3 mHealth changes in developing nations
March 18, 2013 in Medical Technology
Developments in healthcare are usually seen as a first-world matter. Talk about mobile health, or mHealth, and an image of RD trials in some suburban hospital almost immediately come to mind. But some of the most groundbreaking advances in mHealth are taking place far away from American medical facilities, and are taking root in new territories where the mobile phone has perhaps exploded in popularity faster than it did in the west.
Alain Labrique is a director of the Global mHealth Initiative at Johns Hopkins University. His program looks at ways that mHealth has advanced around the world and how initiatives take hold in developing nations. He’s noticed three trends playing out lately on the world stage.
1. Grassroots explosion. Labrique started work on a project in Bangladesh where it was “near impossible to make phone calls between sites 10-20 miles apart.” After a local telecoms firm began to invest in bringing mobile to the region, things began to speed up. “Overnight [we] went from having absolutely no connectivity to having faster connectivity in some parts than we do in East Baltimore.” Because the burgeoning mobile fields in these developing nations create their own paradigms, Labrique says that healthcare workers can just leverage what has been created to their own needs. He uses the example of how mobile banking was a precursor to mHealth technologies being used in developing nations. He says that it “leapfrogged the traditional cycle of development,” which lead to “a massive industry in sub Sahara Africa,” with tie-ins to currency transfer for payments from family members abroad and mHealth-driven micro insurance.
2. A revolution from the ground up. “People in Zambia aren’t buying smartphones for mHealth,” says Labrique. Some of the advances of mobile banking paved the way for similar health initiatives, such as having relatives abroad send payments for treatment back home. He sees this as indicative of the sort of revolution mHealth is experiencing in the developing world. It is “more of a health systems strategy at this point,” he says. “Less custom app based, more on how to make front line health workers more efficient.” Labrique describes scenarios where a pregnant woman can receive care and stay connected to health professionals before she gives birth; of sending reminders to patients to take their antiretroviral drugs. Labrique says that when you start from the beginning and a project becomes so successful, it enables lots of groundbreaking work to be done. However, he worries about the field becoming too crowded at too fast a pace. “Technology developed without appropriate contextual awareness is doomed for a short lifespan,” he says – adding that his team tries to “take a technology agnostic approach,” using mHealth to address specific problems, not the other way around.
3. Leapfrogging. “In the U.S. we have the unfortunate luxury of a massive system that is fairly difficult to use,” says Labrique. These “megalithic and monolithic” institutions that have governed payment, care, etc. are both a help and a hindrance. Developing nations that have never had a comprehensive healthcare system are able to learn from the mistakes and shortcomings of the West, says Labrique. He points to experiences in India where the nations has been able to “build new systems that not only learn from mistakes of other nation’s histories, but also integrate, don’t do things the way they were done in the west 50 years ago.” Mobile technology has a huge leveling power that has enabled developing nations to set up health records, he says, “even for people living in mud huts.”