Mobile health initiatives: an important lesson for Southeast Asia

Mobile phones are increasingly being used to access health services, particularly in South Asia and parts of Africa. As the effects of mobile health initiatives on health outcomes have been positive, information sharing in the healthcare sector of developing countries can contribute toward more effective and sustainable healthcare systems and services.

The opportunities for mobile health initiatives are vast in Bangladesh for instance, where about 60 per cent of the population – approximately 85 million people – use the mobile phone. Patients can now get free advice from health workers and daily prenatal health alerts through the mobile phone. Should they be unsatisfied with the health services provided, patients can also file complaints through their phones. The complaints and suggestions from the public are received by a web-server which routes them by e-mail to the head of the hospital.

Mobile healthcare has gone one step further in India where mobile phones are used to monitor healthcare workers’ attendance. Through a project initiated by the Indo-Dutch Project Management Society (IDPMS), patients can now send text messages reporting staff absenteeism, and maps of the regions where absenteeism is prevalent are then made available to fellow citizens and policymakers. The IDPMS found that villagers in rural India had limited access to health care, as doctors reported for work only two or three days in a week. Subsequently, many Indians turn to private hospitals despite the higher cost of health services. On average, more than 53 per cent of doctors and health workers are absent each day. The lack of an accountability and incentive system means that doctors are not motivated or penalized for their performance levels.

This emerging trend of mobile health can also be found in Africa, the second largest mobile market after Asia. Mobile phones have made it quicker to report malaria outbreaks from weeks to just minutes, thus encouraging a faster response time by the government. The mobile disease response programme was launched in June 2011 by Hewlett-Packard and its partners: Positive Innovation for the Next Generation, the Clinton Health Access Initiative, and mobile network provider MASCOM. Since then, over a thousand notifications of malaria data and outbreaks have been sent by health workers to the Ministry of Health in Botswana.

Furthermore, as mobile subscription continues to increase among various countries in Africa, there are many positive implications for patients in both preventive and post-treatment healthcare. In South Africa, which has the highest number of people infected with HIV in the world, locals receive text messages encouraging them to go for HIV screening through an initiative called Cell-Life. With its high mobile penetration rate of 95 per cent, mobile technology holds great potential to improve health outcomes in South Africa.

As maternal mortality remains a serious problem in most developing countries in Africa as well as Asia, mobile technology can be used to improve maternal health. However, for such mobile health programmes to be effective, it is important to first identify the different causes of maternal deaths in various countries. India accounts for about a fifth of maternal deaths that occur worldwide, yet many of these cases could have been prevented with proper healthcare and information. For instance, nearly 20 per cent of all maternal deaths in India is caused by anemia, which can be treated easily with iron and vitamin supplements.

Sharing information on and evaluating the outcomes of mobile health projects can help to improve the healthcare infrastructure in developing countries around the world. With closer engagement among government, citizens, NGOs, and the private sector, unique and innovative solutions harnessing mobile technology can be devised to tackle common healthcare problems faced by people in different parts of the world.

Sri Ranjini Mei Hua is research associate at the Institute of Southeast Asian Studies.