launch and product concept development

• Goal is to achieve long-term sustainability of a free mNutrition product at scale through a combination of contributions from for-profit and not-for-profit stakeholders

Palladium’s role in GSMA mNutrition activities


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Conversation between sectors

for mHealth partnerships

Key stakeholder interviews

mHealth Decision Tree

model

Financial Forecast Model

Stakeholder engagement

Palladium’s approach


Financial forecasting for mHealth partnerships© Palladium 2015

METHODSEstimating program reach and cost

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• Draws on a combination of DHS data, Spectrum projections, and literature review

• Considers demographic factors such as access to mobile, literacy, and maternal status

• Estimates program reach

Estimating program reach in Zambia

mHealth Decision Tree model

Register 2%

Women of reproductive age (15-49 years) 100%

Eligible 32%

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Cost inputs include: Calculates:

New registrants Active subscribersMessage volume Annual cost of serviceTotal cost of service Costs per user

All of the above for SMS, IVR, and USSD

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Palladium developed the Financial Forecast Model (FFM) to estimate the annual costs of stage-based messaging

mNutrition Financial Forecast Model

• Content development• Software development• Infrastructure costs (startup)

Capital Expenditure

(CAPEX)

• Infrastructure costs (ongoing)

• Mobile advertising• Connectivity

Operating Expenditure

(OPEX)



RESULTS

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Country comparison: cost per subscriber (USD)


DISCUSSIONFacilitating sustainability of mHealth programs through public-private partnerships

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The Financial Forecast Model:• Allows program managers and donors to think critically about mHealth

for BCC and other interventions, and make evidence-based decisions

• Provides the primary element to support a business case for a scalable, sustainable mobile BCC program

• Can be adapted to other health areas- Mobile BCC messaging for MNCH, HIV/AIDS, TB, etc.

A tool for planning and advocacy


Financial Forecast Modelsor other tools to facilitate dialogue and catalyze partnerships

Sustainability through public-private partnerships

Government Mobile network operators

Non-governmental organizations

International funders

Sustainable, scalable, mobile BCC programs


Sindri Kinnier, MBA, MPH

Palladium, Senior Associate—Innovations & Technology

[email protected]

Joseph Ichter, DrPH, MHA

Palladium, Senior Technical Advisor

[email protected]

Correspondence

mailto:[email protected]

mailto:[email protected]

palladium 2015 10 february 2016 financial forecasting for mhealth partnerships for behavior change

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