Variación de los precios de los insumos entre los municipios de Cundinamarca

5.3.1.1 SMS based Interactive platform

Based on the findings above, it is recommended that an SMS based interactive platform would be the best solution to undertake mobile phone based health education campaigns in Somalia. The key advantages of choosing an interactive SMS platform are as follows.

5.3.1.2 Cheapest option

Sending and receiving (including question and answer replies for interactive education) text messages are less expensive than placing a regular phone call or video call.

5.3.1.3 Record-keeping

SMSs provide a good way of keeping records for reference. This is of particular importance in a context like Somalia where such an approach could be the only source of health education. Communities can refer back whenever they require. For example information on how to mix home based sugar salt solution to manage child diarrhea.

5.3.1.4 Signal economy/applicable on low level 2G network

Text messaging is more efficient in terms of managing service signals. Text messaging uses less amounts of service signals than phone calling, video calling and/or email, which may require the availability of at least 3G network. SMS platforms are basic services available on all mobile phone providers, including the 2G network operating in Somalia.

Despite the fact that text messaging is a widely used medium of communication, it has some limitations. Key ones include the following:

5.3.1.5 Limited storage

There is a limit to the number of text messages that can be stored in an ordinary mobile phone. If the inbox gets full, the phone can no longer receive any more messages unless some of them are deleted. For key information such as how to mix certain remedies, communities should be asked to note the information down on paper. Alternatively the proposed interactive SMS platform should enable retrieval of such important information via a code.

5.3.1.6 Length

SMS texting can only contain a maximum of 160 characters [including spaces]. This can be limiting where the content of information to be sent is big. However, this can be addressed by compacting the messages as well as using multiple SMS texts. A guide on how to develop SMS content should be developed to aid programme officers developing SMS based health messages.

5.3.1.7 Service integration

Access and timely delivery of humanitarian aid still remains a big challenge in Somalia. To be effective, the proposed platform should integrate all the key activities normally implemented in humanitarian public health in a context like Somalia. These activities include data collection (for assessments, research and routine monitoring), interactive

based vouchers (mVouchers). Such integration shall ensure that all key public health programme deliverables are obtainable on a single mobile platform.

5.3.1.8 Two way Mobile Originated Reverse Billing (MORB)

Two way Mobile Originated Reverse Billing (MORB) means that the phone sending the message is charged for the cost of sending and receiving SMS to participating phone numbers. Majority of respondents indicated that they have no capacity to buy credit to enable them pay to participate in interactive sessions. To ensure attainment of required uptake, there is need for the SMS platform to offer the interactive education for free. This can be achieved through a MORB short code. It is therefore recommended that the proposed SMS platform be based on a MORB short code with Hormuud – the largest mobile phone provider in Somalia.

5.3.1.9 Participation based on voluntary subscription

One of the key issues voiced by the mobile telecom companies was the security challenge posed by mass broadcasting of messages to communities. They indicated that a broad cast approach could easily be sabotaged by terrorist groups like the Al Shabaab and use it to indoctrinate communities. For this reason, mass broadcast of text messages is strictly controlled in Somalia.

To address this challenge it is recommended that participation on the proposed platform be based on voluntary subscription. This can be done by providing information on how to register through radio, TV as well as through normal field community mobilisation that happens in public health programs. This shall ensure that only people who register voluntarily are engaged in the interactive health education sessions. This approach shall also prevent this initiative from getting into usual spamming fatigue that emanates from marketing information from mobile phone companies.

5.3.1.10 Partnership with telecom companies as well as WASH and Health actors

In order to reduce per capita cost and get best value for money, the agency implementing this platform should seek a public private partnership with Hormuud. Under such arrangement, the interactive SMS platform shall benefit from discounts as

Partnerships with other implementing actors shall aid in mobilising people to register for the platform’s services. Every effort that leads to the reduction of per capita cost and increased coverage should be made.

5.3.1.11 Phased progressive approach

Somalia is a challenging context in many ways and will certainly present challenges during the implementation of the interactive SMS platform. It is recommended that the implementation be done in four phases as follows:

5.3.1.11.1 First phase

This shall aim at developing the interactive education component of the platform, develop requisite content and to establish partnership with the mobile phone company.

5.3.1.11.2 Second phase

This shall aim at piloting the interactive education component in at most 5 districts and documentation of lessons learnt.

5.3.1.11.3 Third phase

This shall involve redevelopment of the platform to make improvements on the interactive education component based in lessons learnt in phase two and incorporation of field data and mVoucher components.

5.3.1.11.4 Fourth phase

This shall comprise of a pilot for the field data and mVoucher components as well as scaled up implementation of the interactive education component. During all four phases, proper documentation of lessons learned including case studies should be carried out to inform future improvements. The findings should be shared with other actors as well to cultivate wider acceptance/uptake.