MobileActive.org

The number of mobile phone subscriptions has increased by approximately one billion between the end of 2007 and the end of 2008 (ITU, 2009).  At the beginning of 2009, the number has surpassed four billion.  With this, the use of mobile phones and networks in the mobile health has become increasingly popular in low- and middle-income countries, including Ghana where a broad range of mHealth initiatives are now being implemented. 

This offers many opportunities to translate information and communications technology into gains, particularly for fighting disease and improving population health.  This mHealth Ethnography serves as a critical entry point to both assess the initial state of information, communication, and mobile phone use for maternal and newborn health both within the health sector and the general population in the Dangme West District in the Greater Accra Region of Ghana. 

Key study findings illustrate that there is a strong foundation upon which the MoTECH Project can build to advance the use of mobile telephony to support the achievement of the Millennium Development Goals for health.  These can be divided into two broad categories – those within the health sector and those that extend services to target beneficiaries in the general population. 

This report explores the ways in which non-
governmental organizations (NGOs) and
other groups deploy and use mobile
technology in their work to help solve some
of the world’s greatest problems. This study
is not meant to be exhaustive or definitive,
but rather to provide a view into how a
number of organizations are using mobile
technology to achieve social impact. The authors
selected case studies that enabled an
exploration of significant innovations,
opportunities, and emerging trends, as well
as the obstacles, in the use of mobile
technology to advance social goals.

Mounting interest in the field of mHealth—the provision of health-related services via mobile communications—can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the ‘digital divide,’ billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services—even in some of the most remote and resource-poor environments.

This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth’s scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth’s full potential. The report is organized into the following sections:

• 1. Identifying the potential of mobile phones to improve health in the developing world 
• 2. Defining mHealth within the context of eHealth 
• 3. Meeting health needs through a broad array of mHealth applications 
• 4. Examining the impacts of mHealth projects 
• 5 Assessing mHealth and future health needs in developing countries 
• 6. Identifying the building blocks for sustainable and scalable mHealth programs 
• 7. Understanding the incentives for multiple players: mHealth value chains 
• 8. A call for action 
• 9. Looking forward 
• 10. Compendium of mHealth projects

Every year almost 10 million children die before reaching
the age of five despite the fact that two-thirds of these
deaths could be prevented by effective low-cost
interventions. To combat this, the World Health
Organization (WHO) and UNICEF developed the
Integrated Management of Childhood Illness (IMCI)
treatment algorithms.
In Tanzania, IMCI is the national policy for the treatment
of childhood illness. This paper describes e-IMCI, a system
for administering the IMCI protocol using a PDA. Our
preliminary investigation in rural Tanzania suggests that e-
IMCI is almost as fast as the common practice and
potentially improves care by increasing adherence to the
IMCI protocols. Additionally, we found clinicians could
quickly be trained to use e-IMCI and were very enthusiastic
about using it in the future.

Efficient electronic medical record (EMR) storage and retrieval
systems for treating the millions of HIV/AIDS and tuberculosis
(TB) patients in the developing world is largely an unsolved
problem. One attempt at addressing this need is the Open Medical
Record System (OpenMRS) – a framework that provides a free
and flexible EMR system for resource-constrained environments.
Although OpenMRS is a step in the right direction, implementers
of such systems face a question that is largely unanswered by
previous work. Where in the existing paper-based workflow can
such plastic technology be injected and how does one evaluate the
efficacy of this intervention?

In this paper, the authors describe the role manual processes have played
in a rural hospital in Rwanda and how they determined where to
implement appropriate technology solutions of these challenges through an open source framework that provides a free and flexible electronic medical record system
(EMR) for resource-constrained environments. In this
paper, the authors describe the role manual, paper-based processes have
played in a rural hospital and how they determined where to
implement appropriate technologies.

Reliable communication systems are one of the key success factors for a successful first response mission.
Current crisis response communication systems suffer from damaged or destroyed infrastructure or are just
overstressed in the case of a large scale disaster. We provide an outline for a distributed communication
approach, which fulfills the requirements of first responders. It is based on a layered network topology and
current technology used in research projects or already established products. In addition, we propose a testing
framework for the evaluation of a crisis response communication system

This paper examines the design process of the health communication process within the framework of the ICT-for-healthcare-development model (ICT4HC) (Author, Lwin, Ang, Lin, & Santoso, 2008). The paper analyzes the planned deployment of an ICT4H project that introduced a mobile telephony-based system to a specific group of users, rural midwives, and examine the myriad impacts and constraints that arise. The broad research question the paper aims to answer pertains to the design and evaluation of mobile phone-based ICT4H projects using a generalizable theoretical frameworks, specifically the ICT4HC model.

Nearly 40 million people in Africa suffer from HIV/AIDS. African governments and international aid agencies have been working to combat this epidemic by vigorously promot- ing Highly Active Anti-Retroviral Therapy (HAART) programs. Despite the enormous subsidies offered by governments along with free Anti-RetroViral (ARV) drugs supplied by agencies, the introduction and implementation of HAART programs on a large scale has been limited by two fundamental problems: (a) lack of adherence to the ARV therapy regimen; (b) lack of accountability in drug distribution due to theft, corruption and counterfeit medication. In this paper, we motivate the case for SmartTrack, a telehealth project which aims to address these two problems facing HAART programs. The goal of SmartTrack is to create a highly reliable, secure and ultra low-cost cellphone-based distributed drug in- formation system that can be used for tracking the flow and consumption of ARV drugs in HAART programs. In this paper, we assess the potential benefit of SmartTrack using a detailed needs-assessment study performed in Ghana, using interviews with 516 HIV-positive rural patients in a number of locations across the country. We find that a system like SmartTrack would immensely benefit both patients and healthcare providers, and can ultimately lead to improved patient outcomes and better accountability.

Starts page 458.

This paper examines two parallel case studies to promote remote medical consultation in Ghana. These projects, initiated independently by different researchers in different organizations, both deployed ICT solutions in the same medical community in the same year. The Ghana Consultation Network currently has over 125 users running a Web-based application over a delay-tolerant network of servers. OneTouch MedicareLine is currently providing 1700 doctors in Ghana with free mobile phone calls and text messages to other members of the medical community. We present the consequences of (1) the institutional context and identity of the investigators, as well as specific decisions made with respect to (2) partnerships formed, (3) perceptions of technological infrastructure, and (4) high-level design decisions. In concluding, we discuss lessons learned and high-level implications for future ICTD research agendas.

This paper presents our work in the design of a
SDS for the provision of health information to caregivers of HIV
positive children. We specifically address the frequently debated
question of input modality in speech systems; touchtone versus
speech input, in a new context of low literacy users and a health
information service. We discuss our experiences and fieldwork
which includes needs assessment interviews, focus group sessions,
and user studies in Botswana with semi and low-literate users.
Our results indicate user preference for touchtone over speech
input although both systems were comparable in performance
based on objective metrics.

This assessment, commissioned by the United Nations Children's Fund (UNICEF) in South Africa and implemented by Women's Net, aims to provide baseline data that will inform a a strategy to launch a new generation of cell phone technologies to address underdevelopment and in particular, HIV/AIDS as a development issue. The rapid assessment consists of an assessment that will be used by UNICEF as a baseline to inform and kick start further discussions and strategy development with key stakeholders for the potential scaling up of cell phone technology usage in projects with a development agenda. The long term objective of this activity is to support the government and civil society programs to leverage partnerships with companies developing cell technologies and other related service providers to develop a comprehensive strategy and plan for monitoring treatment adherence, providing information on sexual health including help lines and services and prevention messages by the use of technology.

This presentation provides three examples of mobile projects at the CDC: HIV Testing Centers Via SMS, mobile alerts from the CDC.gov web site, and mobile technology for Diabetes Management. The goals of the talk held during the Texting4Health conference in February 2008 were to share examples, results, and learning as well as to generate questions.

This presentation provides insight into current mobile health initiatives and the current global health landscape. The presentation outlines the Thai system as an example of health informatics in resource poor setting, and introduces areas of global health and SMS application. Rwanda's implementation of TRACnet and public health for monitoring of the national HIV/AIDS program is used as an example. The presentation focuses on developing a framework for mobile computing in global health, including: standardizing Health Metrics (HMN), standardizing approaches, and integrating SSM into broader public health information systems and enterprise health information architecture. The report concludes with a look into SMS applications in emergency response, program monitoring and reporting, and patient monitoring. Key challenges are listed.

This paper takes a look at the potential evolution of mobile technology and services over the next ten years and discusses an mServices framework for building and deploying diverse mobile services. The paper also looks at the challenges of such an endeavor and the steps needed to achieve the vision.

The report suggests how mobile devices will be used for much more than voice communications in the coming years in mHealth, mGovernance, mEnterprise, and mPublic Safety. Supporting the projections are: a mapping of mobile penetration, mobile ecosystem dynamics and deployment and adoption of mobile technology in the developing world. The report summarizes the building blocks of a mobile services platform and concludes with an emphasis on public-private partnership and the innovative business models that will accompany these changes.