This month, Liberia’s Ministry of Health and Social Welfare initiated real-time communication with health workers for the first time using mHero—a free SMS mobile phone-based system developed by IntraHealth International and UNICEF to help countries combat the Ebola outbreak, improve health sector communications, and ultimately strengthen the health system.

mHero combines two technologies—IntraHealth’s iHRIS software and UNICEF’s RapidPro—into a powerful communication tool for the ministry and frontline health workers. The new tool allows the ministry to instantly send critical information to health workers’ mobile phones and enables health workers to send time-sensitive information to ministry officials.

mHero will first be used to help the ministry validate personnel records to get a clear picture of its health workforce, share feedback on health facility operational status assessments, and create awareness of and develop confidence in this new communication system. mHero can also be used to collect information on the availability of open beds in hospitals or personal protection equipment needs, track and report emerging cases, communicate lab results for faster treatment, share reference and training materials, and test and improve the knowledge of health workers.

Since March, the Ebola virus has infected more than 18,000 people and killed over 6,900 in West Africa, including more than 365 health workers. The virus is taking its toll on Liberia’s health workforce—which was already experiencing a critical shortage prior to the outbreak. A total of 365 cases of Ebola have been reported in health workers throughout the country, and 177 have lost their lives. Reported case incidence is now on the decline, but health workers still face a long road ahead before the epidemic is over.  

At the onset of the Ebola crisis, the Liberian government did not have a way to communicate late-breaking information to its more than 11,000 public service health workers, especially those working in remote regions. Health workers on the front lines are trying to care for their communities amidst a lack of supplies and training, as well as their own fears of infection and work-related stress. Getting information quickly into the hands of the health workers can protect them and save lives. In the long run, real-time communication can help revitalize the overwhelmed health system.  

“Our health system is recovering from many years of breakdown,” says Rodney Cummings, administrative technician in the Personnel Department of the ministry. “So using innovative means—such as mHero—to communicate from the central level to those in the field is one major step we can take to make sure that staff are motivated and compensated for their work.”

The ministry sent the first messages—to verify contacts—to 482 health workers in four hospitals in Grand Gedeh, Margibi, Bomi, and Grand Cape Mont counties between December 5 and 17. These messages served as a test, so the ministry can document how mHero works and identify and address challenges to scaling it up.

The ministry is leading the effort to implement mHero and to design and develop related content and tools. IntraHealth and UNICEF are providing technical support.

mHero has been developed with support from a consortium of partners including the UNICEF Global Centre for Innovations, USAID, ThoughtWorks, and Jembi Health Systems. The development of mHero was made possible because IntraHealth’s iHRIS software and UNICEF’s RapidPro platform were both built utilizing the OpenHIE archicture. OpenHIE standards facilitate the interoperability of health information systems. This interoperability allows the mHero platform to immediately use the health workforce data contained in iHRIS—such as cell phone numbers—to target specific communications based on the health workers’ cadres, locations, and other information.

Liberia’s Ministry of Health and Social Welfare implemented iHRIS with support from the United States Agency for International Development (USAID)-funded Liberia Rebuilding Basic Health Services Project, led by JSI. IntraHealth’s iHRIS software was developed under the Capacity Project and continues to be supported through the CapacityPlus project, which is led by IntraHealth and supported by USAID.