Application of Novel and Innovative Approaches in addressing nutritional challenges in Children in Sub-Saharan Africa

Leap is a scalable, integrated mLearning solution offering training opportunities, peer collaboration, real time evaluation and supervision

Photo of Peter Waiganjo
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I confirm that I am fully aware of the eligibility criteria, and based on its description, I am eligible to apply to the CSV Prize 2017.

  • Yes, I'm eligible

Preferred language

  • English

Organization name

Amref Health Africa - Enterprises

Year founded

2016

Initiative stage

  • Scaling (the solution has passed the previous stages and is growing its impact on a regional or global scale)

Annual budget in 2017 (USD)

  • $1mil - $5mil

Number of beneficiaries impacted so far

  • More than 100,000

Organization type

  • Social enterprise

Secondary Focus Area

  • Nutrition

Headquarters location: Country

  • Kenya

Headquarters location: City

Amref Health Africa Headquarters
Along Lang'ata Road Opposite Wilson Airport
P.O Box 27691 00506
Nairobi Kenya

Location(s) of impact

Kenya: All the 47 counties
Tanzania: Dar Es Salaam

Website

http://www.leaphealthmobile.com/

Facebook URL

https://www.facebook.com/LEAP-the-mHealth-Platform-340823772782256/

Twitter URL

https://twitter.com/leaphealthmobi?lang=en

Problem: What problem is this initiative trying to address?

The WHO 2013 report on Human Resources for Health (HRH) declared “a universal truth” that there is “no health without a workforce”. Yet majority of the Sub-Saharan countries have an average of 1.1 health workers per 1,000 population, below the recommended 2.3 per 1,000 population, and far less than the 4.45 per 1,000 estimated as necessary to achieve the SDGs and universal health coverage. It is projected by 2035, there will be a global deficit of 12.9 million health workers and hence need use of innovative technology.

Solution Summary: What is the proposed solution? What do you see as its most promising aspects for creating shared value?

Leap is a Scalable, Integrated Mobile Learning Solution that offers continuous training opportunities, peer collaboration, real time evaluation reports and strengthened supervision. Leap employs an appropriate mobile learning pedagogy to train and empower health workers using their mobile device operating from any phone, Basic or Smart enabling the health workers to learn at their own pace and with their own mobile devices while in the community, providing for both the interpersonal and community aspects of learning. The platform provides structured learning to learners, a collaboration platform, performance monitoring and evaluation and dedicated learning support.
Leap has the long-term vision that every African has access to better quality health care. Our mission is to deliver an integrated mobile learning and community health services platform to empower, train and motivate the front-line health workforce in Sub Saharan Africa.

Impact: What is the impact of the work to date? Specify both the social and the environmental impact of your work

Over 31,000 front-line health care workers have been trained using Leap in turn reaching over 3,000,000 household community members with the much needed health education (preventive and curative) including nutrition, basic first aid and referral services. The programme has realized impressive learning and health outcomes which include a learning completion rate of 92%, improved knowledge retention of 15% in comparison to face to face approaches, and a reduction in attrition of the CHWs by 85%.
The over 50,000 community health workers on the mHealth platform from all the 47 counties of Kenya have been recruited and trained as insurance registration and member premium agents for the National Hospital Insurance Fund (NHIF) to recruit 5 million underprivileged community members into the national social protection scheme. This project will accelerate the achievement of Universal Health Coverage (UHC) which is part of the commitment for the global Sustainable Development Goals (SGDs).

Financial sustainability plan: How is this initiative financially supported? How will you ensure its financial sustainability long-term?

After a successful pilot, Leap has successfully transitioned into a social enterprise and it is generating its income from ongoing Amref programmatic work, Governments, private sector and development partners, to ensure that every African has access to better quality health care.
The Leap business model is unique as the users/learners do not pay for the platform; instead partners, who want to invest in training health workers pay the fees of using Leap.
More than 80 percent of Leap income is generated from the partners while the balance is funded through small grants and loans from foundations and the private sector through social impact funding.
Sustainability means adoption of Leap by Governments to train their health workers where leap would charge a subscription fee per learner.

Unique value proposition: What makes your initiative innovative? How does your project differ from other organizations working in the same field?

Unique Features;
Structured Learning - the “mPedagogy” applies advanced learning principles and approaches to basic mobile channels as through role plays, job aids, quizzes and games.
Collaboration - allowing health worker communities to share knowledge among themselves
Monitoring - regular reports on learner performance accessible by the learner and their supervisors, and progress statistics
Learner Support - learners have access to a dedicated, toll free helpdesk in case of any challenges

Founding story: Share a story about the "Aha!" moment that sparked the beginning of this initiative.

Leap was developed through a cross sector partnership comprising the Ministry of Health, Amref Health Africa, Accenture, Safaricom, MPesa Foundation, and Mezzanine of bringing together core capacities required in the development of a sustainable mHealth platform. This was motivated by the need to address;
Poor knowledge retention among the Community Health Workers (CHWs) after face to face training.
High attrition rates due to low ongoing CHWs engagement with no social incentives to maintain engagement or continuously collaborate with peers.
Inability to rapidly connect and mobilise communities given the amount of field work required and challenges in accessing certain geographic regions, especially for rural and nomadic areas.
Lack of knowledge sharing or collaboration capability amongst CHWs
No method to track their training digitally as all training records are all paper based

Where did you hear about the Nestlé Creating Shared Value Prize?

  • Upon recommendation from others

Program Design Clarity: We are hungry to know more about what exactly your model consists of. Succinctly list a) what main activities are you doing with your beneficiaries, b) where you carry out the activities? c) how often? d) for how many hours? e) who delivers the services? and f) any other brief details

Leap is an innovative use of mobile phones to offer to the frontline Health Care Workers (HCWs) plus the Community Health Workers (CHWs) a set of mobile enablement, learning & supervision tools and their supervisors, empowering them in their essential role delivering healthcare to communities, all year round. The Ministry of Health approved content and curriculum are delivered using a basic mobile phone through the IVR (mini lectures) and bi-directional short messages (SMS) through a stuctured and engaging learning.
The structured learning - “mPedagogy”, uses advanced learning principles and approaches to basic mobile channels in a combination of “patterns” to simulate the learning experience and outcomes from traditional in-person training methods, such as role plays, job aids, quizzes and gamifications.
The HCWs are trained on a single nutrition topic for an average of five days through the mini-lectures messages for topic delivery support and continous assessment.
Our beneficiaries are HCWs including CHWs, and mothers and women of reproductive Age. The HCWs are provided with a platform where they are able to interact with each other and share experiences, opinions and other stories through their mobile phones (group chat functionality). The women and mothers in the communities periodically receive key messages on nutrition through their mobile phones to sensitize, educate and create awareness on the role of nutrition in reproductive, maternal and neonatal health.

Focus area

  • Nutrition

We are interested in learning more about your initiative's broad impact on sustainable development. Please reply ONLY to the question(s) related to your above focus area.

The use of mobile technology in training the HCWs and the CHWs on maternal and child health nutrition, Integrated Community Case Management and danger signs in pregnancies and children under 5 aimed to reduce child and maternal mortality.
Through the Leap platform, the women and mothers in the communities periodically receive key messages on nutrition to sensitize, educate and create awareness on child and maternal nutrition which ultimately will reduce the maternal and child mortalities associated with lack of proper nutrition.
Using Leap we have recently specifically trained 1,200 HCWs on the control and the management of Diabetes with the larger part of the content covering nutrition management and behaviour change within the communities. These trained health workers have in turn reached more than 600,000 community household members with much needed information on nutrition and how to avoid the lifestyle diseases through correct nutrition.
Leap’s goal is to contribute to the improvement of the quality of life and reverse the trend of mortalities from the Non Communicable Diseases (NCDs) through the application of innovative technologies to build the capacity of the 1,000,000 Health Workers including the CHWs in Africa.
Leap is able to collect, collate, and analyze the community data on nutrition and other disease conditions at the community level hence improving efficiency of community level health reporting hence improving disease surveillance mechanisms

Creating shared value: How does your initiative create value for different stakeholders?

Leap enables Governments, NGOs, Donors and the Private Sector to roll-out health training far more cost effectively than traditional face to face training – achieving greater scale, higher knowledge retention, lower attrition, and better reporting and analytics. In addition, because Leap is available on basic mobile phones, which ~97% of community health workers in Kenya already have, the barriers to take-up are extremely low.
The Leap learning pedagogy structures training in a unique way, combining SMS messages, audio role plays and lectures, quizzes, practicums and diagnostic trees to reinforce learning and provide an engaging way to deliver content. This unique pedagogy combined with the group chat allows learners to stay engaged, collaborate and be rapidly mobilised in times of emergency.
The adoption of innovative technologies has the capacity to accelerate the achievement of Universal Health Coverage (UHC) partiularli in the HRH challenges of shortage, skills-mix imbalances.

How is your initiative funded, now and over the next 5 years?

Leap is currently self sustaining and does not require additional funding to survive, but for it it grow both in terms of profit and impact, it is prudent for Leap to consider external investment from an impact investor or foundation to invest in:
Cross-country expansion: The current model requires the partner to absorb the cost of Leap expanding into a new country which would understandably be unattractive to a potential partner. Outside investment would enable Leap to invest in expanding into new countries, to open up new markets for Leap to reach.
Invest in new product features: This would allow Leap to expand beyond its core capabilities and aggressively implement new product features as well as investing in new innovative products

How do you plan to influence your field of work if you are a winner of this edition of the CSV Prize?

The vision of Leap is to create lasting health impact by focusing on strengthening the community health system across Sub-Saharan Africa. Leap is currently at the intersection of mHealth and mLearning, our strategic focus will be to invest heavily in:
Maintaining market dominance in the mHealth learning space by serving across all cadres within the health sector – households, community health workers, nurses etc.
Drive partner retention and engagement – introduce a partner portal that allows partners to digitally track their progress of their learners
Strengthen our product differentiation by improving core capabilities – specifically Smart App, reporting and dashboards, simplifying the on-boarding process and enabling self-enrolment.

How will you leverage an investment from Nestle to expand the impact of your work?

The CSV prize will used in;
HCWs training on new content related to nutrition and how to dialogue with households on nutrition demand
Supporting CHWs during the household visits to educate on the importance of nutrition using a specially designed job-aid
Nutrition Community Groups - CHWs and Committee organises the households into nutrition community groups to discuss issues and create accountability and ownership
Household Education and Communication - Households receive educational SMS messages on the importance of nutrition and demystifies misconceptions. Creation of referral mechanisms in case of emergencies
Nutrition Data Collection- The HCWs capture nutrition data that is used for decision making and planning and communication.

Spread Strategies: Moving forward, what are the main strategies for scaling impact? What’s the projected impact for the coming years? Are you planning to expand your programme into new locations? On what assumptions do you build your scale-up plans?

Leap has plans to expand aggressively into South Africa, Ethiopia, Uganda, Tanzania, South Sudan and many others across Sub-Saharan Africa where Amref and its partners have physical presence. Building the capacity of community and frontline health workforce, through training & empowerment, strengthens the health system from the ground up. It is estimated that full utilisation of CHWs could save 3.6 million children’s lives each year. There is a target to train 1 million community health workers across Sub-Saharan Africa, 80,000 in Kenya alone. The adoption of innovative technologies has the capacity to accelerate the achievement of Universal Health Coverage (UHC) particularly in the developement and skilling of the Human Resources for Health.
We plan to maintain the relationships with Governments and Ministries of Health and key development partners in these countries to champion and advocate for policy and practise change in using of technology in capacity development.

Team: What is the current composition of your team (types of roles, number of full-time vs. part-time staff, board members, etc.)? How will this team evolve as your initiative grows?

Amref Enterprises Limited (AEL) is led by a General Manager supported by Technology, Business Development, Finance, and Research Leads to provide overall commercial leadership, strategic direction, and business development leadership to the organization.
A team of 4 Key Account managers are managing the relationships with our partners on full time and also assist in the program delivery. The digital content in developed and translated by a team 4 experts on full time basis. There is a team of 5 developers on part-time to assist in the development of new products and new products features. AEL also provides an in-residency programme for a maximum of 4 entrepreneurs - ChanjoPlus the winners of the Incubation and Acceleration Programme for the Amref Health Africa Global Innovation Fund

Awards: What awards or honors has the initiative received?

Brandon Hall Groups Excellence in Learning Award: Amref Health Africa – Use of responsive technology in empowering Community Health Workers in Africa – The case of Health Enablement and Learning Platform Project - Now LEAP

2014 GBC HEalth Award for Business Action on Health.

Organizational leadership: How are you influencing your field of work in the present?

Through working with partners with similar innovations to achieve a holistic approach to health care interventions for example is the case of i-PUSH (Innovative Partnership for Universal Sustainable Healthcare) programe currently applying the technological innovations Leap M-JALi and M-Tiba for UHC for women and mothers.
Through the Innovate4Life Fund Amref Enterprises is one of the incubation and acceleration hubs for the most promising innovations in Health – Currently hosting ChanjoPlus Entrepreneurs
Internship and mentorship programmes together with our partners for young software developers and designers to develop product features on the existing innovative Leap product as well as conceptualizing new ideas.

Should you be successful, please confirm your availability to attend the Ashoka Impact Boot camp and Creating Shared Value Prize Live Pitch Event at the World Water Forum 13-16 March 2018

  • Yes, I am available to attend the events on 13-16 March 2018

3 comments

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Photo of Joseph

Leap is definitely a unique mLearning solution. As the health workforce is constantly trained for effective service, they will be equipped to give appropriate health services to their communities. Financial sustainability is quite vital and how the project is sustained through an earned income of 80% is not very clear. It will be very valuable if effort is put to maintain or exceed such. After training, provision of essential medical inputs must be generated or supplied. Hope such is thought of appropriately. Quite a laudable initiative.

Photo of Peter

Thank you Joseph for the positive review. Adoption of use of technology for training the health workforce by Governments in Africa will definitely be a game changer if we are to meet the skilled health workforce deficit. We are more than happy to share further information.

Photo of Joseph

We will definitely be in touch and will recommend your project to others. Keep up with the good work.