Mobile + Health In Developing Countries

March 1, 2011

11:48 am

Developing countries, sometimes with the assistance of Western NGO’s, are experimenting with mobile phones to solve tough healthcare problems. Mobile phones offer a few compelling advantages: They are cheap, don’t need an Internet connection to transfer data, and just about everyone has one. Here are a few examples of how mobile and healthcare are coming together.

Drug Compliance
Tuberculosis drug compliance is often challenging, in that the six-month drug regimen usually relieves symptoms within two months but the drugs side effects – mainly nausea– may persist for the full course. Thus, many patients quit the regimen early and expose themselves and others to antibiotic-resistant TB.

SIMPill is a pill bottle that, when opened, sends a notification via cell towers to a central server that keeps track of the patient’s drug compliance. Should the bottle not be opened on schedule, the server calls the patient to remind them to take the medication. After that, the system may send an alert to the caregiver. In a ten-month trial in 2006-2007 among 155 TB patients in South Africa, SIMPill reported drug adherence of 86-92% with a treatment success rate of 94%.

Mobile + Health2


Researchers at the Innovations in International Health project at MIT devised a litmus-like paper that, when exposed to urine containing TB drug, reveals a special code. When the patient texts-in the unique code for 30-days in a row, he or she receives free cell minutes added to their account. Early trials are reported as promising.

Remote Clinic Supply Chain
Eleven million cases of malaria exist in Tanzania, resulting in 60,000 – 80,000 deaths a year. Many are due to ‘stock-outs’ — when a remote clinic runs out of medicine –causing delays in treatment. Recently, IBM and the Tanzania Ministry of Health piloted an SMS-based system to notify central authorities when medicine stocks were running low. Clinic workers texted-in stock levels and IBM’s data center and message routing/tracking system in London, England managed the data.

In a 21-week program, stock-outs among clinics in three remote districts were reduced, on average, from 79% to 25%. The pilot covered 13,500 data points from 129 health clinics in Tanzania.

Public Health

In South Africa, “Beeping” is the practice of calling someone, hanging-up before they answer, and letting caller ID communicate to the recipient that they should call you back – using their cell minutes. Because this practice constituted roughly 20-30% of all call traffic, carriers started allowing free “Please Call Me” text messages. Local NGO’s asked South African carriers to place HIV-testing PSAs on the end of the “Please Call Me” texts, with great success.

In a six-week trial, LifeLine Southern Africa saw a 136% increase in calls for HIV requesting counseling. The other NGO, HIV911, saw 98% of their calls come from the texting initiative, and of those callers, 41% subsequently accessed HIV services.

In Kenya, an NGO called Text to Change teamed up with a local employer, Zain, to help educate Zain’s employees about HIV information and testing. Employees received periodic SMS quizzes about HIV topics and prizes were awarded for correct answers. Each question session ended with directions to the Zain-sponsored HIV testing center.

Using mobile phones to deliver healthcare is on the rise, as healthcare providers look for better ways to connect with patients and caregivers. In the West, the next few years will show if users will find value in health-by-mobile or not.

Guest writer Douglas Naegele is President of Infield Health, a US firm that brings people closer to healthcare via mobile phones. In addition, he’s hosting a panel at SXSW 2011 titled, “Mobile Health in Africa. What can we learn?”

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