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What makes a mobile health project successfuly grow? What causes so many m-health projects to wither or fail? And what can practitioners learn from existing m-health projects to build growth into programs for the future? "Scaling Up Mobile Health: Elements Necessary for the Successful Scale Up of mHealth in Developing Countries" examines these questions by looking at nine case studies on successful mobile health projects and pulling out the key strategies that led to successful growth. 

The case studies cover a wide array of health issues, including maternal and early childhood health (ChildCount+, Pesinet, Project Mwana, Tele Salud), medication stocking and verification (mPedigree, SMS for Life), disease outbreak monitoring (mTRAC), and HIV/AIDS awareness (SMS for Health, Txt Alert); the report details how the projects deal with issues like local buy-in, scale, and sustainability. "Scaling Up Mobile Health" is broken up into three sections: case studies, best practices, and recommendations for future m-health projects.

The main lessons from the report focus on what has worked within the highlighted case studies and what is needed for future m-health projects to be successful. Below is a summary of the key points and takeaways from the report:

• Building local capacity and fostering local buy-in are linked; encouraging in-country design and use gives a sense of ownership to users and makes it easier to resolve tech problems.
• Plan for scale and sustainability from the start rather than building only for a small area/sample size. It will be hard to expand if there isn't the technology, money, or support to continue the project.
• Learn what's worked before: what problems have similar projects faced? How did they resolve them? Learning from previous experiences can stop the cycle of failure and can increase the chance of a new project's success.
• Design the project with the end user in mind. It must work within the local context, including being user-friendly and cost-effective. Working with end users during the design and development process ensures that the project will reflect what they want and need and will encourage ownership among users.
• Align the project with local and national programs, and integrate it with existing healthcare structures. Collaborating with local implementers can also help increase buy-in from the community because it shows the project is engaging with the community. There is a need for partnerships, both with private industries (like telecoms) and government partners.
• Build the project with a business model in mind – how will it grow? How will it be marketed and promoted within the community and among users? What does it need to go to scale and become sustainable?
• Set clear goals and plan for regular monitoring and evaluation. Early monitoring and evaluation can identify problems and missteps before they derail a project.

The report provides a roadmap for mobile health projects. Repeating failures and continually launching unsustainable and unscalable projects wastes time and money; "Scaling Up Mobile Health: Elements Necessary for the Successful Scale Up of mHealth in Developing Countries" highlights the best practices that have led to long-term, well-received, mobile health initiatives.

MobileActive.org has covered several of the organizations in the report. Check out our mDirectory for coverage on ChildCount+, Pesinet, mPedigree, mTrac, and TxtAlert.