Editor's note: This is a guest post by Sameer Pujari, Virginia Arnold, Vinayak Prasad, and Rahoul Ahuja from the WHO's Tobacco Free Initiative.
The global tobacco epidemic is one of the biggest public health threats the world has ever faced. According to the World Health Organization's 2011 Report on the Global Tobacco Epidemic, tobacco kills more than 6 million people per year and is expected to increase to 8 million by 2030. It is one of the major risk factors for non-communicable diseases and is a global burden not only in developed countries, but also increasingly in developing countries. According to the World Economic Forum's "The Global Burden of Non-communicable Diseases." NCDs are expected to cost the world more than $30 trillion (48% global GDP in 2010) over the next 20 years, posing a significant risk to economies worldwide.
In the last couple of years, the use of mobile phones in most countries, particularly in Asia and large parts of Africa, has seen an unprecedented increase. According to the International Telecommunication Union's (ITU) Measuring the Information Society Reports (2009 and 2011), mobile technology penetration has risen from 2% to 40% throughout much of Africa in the past decade. With more than 5.3 billion mobile phone subscriptions globally, the advantages of mobile health technology for public health, are promising because of its ubiquitous outreach.
Mobile Technologies for Child Protection data sheet 1554 Views
Author:
Mattila, Mirkka
Publication Date:
Oct 2011
Publication Type:
Report/White paper
Abstract:
The purpose of this briefing note is to provide an overview of current applications of mobile technologies with relevance for child protection. This is an area of rapid innovation and new applications are being developed all the time. Telecommunications is one of the fastest growing sectors in Africa and the relevance and reach of mobile technologies for development and humanitarian work is only going to increase over the coming years. Many technical, legal and security aspects of these new technologies remain to be fully addressed and worked out. The dependence on technology, network coverage and electricity supply also mean that mobile technologies cannot be used everywhere.
The main part of this note presents three different types of mobile applications for: (a) gathering and transmitting data by child protection service providers; (b) self-protection and for complaints mechanisms; (c) social transfers.
Scaling Up Mobile Health: Elements Necessary for the Successful Scale Up of mHealth in Developing Countries data sheet 1271 Views
Author:
Jeannine Lemaire
Publication Date:
Dec 2011
Publication Type:
Report/White paper
Abstract:
Despite the strong promise demonstrated by mHealth tools and applications, the current landscape of mHealth development in developing country contexts is characterized by a proliferation of unsustainable pilot projects that often expire once initial funding is exhausted. For example, in Uganda alone there were 23 mHealth initiatives in 2008 and 2009 that did not scale up after the pilot phase. In India, there were over 30 mHealth initiatives in 2009 that did not go beyond the pilot phase.
Current policy environments, business models and funding schemes around mHealth have fueled the proliferation of pilot projects without enabling them to scale up in a meaningful, replicable way. An additional, and perhaps most significant, obstacle to improving and scaling the implementation of mHealth initiatives is the lack of monitoring and evaluation (M&E) and use of meaningful, consistent indicators and rigorous evaluation methods.
Given the obstacles within the current landscape, this white paper was commissioned by Advanced Development for Africa (ADA) to assess current implementations of successful mHealth programs in developing country contexts. The objective is to identify elements necessary for successfully scaling up, with the aim of highlighting best practices and specific programmatic, operational, policy and global strategy recommendations that can promote scale up of mHealth.
Profiled in this report are several select mHealth programs that have been piloted and are currently in the scale up phase, and have proven enough success that they should be considered as models for other initiatives to follow. As the following case studies will demonstrate, through more accurate and timely data, disease surveillance, decision support and health information management, mHealth can effectively inform policy-making and planning within healthcare systems and improve the health of local communities, particularly remote populations. The scale up of mHealth within national health agendas should be supported by all departments within the Ministry of Health and across other relevant ministries and agencies including Telecommunications. Both internal stakeholders, such as end-users and beneficiaries, and external stakeholders, such as mobile network operators and donors, should be engaged in the planning and business model design and scalability assessments. The primary goal of this white paper is to provide evidence and recommendations that will allow mHealth initiatives to better plan their own scale up beyond successful pilot phases.
What makes a mobile health project successfuly grow? What causes so many m-health projects to wither or fail? And what can practitioners learn from existing m-health projects to build growth into programs for the future? "Scaling Up Mobile Health: Elements Necessary for the Successful Scale Up of mHealth in Developing Countries" examines these questions by looking at nine case studies on successful mobile health projects and pulling out the key strategies that led to successful growth.
The case studies cover a wide array of health issues, including maternal and early childhood health (ChildCount+, Pesinet, Project Mwana, Tele Salud), medication stocking and verification (mPedigree, SMS for Life), disease outbreak monitoring (mTRAC), and HIV/AIDS awareness (SMS for Health, Txt Alert); the report details how the projects deal with issues like local buy-in, scale, and sustainability. "Scaling Up Mobile Health" is broken up into three sections: case studies, best practices, and recommendations for future m-health projects.
The main lessons from the report focus on what has worked within the highlighted case studies and what is needed for future m-health projects to be successful. Below is a summary of the key points and takeaways from the report:
Mali has one of the highest infant mortality rates in the world. There are roughly 111 deaths for every 1000 live births in the country and the under-5 mortality rate is 191 out of every 1000 children. The need for early detection of diseases and stronger local health structures led to the creation of Pesinet, a non-profit that uses mobile technology to provide regular health checkups and affordable health insurance for young children in Mali's capital, Bamako.
Roughly 600 children are currently enrolled in the program in the neighborhood of Bamako Coura, under the care of four Pesinet agents (each covering around 150 children). Pesinet combines both early warning systems and insurance. Families pay 500 CF a month for each enrolled child; the payments cover doctor examinations and half the cost of any medications the child needs if he or she gets sick.
Enrolled children are tested weekly for symptoms of illness such as fever, cough, diarrhea, low weight, or vomiting by community health workers who enter data from each visit into a custom-designed Java application on their phone. The data is sent via GPRS to an online database. Doctors at local community health centers monitor the patient data for sudden changes in health. If changes occur, the community health workers receive an alert on their phones and then go back, in turn, to alert the family that the doctor needs to give the child a checkup.
FailFaire – where it's okay to admit the mistakes. MobileActive hosted another round of FailFaire, bringing together practitioners, developers, donors, and students involved in the use of technology for social change development to discuss what's usually swept under the rug – project failure. The event is an open space to discuss those projects that went wrong in our field fostering a sense of learning from mistakes and knowledge sharing. The latest FailFaire in New York brought together eight practitioners to present their failed projects and what they learned along the way. Take a look at this FastCompany article about the NYC FailFaire for some background.
We recently attended the mHealth Summit 2011 to learn more about the latest developments in the mobile health field. The conference brought together developers, practitioners, NGOs, representatives from corporate industries, and government officials to discuss the current state and future of mobile health.
Several key trends emerged among the discussions, focusing on: local buy-in and capacity building, the importance of building partnerships and trust among communities, and the need to transition from short-term pilots to scalable, sustainable mHealth projects.
Scale, Sustainability, and Hype
There was a lot of discussion at the mHealth Summit 2011 about the number of failed pilot projects and the hype around mobile health. More productively, there was considerable discussion on what steps can be taken to reduce the waste (including financial, time, and community good-will) that results from launching unusable, unscalable, or unsustainable mobile health projects. The honest assessment of challenges in the m-health field led to discussions about scalability and sustainability.
A Doctor in Your Pocket: Health Hotlines in Developing Countries data sheet 1184 Views
Author:
Ivatury, Gautam, Jesse Moore, Alison Bloch
Publication Date:
Jan 2009
Publication Type:
Report/White paper
Abstract:
The GSM Association—the global trade association for mobile network operators—and its Development Fund believe that health hotlines can transform healthcare for poor people just as mobile phones are revolutionizing financial services (‘mobile money’). Health hotlines are simple to understand (“call a doctor”), provide immediate assistance, and are available to anyone with a mobile phone. The reach and branding of a mobile network operator (MNO), and the scalability of call center technology may mean that health hotlines serve vast numbers of people in the coming years.
As a first scan of the approach, this report tracks hotlines operating in developing countries, assesses their social and commercial success to date, and offers suggestions for governments, industry bodies and development agencies to advance this approach.
In the first section we define the health hotline model and present a brief landscape of health hotlines in operation today. Section 3 spotlights four of the most prominent health hotlines in developing countries, and compares their business approaches. In Section 4 we assess their commercial viability and potential for growth, and in Section 5 we evaluate their potential for social impact. Finally, Section 6 offers thoughts on how development agencies and governments can support the health hotline phenomenon.
Case Study for Incorporation of Mobile Technology in Maternal, Neonatal and Child Health (Manoshi) Program at BRAC Health data sheet 1020 Views
Author:
ClickDiagnostics
Publication Date:
Jan 2009
Publication Type:
Report/White paper
Abstract:
After extensive studies of BRAC’s health services for mothers, neonates and children in rural and urban areas (MNCH and Manoshi, respectively), ClickDiagnostics has developed a mobile phone-based solution for streamlining BRAC’s data collection procedures in Manoshi, enabling BRAC to take a more pro-active approach in strategizing and reaching the women most in need in the urban slums.
ClickDiagnostics is in the concluding stages of piloting thissolution jointly with BRAC, and after the completion of the project in January, will support BRAC in refining the model and scaling up for nationwide implementation in MNCH and Manoshi projects, and possibly also in BRAC Health’s other program.
One important reason why many pregnant mothers succumb to death or preventable miscarriages is that it is expensive for government or non-government health organizations to track pregnant mothers to assess their level of risk and prioritize its limited resources for targeted intervention. A model in which community health-workers use ICT to gather real-time information about pregnant women and send to a specialist can help to address this gap and help health organizations take precautionary measures about risky cases of pregnancies.
Making health initiatives more accessible through technology can help patients and doctors keep themselves better informed about health and wellness. On October 25th, The Path of the Blue Eye hosted unNiched: Scratch, Sniff and Learn, a short conference focusing on innovation in the health marketing and communications world. Fard Johnmar, one of the founders of the Path of the Blue Eye project, introduced all the speakers and explained that the event is about " really getting people together from different disciplines, so that they can learn from each other and improve health and wellness."
Seven organizations gave short presentations on their health and technology initiatives before the group broke out into smaller discussions and demonstrations. Three of the projects presented at unNiched with a mobile focus: MoTeCh, a program using mobile phones to connect community health workers and beneficiaries in Uganda; Ubiqi, a mobile tracking tool for patients with chronic disease; and InStrat, a personalized SMS health alert system. While introducing the mobile technology section of unNiched Johnmar said, "So mobile – you'll see in today's presentations and by interacting with our innovators – really means empowerment, education and finally, most important for me, behavior change." Watch a short video featuring excerpts from the mobile UnNiched presentations below to see how the organizations are using mobile in their work, and read on for a description of each project.
Today's Mobile Minute brings you news about the decline of knock-off phones in China, mobile phone statistics in South Africa, the case for password protecting your mobile phone, challenges to mHealth projects in Africa, and new global mobile statistics.
A new article from the L.A. Times looks at the fall in popularity of shanzhai (knock-off) phones in China, as shanzhai phones now represent only 7% of the Chinese market, down from 20% in 2007. The article says that the trend for buying brand-name phones is due to the greater availability of low-cost smartphones, and a preference for high-end features in smartphones that the knock-offs can not replicate.
Nielsen Wire recently released a study on mobile use in South Africa, examining everything from network loyalty and social mobile use (such as downloading ringtones, wallpapers, and screensavers), to comparisons between mobile contracts and pre-paid phones and the use of SMS and mobile instant messaging services.
Do you password protect your phone? Read Write Web reports that more than half of smartphone owners surveyed by Confident Technologies do not lock and password protect their phones. If your phone is stolen, lost, or confiscated then all of your personal data (including contacts in the address book, emails saved in your inbox, and log-ins for social media sites like Twitter and Facebook) stored on your phone could be compromised; using a password makes this information harder to access.
PBS examines the hype around mHealth projects in the developing world, and whether mobile technologies are successful at managing health issues. The article looks at challenges to mHealth projects such as limited mobile access for beneficiaries, spotty network coverage, the high costs of large-scale projects, and the difficulty of maintaining charged phones.
Aarogyam ICT for Mother and Child Care data sheet 456 Views
Author:
Tiwari, Alok
Publication Date:
Jul 2011
Publication Type:
Report/White paper
Abstract:
‘Aarogyam’ is a Sanskrit word which means "complete freedom from illness”. Aarogyam is an ICT based responsive system which ensures and involves active participation of all key stakeholders viz. local administration, health facilities and doctors, frontline health workers (ASHA (Accredited Social Health Activists), ANM (Auxiliary Nurse Midwife), and AWW (Angan Wadi Workers)), village heads and beneficiaries, to ensure that a pregnant woman is provided with ANC, PNC and complete immunization throughout the continuum of care. Aarogyam maintains a village wise database of all the beneficiaries (pregnant/lactating women, children up to 5 years) of an area, which gets continually updated with new data generating on the field with the help of front line health workers. The database thus generated is the backbone of the software system used by Aarogyam. This system generates automated alerts in the form of vernacular voice calls/SMS to the beneficiary thus enabling the beneficiary with vital information at their door step. The system not only provides beneficiary with the information to be acted upon but also ensures that the services are delivered to the beneficiary by generating automated alerts (vernacular voice calls/SMS) for the ANM and Block level health officials, informing them of due services in their area.
Today's Mobile Minute brings you coverage on a new mobile frequency breakthrough, comparisons between mobile devices and PCs, the results of a mobile-based South African youth sex survey, the growth of apps in the Asia-Pacific region, and a look at the future of the global mobile payment industry.
Researchers at Rice University have developed a new technology that allows mobile devices to use the same frequency to both talk and listen to cell towers. Normally, two frequencies are needed to transmit and receive wireless data; the new technology could allow operators to double the capacity of their towers.
A new study from the International Data Corporation predicts that mobile Internet users will outnumber PC Internet users by 2015. Read Write Web reports that although smartphones are a big part of the shift, the release of tablet devices like the iPad give the predictions of mobile-dominance more credence.
The Praekelt Foundation recently released the results of its "Youth Sex Survey," which received more than 130,000 responses via the mobile platform Young Africa Live. The survey asked users of the social portal questions about their sexual health and opinions about sex and relationships; AudienceScapes reports on some of the responses: "Findings included a high percentage (44 percent) of South African youth admitting they are sexually active at the same time that they are significantly concerned about HIV/AIDS – 81 percent of respondents indicated they equate 'not telling a sexual partner that you carry the virus' with outright murder." (Read more about the Praekelt Foundation and Young Africa Live here.)
Mobile applications are huge in the Asia-Pacific region; a study by the analyst firm Ovum estimates that "total number of mobile apps downloaded could reach 14 billion in 2016." TechCircle reports that the region already anticipates 5 billion app downloads for 2011, and that estimated revenue from paid mobile applications could reach $871 this year.
If you like charts, check out this graphic depicting a prediction of the global mobile payments market (based off data from Juniper Research) by the year 2015. Divided into eight worldwide regions, the graph (and research) shows how the world will use mobile payments (including near field communications, mobile payments/transfers, and regular purchase of goods).
[Mobile Minute Disclaimer: The Mobile Minute is a quick round-up of interesting stories that have come across our RSS and Twitter feeds to keep you informed of the rapid pace of innovation. Read them and enjoy them, but know that we have not deeply investigated these news items. For more in-depth information about the ever-growing field of mobile tech for social change, check out our blog posts, white papers and research, how-tos, and case studies.]
Harnessing the Mobile Revolution to Bridge the Health Education & Training Gap in Developing Countries data sheet 301 Views
Author:
Callan, Paul, Robin Miller, Rumbidzai Sithole, Matt Daggett, and Daniel Altman from Dalberg Global
Publication Date:
Jun 2011
Publication Type:
Report/White paper
Abstract:
This report for mHealthEd 2011 at the Mobile Health Summit focuses on the effectiveness of mHealth Education applications, analyzing at length the first wave of projects and the steps to be taken into consideration for further initiatives.
The first wave of mHealthEd applications for health workers – most introduced within the last 4 years and some of which are 7 presented in this report – include ones which enable workers to learn new treatment procedures, test their knowledge after training courses, take certification exams remotely, look up information in medical reference publications, and trade ideas on crucial diagnostic and treatment decisions. It is too early to test for impacts on health outcomes, but projects suggest that mHealthEd applications are improving the provision of care and levels of knowledge. Improved training can also increase job satisfaction and reduce attrition rates for healthcare workers.
uReport: Citizen Feedback via SMS in Uganda data sheet 4545 Views
For aid organizations, knowing what local communities and beneficiaries want and need is the key to running successful, sustainable programs. In Uganda, UNICEF is using mobile phones and broadcast media to get direct feedback from Ugandans on everything from medication access to water sanitation. The project, called uReport, allows users to sign up via a toll-free shortcode for regular SMS-based polls and messages. Citizen responses are used both in weekly radio talk shows to create discussion on community issues, and shared among UNICEF and other aid organizations to provide a better picture of how services work across Uganda.
Sean Blaschke, a Technology for Development specialist at UNICEF Uganda, explains that uReport gathers information from participants and informs citizens of their rights and available services. Recent polls have included questions about school dropouts, water point availability, mosquito net usage, and youth employment, all collected via SMS polls.
The use of SMS makes the program available to all literate mobile users regardless of handset; says Blaschke,
The Case of the Interdisciplinary Researcher: Using Mixed Methods to Observe ICT in Healthcare in Uganda data sheet 1583 Views
Author:
Densmore, Melissa R.
Publication Date:
Oct 2010
Publication Type:
Report/White paper
Abstract:
While researchers are often depicted as either ‘social scientists’ or ‘technologists’ often their educational and ideological backgrounds are much richer than the two simple terms might imply.
This paper describes the methodology and approach of a qualitative researcher with a computer science background in investigating how information technology changes communications and information management practices within the health ecosystem constitutued by a health subsidy program in southwest Uganda.
Access to basic health service is limited in rural areas of Bangladesh, where 80% of the total population lives. For instance, 35% of doctors and 30% of nurses are located in four metropolitan districts where only 14.5% of the population lives. Most of the rural people are physically removed from qualified health care providers. Two major mobile phone service providers in Bangladesh have initiated mobile health care help line services nationwide as a remedy to this situation.
Since there is much hope of mobile phones to be used for basic health care services for populations living in rural areas, this research aims to evaluate how far such interventions reached for the improvement of health care in those communities. Through an interpretive case-based research strategy, our field studies uncover enthusiasm from the rural people towards availing health help line services and the intervention's contribution to improved health-seeking behavior.
Making Mobile Phones Work for Women with Fistula: The M-PESA Experience in Kenya and Tanzania data sheet 1632 Views
Author:
USAID and Fistula Care
Publication Date:
Jan 2011
Publication Type:
Report/White paper
Abstract:
The Freedom from Fistula Foundation (FFF) in Kenya and Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) have taken great strides in reducing these barriers. Using a combination of mobile banking, public information, and free treatment, they have helped make fistula repair a reality for women who were previously excluded from care.
The Grameen Foundation
recently released an in-depth report on the
state of MoTeCH, a multi-part project that uses mobile technology to
send pre- and post-natal health information to Ghanaians and allows
community health workers to collect and share health data. Launched in
July 2010 in the Upper East Region of Ghana, the system rolled out
the next phase of the pilot in April 2011 in the Awutu
Senya distract in the Central Region of Ghana. The report, "Mobile
Technology for Community Health in Ghana: What It Is and What
Grameen Foundation Has Learned So Far," takes an honest look at the
progress and challenges the organization has faced while implementing a
long-term, large-scale mHealth project.
On Monday, Vodafone and the mHeatlh Alliance announced the winners of the Vodafone Americas Foundation Wireless Innovation Project and the mHealth Alliance Award. Although all three winning projects focus on health applications of mobile technology, each project has an entirely different focus: in first place, NETRA uses a clip-on device for mobile phones to quickly diagnose eye disorders; in second place, SMART Diaphragm monitors high-risk pregnancies by wirelessly transmitting information to physicians; and in third place is Cool Comply, a system designed for community health workers to keep medications cool and to allow them to stay in contact with patients.
Mobiles for Development is a research study commissioned by UNICEF to help the organization understand the global mobile telephony landscape as it relates to advancing development, and as an area of significant future opportunities. Evidence for the report comes from UNICEF operational staff and representatives of mobile operators in 14 countries (Bangladesh, Egypt, Ghana, Iraq, Kosovo, Lao PDR, Malawi, Mongolia, Philippines, Sierra Leone, Sri Lanka, Suriname, Uganda, and Zambia). The report suggests that mobile tools can identify the most deprived children and communities, provide cost effective iinterventions, overcome bottlenecks to services, and enable communities to maximize the impact of available resources.
Adherence reminders, patient data transmission via community health workers, HIV/AIDs info services – mobile phones can be used in a variety of health settings. As mobiles have become cheaper and more easily available around the world, mobile health projects have followed, taking advantage of the devices’ data storage capabilities, information transferring potential, and social networking features.
MobileActive has covered the m-health area extensively as NGOs, aid organizations, and governments continue to launch new projects incorporating ICTs into their work. Organizations like the Praekelt Foundation, which runs multiple mobile health projects, Pesinet, a micro-insurance and community health worker data collection tool, Dimagi, which developed CommCare (a project that helps community health workers promote healthy behaviors in patients), and MoTeCH, a Grameen Foundation project that uses mobiles to send medical advice to pregnant women and young parents along with creating a data managing resource for community health workers, are exploring the potential that mobile technology offers for delivering health care.
Looking at some of these organizations’ experiences, we put together a list of key lessons organizations are learning as they develop m-health projects:
In Jordan, a new program called SOHITCOM (Social Health and IT for Rural Communities) uses mobile phones and web-based technology to improve access to maternal and early childhood healthcare information.
Developed by the Royal Scientific Society of Jordan in a partnership with Canadian funder IDRC, SOHITCOM is part of a larger program promoting and developing ICT4D in the Middle East. A two-part project, SOHITCOM is both a vaccination adherence service and a health information portal for rural Jordanians.
Using Mobile Phones and Open Source Tools to Empower Social Workers in Tanzania data sheet 1876 Views
Author:
Dias, M. Beatrice, Daniel Nuffer, Anthony Velazquez, Ermine A. Teves, Hatem Alismail, Sarah Belousov, M. Freddie Dias, Rotimi Abimbola, Bradley Hall, and M. Bernardine Dias
Publication Date:
Dec 2010
Publication Type:
Report/White paper
Abstract:
Although para-social workers carry the primary responsibility in providing essential services to the growing population of orphans and vulnerable children in Tanzania, they are often not paid for this work. Moreover, these para-social workers are unable to access governmental resources due to the lack of an efficient means of reporting their needs to relevant government officials in a timely manner.
In this paper we describe a text message (SMS) based solution that harnesses the prevalence of mobile phones coupled with several Open Source tools to empower these para-social workers. Specifically, we build a more efficient mechanism for reporting summary data on orphans and vulnerable children to relevant government officials in a cost-effective and efficient manner. This paper reports on our needs assessment process, reviews the related work, describes the implementation and testing of our prototype solution, and concludes with a discussion of relevant future work.
Assessing the Scope for Use of Mobile-Based Solution to Improve Maternal and Child Health in Bangladesh: A Case Study data sheet 1703 Views
Author:
Alam, Mafruha, Tahmina Khanam, and Rubayat Khan
Publication Date:
Jan 2010
Publication Type:
Report/White paper
Abstract:
Patient data collection and emergency health service is the primary challenge in developing countries. Risk assessment of pregnant mother and healthcare based on priority is almost impossible in present health service of Bangladesh.
A pilot study was done in three urban slums of Dhaka where BRAC health workers were provided with mobiles. A smart algorithm was incorporated in the mobiles. The mobile solution came up with useful findings. The health workers now could send data directly to central MIS system which reduced previous time lag. A secure web page contained all the patient data which was accessible by BRAC Personnel from anywhere any time. An automated risk assessing decision tree categorized the patients depending on their risk levels for timely treatment.
The mobile solution proposed a pro-active, cost-effective platform for rapid health service for pregnant mothers and neonates with reduced manpower.
