Mobile health: transforming the face of health service delivery in the African Region
A new wave of mobile technology is having a dramatic impact on the way health care is delivered to both urban and rural communities in the African Region.
Known as mHealth, mobile health technology has a tremendous potential to strengthen health systems in low and middle-income countries through better access to knowledge and information, improved service delivery and reduced response time during crises.
For the past decade, the lack of a stable internet and telephone network in developing countries has hampered the use of eHealth to improve access to health care. Nowadays, a rapid explosion in mobile technology, particularly in the African Region, is finally making a number of eHealth initiatives possible via mobile networks and devices. The penetration of mobile telephone networks in many low and middle-income countries now surpasses other infrastructure such as paved roads and electricity, and dwarfs cable internet deployment.
The advantages of mobile technologies are numerous: wide availability and accessibility, cost effectiveness and portability are just a few. With the support of WHO and other partners, several countries in the Region are integrating mobile phones in a range of promising health applications: promotion of vaccination campaigns, monitoring TB treatment adherence; communicating test results and monitoring patients’ conditions; tracking malaria prevention and control efforts; delivering behavioural change messages to improve awareness and reinforce healthy behaviours, etc.
A powerful tool for disease prevention and control
Mobile phones are currently used in connection with a wide range of public health initiatives. Several examples in the African Region show how mHealth is changing the landscape of disease prevention and control:
In Ghana, mobile phone technology, available even in remote communities, has proven to be a valuable tool to help bridge the gap between access to health information and service provision. The Mobile Technology for Community Health (MOTECH) initiative, focused on improving maternal and child health, uses mobile phones to increase access to and demand for health information and services among rural women, while also providing data on health service delivery and outcomes to the Ghana Health Service.
Kenya, known for its leadership in mobile phone money transfer, now has a system which enables residents with a mobile phone to download a locally-developed application that allows them to determine if a doctor or clinic is genuine. By simply sending an SMS, the user is shown up-to-date lists of licensed medical professionals and approved hospitals, starting with those nearest to him or her.
In Mozambique, SMS reminders and educational messages sent to HIV positive persons, including HIV positive pregnant women, help to improve HIV treatment adherence and prevention of mother to child transmission of HIV.
In Nigeria, the SMART programme strengthens early infant HIV diagnosis services by reducing the turnaround time for test results by more than half. Nearly every district in Nigeria has network coverage for mobile telecommunication, even in remote areas lacking roads and electricity. Using mobile SMS technology and small battery-operated printers, health facilities can receive and print test results without having computers and Internet access.
In South Africa, the MAMA SMS service gives support to pregnant women and new mothers through an evidence-based free messaging service that extends the support provided at health facilities. The service provides pregnancy, postnatal and baby care information to women in their preferred local language.
In Rwanda, in order to strengthen community-level and facility-based maternal and child health interventions, RapidSMS and mUbuzima track pregnant women and newborns, promote early detection of life-threatening emergencies, and facilitate reporting on community-level indicators relevant to Millennium Development Goals 4 and 5.
At a broader level, WHO has been promoting mHealth initiatives for tobacco control, to help combat noncommunicable diseases, and to help people with diabetes to manage fasting and feasting during Ramadan – mDiabetes.
WHO mHealth Technical and Evidence Review Group (mTERG)
Leveraging eHealth to improve national health systems in the African Region, The African Health Monitor, issue 14
Prioritizing integrated mHealth strategies for universal health coverage, Science 345, 1284 (2014)
mHealth: New horizons for health through mobile technologies, Global Observatory for eHealth Series, Volume 3