Digital communications and media are now part of everyday life for many people around the world. But while people have turned to smartphones for entertainment, socializing and commerce, the health community is still working to make services, outreach and treatment digitally accessible. Examining successful applications allows us to understand what approaches might be possible for digital health services. During the COVID-19 pandemic, it is more crucial than ever that digital health resources provide support for people to access from their homes.
FHI 360’s Mobile for Reproductive Health (m4RH) project has been nominated for a prestigious 2013 Katerva Award, which recognizes “the most promising ideas and efforts to advance the planet toward sustainability.” This nomination adds to the considerable recognition that this innovative mHealth information service has already received. In June of this year, m4RH was one of ten recipients of the first African Development Bank eHealth Awards. Just a year earlier, Women Deliver 50! selected m4RH as one of the top 10 innovative technology programs supporting women and girls.
The Katerva Award nomination highlights m4RH’s innovative packaging of reproductive health information and behavior change components in a single mobile phone technology. Using mobile phones, m4RH disseminates family planning information to the general public, as well as information on the nearest clinic that offers these services. One of the few text-messaging services globally that provides family planning information as a means of education and behavior change communication, m4RH has revolutionized the concept of informed choice in the provision of family planning information. With m4RH, any person with a mobile phone can access standardized, essential and comprehensive information in simple language. One user said, “m4RH is using terms you can understand, it has clear knowledge on what you want to know. It is simple to understand, simple language that everyone can understand.” Given that more than 85 percent of global citizens have mobile connectivity, the potential impact of this simple service is truly exciting.
A version of this post originally appeared on K4Health’s Blog. Reposted with permission.
Are there more mobile phones than toilets in some places? Yes, in some developing countries, that’s true. This was one of the take-aways from the mHealth Summit that took place last week in Washington, DC, where over 3,800 people gathered to hear about the fast-growing health-related mobile phone industry. The Summit featured for the first time this year a Global Health Track that focused solely on mobile health interventions and lessons learned from developing countries– lack of access to care, providers without the necessary knowledge or information to do their job properly, and stockouts of supplies and medicines.
Patty Mechael, Executive Director of the mHealth Alliance, said in her introductory remarks on the first day of the conference that “more people in developing countries have access to mobile phones than clean water or bank accounts,” things we take for granted. What a possible game changer for health in developing countries if mobile phones can be used to leverage access to health care.
The number of doctors in Africa is woefully low, and there exists a game-changing opportunity to use mobile phones with front line health workers to improve patient care. According Sandya Rao, Senior Advisor of Private Sector Partnerships in the Office of Health, Infectious Diseases and Nutrition at USAID, working with frontline health workers is the “most immediate and cost-effective way to save lives and improve health”, quoting the Frontline Health Workers Coalition. The challenges of frontline health workers include inadequate training, inadequate performance incentives and weak health systems. Many different approaches to using mobile phones with health workers exist and are working. The successful ones have benefited from stakeholder inclusion in design and taking a holistic systems approach. According to Alain Labrique, Director of the Johns Hopkins University Global mHealth Initiative, countries can “recognize the individual, support disconnected frontline health workers, engage the community, and make the invisible visible.”
In her keynote address at the 2012 mHealth Summit, which for the first time included a Global Health Track, mHealth Alliance executive director Patty Mechael said that mHealth has “transitioned from a novel idea to a strategy for global health.” She also said that 2013 would be the “year for scale,” to which I would add the ‘year of integration’, because mHealth is increasingly being applied as a game-changing approach for empowering individuals as well as strengthening health systems. There is an evolution along at least two dimensions: from initial pilots to programs with broad national or multi-regional reach, and from single-solution applications to multi-function catalysts of health system interventions.
For example, in the category of client-centered mHealth, the Mobile Alliance for Maternal Action (MAMA) provides free or low-cost text (SMS) or voice messages for pregnant women related to each stage of pregnancy and a baby’s first year. In Bangladesh, MAMA is known as Aponjon, which means “close friend.” Aponjon service was launched in September 2011 in four districts with 1,000 subscribers. It started to scale nationally in August 2012, with the aim of reaching more than two million mothers by 2015.
In “Health Workforce Capacity Development,” iHeed CEO Dr. Tom O Callaghan noted that each year, approximately 160,000 doctors are trained in Europe for a population of around 1 billion people, while in Sub-Saharan Africa for the same population size about 5,000 doctors are trained. Over the past 20 years, about 500,000 community health workers (CHWs) have been trained across Sub-Saharan Africa at a very high cost. Yet, there are 700 million mobile phones in Africa, about a billion people on Facebook, 300 million on Skype, and cheap tablets are increasingly available. “Aspirations to train another 1,000 or 10,000 CHWs seem very bland compared to the scale being achieved by other technology ventures,” O Callaghan said, suggesting that mHealth can aim much higher, training health workers and supporting their performance in innovative ways. In fact, emerging evidence indicates the potential of mHealth to positively impact multiple aspects of health systems, including adherence to treatment guidelines, supply chain management, and data collection and reporting.