The promise of mHealth is quite attractive to many health program implementers, but few know how to actually implement it. That’s why, during the final day of the [2011 Social Franchising for Health Conference](http://www.sf4health.org/) in Mombasa, [Pam Riley](http://www.shopsproject.org/about/who/pamela-riley) of the [SHOPS Project](http://shops.hfwebdev.com/) clearly laid out 7 steps for implementing a mass-SMS mHealth program - this could range of blasting out text messages to patients for health education to sending group messages to nurses and doctors to remind them to always dispose of used needles.
1. **Needs Assessment.** Pam stressed the importance of identifying a problem for which mHealth is the logical solution and not simply using mobile technology because it is the “hot new thing.” The program manager also has to assess the infrastructure: is mobile penetration sufficient to support this program? Finally, they must ask who their target audience is; are they used to using mobile phones? Are they even literate?
2. **Planning and budgeting.** It is crucial to know how much an mHealth plan will cost to know if it is even feasible. Some aspects that will need to be budgeted for include: planning, design, the technology itself, deployment, monitoring and evaluation. In Pam’s experience with an SMS project in Uganda, the planning period was the biggest expense. She also urged implementers not to underestimate the importance of trouble-shooting in the deployment of the strategy.
3. **Technology installation.** For this particular type of project, Pam recommended the use of [FrontlineSMS](http://www.frontlinesms.com/) because it is free and easy to use. That being said, a program doesn’t have any tech-savvy staff or they are planning to use multiple mobile applications in the work, she recommended the use of a consultant. Depending on the scale and needs for customization, an implementer should also consider engaging the mobile operator itself.
4. **Content development.** When choosing the content of the mass-SMS’, one must ask what the desired behavior change is and why the target audience isn’t already behaving that way. Then the tone, the frequency, the language, and the vocabulary of the text must be considered. Finally, Pam stressed that the message should be tested over and over to be sure that it is effective and clear.
5. **Deployment.** Once the messages have been adequately tested and the appropriate staff have undergone training and orientation, the mHealth program can be deployed. During deployment of a program using mobile phones, it will be important to find a way to keep the telephone numbers updated.
6. **Monitoring.** It is important to keep track of data surrounding the deployment of the program: who is being reached? Who is responding? If the mHealth program is using a quiz style format, who is getting the questions right and who is getting them wrong?
7. **Evaluation.** Evaluation is a key step that should not be forgotten, as the mHealth community is in desperate need of knowledge and evidence around what works. What outcomes will be measured? Is the project scalable?
Implementing an mHealth program is rarely as simple as it looks and programs are likely to encounter a number of challenges along the way. Nevertheless, the potential returns are great, so hopefully, using the 7 steps laid out above, more implementers will be able to incorporate technology and mobile phones into the work. As Pam advised, **“Do, learn, iterate, document."**
_This post is part of a series on social franchises for health in association with the [First Global Conference on Social Franchising](http://sf4healthconference2011.com/) (which took place Nov. 9-11 in Kenya). Find this post, and others in the series, [here](http://sf4healthconference2011.com/)._