What is the real world experience of using new technologies to support grassroots healthcare delivery? This was the question at the core of the health panel.
Moderator: Dr. Loren Triesman, Executive at Indigo Trust, who has developed strategies, consulted on, and managed a wide variety of health programmes in East Africa and the UK.
Dr. Ashifi Gogo, CEO of Sproxil, a for-profit enterprise which delivers authentication to pharmaceutical products, and that allows customers to check whether their medication is genuine before purchase and without charge.
Ida Jooste, Project Manager at Internews in Kenya, which trains journalists in health journalism and conflict sensitive journalism as well as introducing platforms for citizen journalism engagement.
Anna Kydd, Director of SHM Foundation and co-founder of two projects using group SMS to help those with HIV/Aids; Zumbido, was a support network for those living with HIV/Aids in Mexico and Kopano helps prevent mother-to-child transmission of HIV in South Africa.
Gustav Praekelt, founder of Praekelt Foundation which incubates scalable mobile technologies and solutions to improve health and well-being of people living in poverty in sub-Saharan Africa.
With a large, and increasing, number of mobile phone users in developing world countries there is great scope for utilising mobile phones to improve health services and information. Information is both being disseminated to users and collected from users, and projects are working with multiple mobile channels from simple SMS to smartphone apps to reach their audiences. However there are challenges such as cost that are preventing some initiatives from scaling-up.
Lessons from the field
mHEALTH – small ‘m’, big ‘HEALTH’
Solutions need to be user-friendly, appealing and aim to engage the health community as well as the ‘tech community.’
- Both mobile phone platforms for health and journalism on health issues should be science and facts-based.
- Although new technologies present opportunities for improving healthcare in developing countries, the quality and success of health services relies on the people providing the care; they are the change-makers, not the technology, and there is a need to invest in people and teach skills so that the platforms being develop are used.
- Platforms can be developed that do not need training. YoungAfricaLive of Praekelt Foundation is an easy-to-navigate social website and information service. It also does not use HIV in its name, even though raising awareness of HIV is part of its mission, as many of the young people it aims to reach do not associate with the word.
- It is important to provide information in an easily understandable format for users. For example Sproxil SMS messages’ first line is ‘NO’, ‘FAKE’ or ‘OK’, none of which require a high literacy level to understand.
- Solutions can involve stakeholders other than those requiring health services. For example Sproxil is financed by pharmaceutical companies. Internews helps to train journalists in health reporting and thereby reduces stigmatising media coverage around health issues such as HIV.
- It is important to factor in the cost element in order to reach people.
“Corn-starch doesn’t cure malaria”
New technology platforms are vehicles to provide and collect accurate and up-to-date information, which is at the core of many health development projects.
- There are many platforms supporting on-the-ground healthcare services such as allowing patient registration from mobile phones, sending SMS reminders to take medication, supporting healthcare workers and providing information on available medical treatment, for example Cell.Life and CommCare HQ.
- Access to platforms for healthcare issues is exposing ignorance around health issues and allowing accurate information to be disseminated. For example SHM Foundation have dispelled some myths around HIV/AIDS through their group SMS projects and although YoungAfricaLive does not restrict the user-uploaded content on the website, it does respond to inaccurate information and has a SexPert page to answer questions on sex. Sproxil is promoting genuine medicines not counterfeit ones made ‘of corn-starch’ and is receiving a variety of health questions from customers.
- The networks created by some of these platforms enable a model of user to user advice, support and information rather a top-down model.
- Mobile platforms are being used to supply and collect accurate information to and from different points in healthcare systems. For example, ChildCount collects and monitors information on the individual level, and Matt Berg spoke of registering and mapping facilities such as location of clinics and whether they have electricity.
- Using information collected can help inform health policy.
- It is important to share data, such as OpenMRS aims to do; to have access to government data as allowed by Kenya Open Data; and to collect more data where gaps exist.
- Gaps between different stakeholders need to be bridged – patients / end users, healthcare workers, pharmaceutical companies, journalists and government.
- There is also a need for more user-centred research and evaluation of outcomes.
- It is important for people, including funders, to explore what tools are out there before creating or investing in new ones.
- There is more that can be done to adapt successful existing technology tools for health problems other than those they were developed for.
- The cost of SMS and technology systems can inhibit projects, as can lengthy and repetitive negotiations with network providers that are different in each country and have no incentive to reduce costs to users.
There are other barriers to these services such as the gender gap: in Africa women are 23% less likely to own mobile phones than men. If you’d like to find out more about this and other issues, all the speaker videos from this panel are available to view here.
Thanks to Daisy Wakefield, Aphra Sklair and Deanna Laforet of the Institute for Philanthropy for producing these notes.