Hey Kathlem,
Thanks for your comments.

About your first question “In the refugee communities you work with, do most individuals have access to a phone?”

Information communication technologies (ICT) such as mobile phones and the internet are a common presence in the day-to-day life of refugees in Uganda. Despite (or perhaps, because of) the remote locations of for example Nakivale, Palorinya and Kyangwali in Uganda’s rural countryside, refugee residents there rely heavily on mobile phones for their daily communication needs. According to our survey, roughly 70% of these rural refugees regularly use mobile phones to communicate, even though, due to limited access, internet use is only available to around 10%, and as a result of the introduction to ‘Over the Top Tax-OTT’ the 10% internet use my further reduce.

However, some statistics say; for example, as cited in the New vision of 3rd December 2017 https://www.newvision.co.ug/.../digital-solutions-sought-challenges-facing-refugees-u...Country director Dan Church Aid, Karin Elisabeth Lind, mentioned that information penetration in the refugee communities remained low with phones infiltration at only 30% and digital literacy as low as below 10%. And “this makes it complicated to effectively mobilize refugee camp villages for food, agricultural outstanding information on seed varieties, inputs, markets or education opportunities”, she said. In addition, Emilienne Cyuzuzo, in charge of cash and digital solutions Dan Church Aid at Bidibidi refugee camp, in Yumbe district, said: “the over 21,000 basic phones, they gave out in the camp of 287301 did not serve the purpose since they are not digital enhanced.”

Our HCD project model is unique in a sense that it does not 100% necessary depend on phones or digitally enhanced phones and on our end user beneficiaries’ ownership of a phone. But the existence of our Health Camp Ambassadors-HCAs in every zone of a refugee camp whom we give phones and make sure that every HCA is known to everyone in a particular zone he/she serves through our effective and frequent refugee awareness and mobilization about our HCD mobile services, makes it easier for every refugee in need to be served at an affordable cost.

At least during our beneficiary research, one of the key feedbacks was that in every after 3 refugee camp household 1 person has a cell phone, and that in 1/3 adults in the household with over three adults can access a phone. Meaning there won’t be any barriers to access a phone in case there is an emergence case within the most 4-5 nearby houses that requires HCD Mobile services. Since the HCAs is within and known to them it is easier to reach him or her and connects with the QHDs/Standby nurses.

Concerning the question of a cost for the transfer and services, whether this cost still become a barrier for some, or they are typically low enough that these services are accessible?

Our major aim is to save a life, I may not guarantee that every refugee who needs our services cannot fail to even raise the little overall 30% cost we ask from them after the transfer and other care services have been offered.
However, the cost is not higher that the refugees in need of emergences care will not use our services. For refugee clients who cannot afford to pay the 30% cost immediately after being discharged from the health facility he/she or the care giver is given enough time to go and mobilize for the money. In such situations the HCA will keep truck of such beneficiary.

Our camp based monthly Mobile Maternal clinic a services are for free of charge, unless when an identified case requires obstetric care that needs the service of the QHDs. The purpose of the monthly Mobile Maternal clinics is also carter for those who cannot afford transport to health facilities. And also identify and keep track of pregnant women in the camp.

Refugee communities are often integrated within vibrant and complex economic systems. Recognising and understanding this represents an opportunity to turn humanitarian challenges into sustainable opportunities.
Thanks,
Cheers
Baluku

Hello Anubha,
Thank you for appreciating our efforts and the idea towards empowering and supporting this vulnerable group of people.

Dear Tuba,
Thanks for your comments and guidance.
During our beneficiary research, we entirely looked at the end user beneficiary of our ICT tools model; these were refugee women and men who should benefit from our HCD Mobile App service providers, some of the key questions during our interaction were related to, the would be challenges to maternal health care access, the best ways to get help when a pregnant woman in emergence situations can quickly get professional health care that are currently far away from the camps? And what could be the best options to use for timely access?
Here, we were testing whether our model answers and will deliver the health care needs of the pregnant refugee women in vulnerable communities in line with what they think can work better for them.
Some of the top learnings and feedback was; the limited friendly health care services (reproductive services) for women and young girls in the camps, silent prevalence of fistula disease among women but they never heard of a health care service provider on that, high cell phone penetration in the camps-however majority owned by men and still they don’t use them for seeking care since its expensive to even obtain airtime and to whom they can call for such a service, few ambulance services (only two ambulances in the whole camp serving a population of over 200,000 refugees), existing health care services in the camps exclude host community and this may increase resentment. Some of the best options from the target beneficiaries was to; if possible identify among them skilled refugee individuals who can be reporting emergencies when they happens, bring the MHC services nearer the camps, increase the number of ambulance services if possible and also health service providers giving out a telephone numbers to which they can send messages just in case there’s need for a certain health care service.
And therefore, I believe using HCD mobile App with an embedded Unstructured Supplementary Service Data-USSD a menu-based service build as real-time open session between application & end-users, and a Toll free number system-where women or girls in emergence situation will call and be linked to care, shall answer needs of these vulnerable refugee women, girls and even men in camps and the host communities. The App is basically used by ‘HCD Team-our trained health service providers’ who will include the Quick Health Drivers (QHDs), Health Camp Ambassadors selected from refugees themselves (HCA) and Standby nurses/midwives/gynecologist. Women seeking health care service will use a toll free line calls and a USSD service system messaging on their local cell phones (using any language) to report their emergency cases. The HCD team through the use of App locates and coordinates the reported emergence case.
The QHDs having a smart phone with HCD mobile App which automatically will link and locates the caller and nearby HCAs. As soon as the HCA reaches the caller, he sends a confirmation note of the reported case. Immediately the QHD receives alarm notification, he drives to the location with a standby nurse/midwife. The caller is reached and taken to a nearby quality health care facility for maternal care service or any other care service.
The wireframe for this HCD Mobile App will be attached.
However, I would wish to get more guidance from you, my email is; tibamanya.son2000@gmail.com
Thanks
Baluku.