Implementation kit

This implementation toolbox includes resources that may be useful in the process of deciding to use mHero, getting stakeholders on board, planning and developing, and ongoing monitoring and management. The tools and resources shared here are by no means the only ones needed for implementation. Rather, they represent some of the tools and resources that were developed for use in the initial country implementations. Feel free to adapt these materials to serve your local needs and share additional tools and resources that you developed and found useful.

• Assess: Understand what is available and what is needed
• Assemble: Identify and engage stakeholders
• Plan: Ensure that resources can be mobilized to develop and deploy mHero
• Create: Identify use cases and develop frameworks to operationalize the use cases
• Track: Define indicators and develop tools for monitoring workflow
• Implement: Manage initial and new workflows and support use case teams

You can also find some training materials developed for the initial implementations of mHero. As with the other tools and resources, these training resources do not address all training needs. Please note that some of these materials are included in the previous section of tools and resources presented by development and deployment stages.

 

For links for the technology platforms that can be connected through mHero, go to the technology tools and platforms section of this page.

 

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Assess: Understand what is available and what is needed

To get started, it is essential to have a solid understanding of the context and conditions of where you plan to implement mHero. This includes:

• Identifying available resources - human resources, hardware and software, funding
• Technology platforms already in use by the MOH
• Locally popular communication platforms 
• Familiarity with and skills related to digital devices and platforms
• Current communication practices between the MOH and health workers
• Awareness of mHero

The following tools and resources may be useful to understand the local context to identify challenges and opportunities.

Title:	mHero Awareness Raising Survey
Language:	English
Description:	This survey was developed to conduct a baseline assessment to document health worker knowledge of, opinions about, and experiences with mHero. Surveying health workers about their experiences with mHero provides implementers with valuable information that can be used to improve the system. This short survey can be adapted to meet individual project needs and can be conducted over the phone.
Link:	Download survey
Title:	Sample mHero MOH Staff Survey
Language:	English
Description:	This mHero Staff Survey can be used to assess MOH staff knowledge of, opinions about, and experiences with using mHero. Surveying MOH staff about their experiences with mHero can help mHealth service providers understand how MOH staff are using mHero, how useful staff feel mHero is, and how mHero could be improved to fit their needs. This short survey can be adapted as needed.
Link:	Download survey

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Assemble: Identify and engage stakeholders

During the Assess stage you should have identified stakeholders that will play a role in the development and deployment of mHero. Stakeholders can range from ministry of health officials who need to approve the use of mHero with health workers, to mobile network operators (MNOs) who will set up a short code for the platform, and platform data managers who are responsible for day-to-day management of the platform. Once stakeholders have been identified you should engage them by explaining what mHero is, what the vision is for its use, and what their role will be related to the platform.

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Plan: Ensure that resources can be mobilized to develop and deploy mHero

Preparing to deploy mHero requires a significant amount of logistical planning and coordination to ensure that all the pieces are in place for a successful deployment of mHero. Necessary human resource inputs include training platform managers and providing ongoing support to them, as well as communicating with district- or other lower-level staff or teams to prepare them for the deployment with health workers in their jurisdiction. Related to ICT, necessary inputs include the hardware (computer, mobile phones of health workers), internet connectivity, a dedicated server, FHIR-compliant HIS software, RapidPro instance, and ongoing dedicated tech support. Needless to say, there must be a guarantee of funding to cover costs related to the hardware, software, and messaging. 

In addition to the training of platform users, there must be a plan for orienting health workers to the platform and standard operating procedures should be drafted for requesting, developing, and testing new workflows as well as for regular monitoring and reporting on workflows. Across the board stakeholders need to be involved in decision making to ensure local buy in and support.

The following tools and resources may be useful for ensuring thorough planning of the logistics of a mHero intervention.

Title:	mHero Operational Plan Template
Language:	English
Description:	The mHero Country Operational plan is an Excel document comprised of worksheets to be completed by the mHero team when planning activities and timelines for implementation. This tool includes a timeline for overall implementation with illustrative activities, and a stakeholder matrix, which can be used to document the stakeholders involved in the project and the manner and schedule for sharing project information with them.
Link:	Download Operational Plan
Title:	mHero Standard Operating Procedure (SOP) Template
Language:	English
Description:	The purpose of this Standard Operating Procedure (SOP) is to provide detailed implementation guidance to the Ministry of Health or other key stakeholder on the purpose and scope of mHero, programmatic definitions, and prerequisites necessary for successful implementation. It also includes an overview of key mHero roles and responsibilities and detailed central level operating procedures. The SOP should be adapted to the implementing country and reviewed quarterly to make updates and revisions. Also included is an SOP Quick Guide, which provides an introduction to what a Standard Operating Procedure (SOP) is and its importance when thinking about mHero.
Link:	Download standard operating procedure template in English Download SOP Quick Guide
Title:	mHero Costing and Sustainability Document
Language:	English
Description:	This tool can be used for a Ministry or implementing partner to budget for mHero implementation. Included here is a sample budget was developed based on base operations and activities of mHero. This budget does not take fully into account potential changes for: additional HIS interoperability or Decentralization (should Counties start operating mHero independently). This tool should be reviewed and modified in conjunction with an mHero strategic document by key stakeholders who have an understanding of local costs.
Link:	Download form

 

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Create: Identify use cases and develop frameworks to operationalize the use cases

In this context, use cases are descriptions of how you want to use mHero. mHero is flexible and can be used for many different purposes, from sending out urgent messages to all health workers, to targeted surveys to collection information from specific cadres of health workers. When brainstorming use cases and planning when to send out workflows, you may want to schedule flows around holidays, other significant days, and planned events.

Once a specific use case has been determined then you need to think through how to realize the use case. The "Goal, Question, Metric" approach may be useful for this purpose.

Each use case should have a corresponding message flow (or multiple message flows). Message flows may include a single text message sent out on a regular schedule or they can be more complex surveys with logic that determines follow up questions or actions. When developing the message flow it is important to plan for how you will use the data collected (directly or indirectly) through the flow and also keep in mind the concept of feedback loops. Feedback loops should be used to acknolwedge information received by health workers and take action on that information. For example, when asking a health worker about the number of PPEs in stock and the provide that information, then there should be a plan for distributing additional PPEs when the facility will need them and you need to inform health workers at the receiving facilities about the plan.

The following tools and resources may be useful for developing use cases, drafting message flows, planning for data use, and closing the feedback loop.

Title:	mHero Message and Development Tips: Sending Good SMS Messages
Language:	English (a previous version of the document is available in French)
Description:	This document provides guidance on developing questions to be sent out via a SMS channel of mHero. These message development tips will help mHero implementers design quality messages and flows that will catch the attention of the recipients and solicit the desired response, be it a response via mHero or reminding health workers about important information for doing their jobs. The document also provides guidance related to raising awareness about mHero before any messages are sent out, as this will make a significant difference in how well mHero messages are received by health workers.
Link:	View mHero Message and Development Tips: Sending Good SMS Messages
Title:	mHero Message and Flow Development Tips: Asking the Right Questions
Language:	English
Description:	This document provides guidance on developing message flows that will get desired responses from health workers. Some of the tips pertain to asking questions via SMS and other tips are related to programming questions and response options into RapidPro to ensure that data collected is appropriate and organized. There are concrete examples with most of the tips, including screenshots from RapidPro to help you figure out how to formulate your own questions and input them into the communication platform of your choice.
Link:	View mHero Message and Flow Development Tips: Asking the Right Questions
Title:	Use Case Brainstorm and Prioritization Materials
Language:	English
Description:	These materials introduce key concepts and components related to use cases (the steps taken by a user to achieve a specific goal), and include worksheets that can be used for brainstorming use cases and prioritizing them.
Link:	View Use Case Brainstorm and Prioritization View Use Case Brainstorm Activity Sheet View Use Case Prioritization Activity Worksheet
Title:	Overview of the GQM (goals, question, metric)
Language:	English
Description:	The Goals, Question, Metric (GQM) process brings context to your data and allows you to examine what you want to achieve. Basic definitions as well as SMART objectives are reviewed and the GQM process is displayed in six steps.
Link:	View materials
Title:	mHero Data Use Tip Sheet
Language:	English, French
Description:	mHero provides a simple and timely way to collect information from and about frontline health workers but to make a difference, the data must be used. This document provides guidance on planning ahead for data use, which should be done when planning every new workflow in mHero.
Link:	Download tips in English and French
Title:	mHero Feedback Loops Tip Sheet
Language:	English, French
Description:	In addition to having a plan for making use of data collected via mHero, you should also plan for how you will share the results of data collection and how the data is used to inform decisions. This tip sheet includes questions to ask when planning a new mHero workflow and examples of closing the feedback loop.
Link:	Download the tips in English and French
Title:	Calendar of International Days
Language:	English, French
Description:	This calendar of internationally recognized days related to health can be used to schedule annual messaging campaigns to health workers to boost morale and engagement.
Link:	Download calendar in English and French
Title:	Health System Strengthening Workflows
Description:	Strong health systems are essential for achieving health goals. The Ebola outbreak in West Africa exposed cracks in health systems, causing a breakdown in health services and the loss of lives for over 11,300 people, including more than 500 health workers. Gathering information from your health workforce about health facilities, health worker pay, health worker absenteeism, and other indicators can provide essential information for maintaining coordination at the central level. The mHero Liberia team developed several workflows for health system strengthening. These include Health Facility Service Validation, Health Facility Status, County Ledger Use, and Human Resource Questionnaire. To access information about these workflows and learn how to best use the information, please click here.
Title:	Family Planning Workflows
Description:	Family planning services are essential to the health of women of reproductive age. These services also help men and women achieve their ideal family sizes, are important for national economic growth, and contribute to environmental sustainability. mHero family planning workflows will help ministries of health gather family planning and reproductive health information from health workers, which in turn can assist in increasing contraceptive prevalence rates, reducing total fertility rates, and improving family planning and reproductive health services in the country, especially those with high unmet need. Four workflows have been developed for family planning support, including Expanding Method Mix of Contraceptives, Client Barriers to FP Uptake, FP Counseling, and FP Training. To access information about these workflows and learn how to best use the information, please click here. Links to the workflows in a Word document can be found here along with information on where to access them in RapidPro. As new workflows are created, they will be grouped and shared here. If you wish to submit a workflow to post to this website, please contact mHero@intrahealth.org
Title:	Maternal, Newborn, and Child Health Workflows
Description:	Strong antenatal and postpartum care can lead to better health outcomes for mothers and newborns. Maternal and newborn mortality rates are higher in many low- and middle-income countries than in high-income countries. Common causes of both maternal and newborn mortality can, in many cases, be prevented with proper care before and after birth. Supporting the health worker to provide both routine and emergency care during and after pregnancy can reduce both maternal and neonatal mortality. Additionally, childhood immunizations and proper nutrition can help lay the foundation for a healthy life for children. Four workflows have been developed for the support of maternal, newborn, and child health services including Antenatal Care, Postpartum Care, Immunizations, and Nutrition. To access information about these workflows and learn how to best use the information, please click here.

Title:	mHero Data Cleaning Tip Sheet
Language:	English, French
Description:	Data cleaning is the ongoing process of identifying and correcting data that is incomplete, inaccurate, or otherwise problematic. This document provides guidance on cleaning the contact information of health workers with the recommendation of having a strategy for ongoing data cleaning to reduce the workload burden.
Link:	Download tips in English and French

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Track: Define indicators and develop tools for monitoring workflows

After use cases and corresponding workflows have been developed, it is necessary to figure out how you intend to monitor the workflows. This entails defining indicators and developing tools. Indicators should measure usage of the platform, engagement with workflows, and achievement of specific objectives and outcomes.

The following tools and resources may be useful in defining indicators and planning how to measure your indicators. 

Title:	mHero Sample indicators
Language:	English
Description:	This list of indicators can be used to monitor progress during program implementation or to evaluate the platform on a yearly basis. The indicator table includes indicator definitions, units of measure, sources of data, information on data disaggregation, and a reporting schedule.
Link:	Download indicators
Title:	mHero Analysis Template
Language:	English
Description:	This template can be used to provide data requestors with a high-level analysis of data obtained through mHero. It provides a space for action items coming out of the analysis to be identified and contains a table where health workers’ responses can be summarized by question for deeper analysis.
Link:	Download Template
Title:	mHero Use Case Response Report Template
Language:	English
Description:	This template can be used to provide requestors with an overview of the results of a use case, including spaces to list the response rate and other information such as the cadre, location and facility corresponding to the health workers communicating through the platform. This template should accompany the mHero Analysis Template to provide data requestors with an overview of the results of their use case.
Link:	Download Template

 

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Implement: Manage initial and new workflows and support use case teams

In the standard operating procedures developed in the logistics planning stage, you hopefully included procedures for overseeing workflows. Data collected and analyzed using the tracking and monitoring tools can be aggregated to keep track of the overall activity of all workflows, as well as to inform decisions about the structure and schedule of workflows. In addition to the data reported on workflows, it can be helpful to engage the teams using the workflow to have a more complete picture of the way that the data is being used and if there are any challenges or issues. To address issues and highlight successes it can be useful to organize opportunities to share experiences and crowd-source solutions. Lastly, it is beneficial to have a standard operating procedure for new requests, from how the request is submitted to the process of setting up the new use case.

The following tools and resources may be useful for managing workflows and supporting use case teams.

Title:	mHero Use Case Request Form
Language:	English
Description:	This form is completed by staff within the ministry of health who wish to develop and initiate an mHero workflow. The form also requests information on what feedback the Requestor will be providing to the health worker. The form should be submitted to the mHero team to begin the process of creating a new workflow. The mHero team will then schedule a consultation with the staff to draft the workflow, ensuring that the workflow meets their data-collection needs.
Link:	Download form
Title:	mHero Use Case Planning, Implementation, and Monitoring Tool
Language:	English
Description:	This Excel document is comprised of worksheets regularly completed by the mHero team to keep track of the status of the many workflows they manage. There is a “Use Case Request” worksheet to log all use case requests coming to the team, a “Use Case Tracker” worksheet to monitor each of the workflows sent out by the mHero team, including information such as the number of expected recipients and whether the work flow is recurring, and a series of blank “Use Case” worksheets to monitor the specifics of each workflow, from its development through implementation and monitoring.
Link:	Download tool
Title:	mHero Workflow Follow Up Questions
Language:	English
Description:	This form can be used both to understand more about the Requestor’s experience with mHero and also to better understand how the data will be used. The form can also be used as a learning tool for the mHero Team and as a sort of customer service survey.
Link:	Download form

 

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Training materials

​A note on audience type: These training materials have been organized by different user types that have different roles and responsibilities within mHero projects. However, each person may have different learning needs and materials provided to them should be based on those needs. Training strategies should take into account both the type of user using the system and their different needs to tailor training materials.  

Title: Introduction to mHero (video)
Language: English
Audience: All Users
Description: This ten minute video begins with a description of the mHero platform and then  introduces the idea of use case development. Several examples of mHero use cases are provided, followed by an explanation of the steps one would take when implementing a use case and deploying a workflow. The video closes with an overview of the benefits of mHero for governments and brief description of equipment necessary to implement the platform.

View Video

Title: Components of mHero (slides)
Language: English
Audience: All Users
Description: This presentation walks you through the technical components of mHero including how the different technologies work together to create the platform.

View presentation

Title: mHero: A Cost-Effective, Real-Time Communications Solution for National COVID-19 Response
Language: English

Description: This short video describes mHero and explains how the tool can be used in a country's COVID-19 response and how IntraHealth can assist health ministry officials with deploying the tool. mHero is a flexible, scalable, and sustainable tool that can address common challenges faced by ministries of health during an outbreak or health emergency. 

View video

Title: Technical Deep Dive into Interoperability (slides)
Language: English
Audience: System Administrators
Description: This visual compilation of slides highlights mHero as a platform capable of connecting varying components, such as  different databases, and displays the interoperability underlying the platform. SMS messaging spotlights mHero's ability to communicate between different actors in a health system.

View presentation

Title: Design Thinking for mHero (pdf)
Language: English
Audience: All Users
Description: Design Thinking is an innate human process that relies on our ability to be intuitive, to recognize patterns, to construct ideas that are emotionally meaningful as well as functional, and to express ourselves through means beyond words or symbols. It is a highly creative process that relies on empathy, problem solving, rapid ideation, prototyping and testing.

View materials

Title: Overview of the GQM (goals, question, metric)
Language: English
Audience: Stakeholders
Description: The Goals, Question, Metric (GQM) process brings context to your data and allows you to re-examine what you want to achieve. Basic definitions as well as SMART objectives are reviewed and the GMQ process is displayed in six steps.

View materials

Title: Use Case Brainstorm and Prioritization
Language: English
Audience: All users
Description: We introduce the idea of use case development and processes of brainstorming use cases and prioritizing them. Use cases, workflows, and short codes are examples of components that will be explored and practiced.

View Use Case Brainstorm and Prioritization
View Use Case Brainstorm Activity Sheet
View Use Case Prioritization Activity Worksheet

Title: Asking Good Questions to Create Use Cases (presentation)
Language: English
Audience: Stakeholders 
Description: This Power Point slide presentation acknowledges the need for thoughtful, reflective question generation when developing workflows. It gives a few examples of great workflow questions, as well as others that are sub-optimal, and how you can improve poorly worded questions.

View Asking Good Questions to Create Use Cases

Title: Overview of Data Use (presentation)
Language: English
Audience: All users
Description: This slide presentation introduces the idea of data use and how mHero can be harnessed to gather specific information. Data sources are explored and the means in which data is acquired using mHero, for example, through Workflows generated in RapidPro. The presentation also examines data exploration and analysis and the importance of feedback between stakeholders and health workers to maintain a fluid transfer of information.

Download Overview of Data Use Presentation
View Video Presentation

Title: Overview of Data Visualization (presentation)
Language: English
Audience: All users
Description: This slide presentation exhibits the variety of ways in which data can be demonstrated and visualized. From traditional graphs and scatterplots, to highly advanced digitized maps displaying multivariable analysis, data visualization is discussed as becoming the new gold standard in presenting data.

Download Overview of Data Visualization
View Video Presentation

Title: Data Analysis Key Concepts & mHero (presentation)
Language: English
Audience: All users
​Description: This presentation introduces the basics of data analysis, especially regarding health services, defines key concepts and shows users how to apply these concepts to working with mHero.

Download Data Analysis Key Concepts & mHero

Title: Excel Tips for Data Analysis (tip sheet)
Language: English
Audience: All users
Description: This short tip sheet provides information on using response rate and percentages, filtering data, hiding columns, using Excel Counts and a primer on making graphs. This information will help users with basic data analysis.

Download Excel Tips for Data Analysis

Title: Data Use Tips (tip sheet)
Language: English
Audience: All users
Description: This document is intended to be a summary of the key highlights presented in this module on data use and how data use applies to mHero.

Download Data Use Tips

Title: Running Reports for mHero in iHRIS (video)
Language: English
Audience: System Administrators
Description: TThis eight-minute video takes you through a step-by-step process of identifying workflows of interest within the iHRIS database. The narrator reviews setting search definitions and ranges to populate desired lists and generate reports.

View video

Title: Standardized Data Lists in iHRIS (webpage and resource)
Language: English
Audience: System Administrators
Description: This tip sheet discusses how reporting information in the same way, through standardized data lists, can prove essential when systems, such as iHRIS, continue to collect data and are made accessible to multiple entities.

View Standardized Data List site
Download Standardized Data List tip sheet

Title: Establishing and Using Data Standards in Health Workforce Information Systems (document)
Language: English
Audience: System Administrators
Description: As countries move ahead with HRIS scale-up efforts, it is important to establish and use standards (organizational, national, and international) to align and harmonize the collection, aggregation, and analysis of human resources for health (HRH) data. This document will provide concrete examples in using international standards at the country level.

View document

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Links to technology tools and resources

emNutt GitHub Repository
Language: English
Description: emNutt is the essential component of mHero that connects iHRIS and RapidPro (or other health information system and communication platforms. The emNutt GitHub repository contains installation and configuration instructions and the code necessary for setting up and using emNutt as the mHero Connector.  
Link: https://github.com/intrahealth/emNutt

iHRIS GitHub Repository
Language: English
Description: As the mHero module is embedded in iHRIS, the iHRIS GitHub repository contains installation information, an overview of running iHRIS, and the code necessary for installing and configuring an iHRIS instance.  
Link: https://github.com/iHRIS/iHRIS

iHRIS Toolkit
Language: English, some French documents
Description:A compendium of good practices, tools, training materials, and resources to support deployment of an iHRIS-based system. Serves as a comprehensive orientation to the many tasks involved in planning for, deploying, and maintaining your health workforce system. iHRIS also offers e-courses for iHRIS users and administrators, and a guide for developers who want to download the source code and customize the iHRIS software. Link: iHRIS Toolkit

RapidPro Website
Language: English
Description: The RapidPro Website provides a wide variety of information about the platform, including a “Features” section with explanations on how to utilize messages, flows, campaigns and triggers, a section entitled “RapidPro’s API” for developers supporting the backend of the system, a space for Frequently Asked Questions (FAQ) and links to the RapidPro Community so users can explore how others are utilizing the system for their communication campaigns.  
Link: https://community.rapidpro.io/

DHIS2 Website
Language: English
Description: The DHIS2 Website provides a collection of resources to assist with learning how the platform works, details regarding DHIS2 Academies for training, and step-by-step directions on system installation.  The website also includes a section on “Development” that covers items such as issue tracking, collaboration platforms, and app development.
Link: https://www.dhis2.org/

iHRIS Website​
Language: English
Description: The iHRIS Website provides detailed information on the platform, including its five comprehensive solutions for managing health workforce information and training: iHRIS Manage, iHRIS Qualify, iHRIS Train, iHRIS Plan and iHRIS Retain.  In addition, the website offers resources such as an iHRIS Developers’ Guide, e-learning courses, and an implementation toolkit. A section on the iHRIS Global Support Community is included as well.
Link: https://www.ihris.org/

OpenHIE Website​
Language: English
Description: he OpenHIE Website provides a wide variety of information on the platform, including detailed information on OpenHIE communities such as the Client, Facility, and Health Worker Registries, as well as the Interoperability Layer, Shared Health Worker, HMIS, and Terminology Service. In addition, the website gives resourceful information on the OpenHIE architecture and strategy. Information about the OpenHIE Implementers Network is also given.
Link: https://ohie.org/