MobileActive.org

This White Paper, written by a team of researchers at the Center for Global Health and Economic Development at the Earth Institute, Columbia University, examines and synthesizes the existing mHealth literature to assess the current state of mHealth knowledge, evaluate the impact of mHealth implementations in LMICs and to examine programming, policy and research-related barriers to and gaps in mHealth scale and sustainability.

The paper is divided into two main sections. The first section reviews and summarizes the peer-reviewed literature on mHealth initiatives (focus on LMICS) to highlight trends and challenges. The second section examines the existing mHealth policy environment, barriers and gaps, and key drivers needed for an enabling policy environment.

The major thematic areas include:

• Treatment Compliance
• Data Collection and Disease Surveillance
• Health Information Systems and Point of Care Support
• Health Promotion and Disease Prevention
• Emergency Medical Response

The review identified significant gaps in mHealth knowledge stemming from the limited scale and scope of mHealth implementation and evaluation, a policy environment that does not link health objectives and related metrics to available mHealth tools and systems, and little investment in cost-benefit studies to assess mHealth value and health outcomes research to assess success factors and weed out poor investments.

Access to telephony for low-income groups is largely based on different strategies of mobile telephony usage. The main goal of this research project is to explore the strategies employed by the poor in Latin America and the Caribbean to access and use mobile telephony services, as well as to identify the major market and regulatory barriers for increased penetration and usage. More generally, it seeks to contribute to the discussion on how access to mobile telephony contributes to improving the livelihoods of the poor –what we call mobile opportunities.

Our results show that mobile telephony is highly valued by the poor as a tool for strengthening social ties and for increased personal security, and that it is beginning to prove useful for enhancing business and employment opportunities. Overall, the survey results suggest that the acquisition of mobile phones by the poor has an economic impact reflected mainly in improved social capital variables such as the strengthening of trust networks and better coordination of informal job markets. These findings reveal the continued need to develop innovative business models that extend the market frontier for mobile telephony. They also highlight the urgent need to rethink public policies that are premised on the mobile phone as a luxury good. Clearly, for the poor, mobile telephony has long been the most cost-effective and accessible alternative.

This study reports results of an ethnographic action research study, exploring mobile-centric internet use. Over the course of 13 weeks, eight women, each a member of a livelihoods collective in urban Cape Town, South Africa, received training to make use of the data (internet) features on the phones they already owned. None of the women had previous exposure to PCs or the internet. Activities focused on social networking, entertainment, information search, and, in particular, job searches. Results of the exercise reveal both the promise of, and barriers to, mobile internet use by a potentially large community of first-time, mobilecentric users. Discussion focuses on the importance of selfexpression and identity management in the refinement of online and offline presences, and considers these forces relative to issues of gender and socioeconomic status.