Africa Wired

Texting your way to health:
UN launches ‘mHealth’ initiative to fight diseases

The government of Nigeria sends out SMS text messages to raise awareness about the dangers of HIV/AIDS.

Photo: Panos/Jacob Silberberg

Imagine getting a text message telling you when and how to take your diabetes medication. Or a voice mail reminding you of your next mammogram. That’s what two UN agencies are hoping to do with mobile technology to save lives, reduce illness and disability and bring down healthcare costs.

Increased access to communications technologies has given rise to the concept of “mobile health,” or mHealth, involving the use of mobile phones for healthcare purposes. The World Health Organization (WHO) and the International Telecommunication Union (ITU) are currently testing mobile solutions to help people with non-communicable diseases (NCDs) like diabetes, cardiovascular maladies, respiratory diseases and cancer to better manage their conditions. The agencies also hope to encourage people to quit smoking, exercise more and eat healthier. 

An estimated 36 million people die every year from NCDs in both developed and developing countries alike, according to WHO. They also account for a major share of health care needs and expenditures. In the next decade deaths from NCDs in Africa will jump by 24 per cent, the agency forecasts. 

ITU Secretary-General Hamadoun Touré believes that these diseases can be controlled through the intervention of mHealth initiatives. “Technological innovations are changing the landscape of disease prevention and control,” he said. “The widespread availability of mobile technology, including in many of the least developed countries, is an exceptional opportunity to expand the use of e-health” (which includes computer, Web, mobile phone and other electronic technologies). He was speaking in Dubai at Telecom World 2012, a yearly event at which experts, policy makers and leaders come together to share ideas on the future of global telecommunications.

The initiative builds on current projects like WHO’s use of mobile devices to gather data on tobacco use in 17 countries, covering half the world’s population. Mobile phones have also been shown to help health care providers offer better care and deter harmful practices. In Kenya, according to a recent study, government health care workers were sent text messages coaching them on the proper malaria-treatment protocol. Health clinic workers can send alerts when they run low on medications to avoid stock shortages. 

By early 2012, says ITU, there were more than 6 billion mobile phone subscriptions worldwide, with developing countries accounting for the lion’s share of growth. In that context, mHealth could be one of the best ways to reach huge numbers of patients and care providers. 

However, warns Harsha Thirumurthy, an economist whose research focuses on the link between health and economic outcomes in low-income settings, several aspects of the mHealth interventions warrant further research. In the Bulletin of the World Health Organization, he and Richard T. Lester strongly recommend a more thorough investigation of how text-messaging interventions compare with other interventions such as feeding programmes or home visits by community workers. They also bring up issues of cost — who will foot the bill remains unclear. If not the health care providers, are patients willing to pay for the service? Furthermore, it remains to be seen if mHealth can help induce behavioural change and get people to better adhere to treatment regimens for diseases like malaria and tuberculosis.

Huge leap in African ICT development

Three African countries have made the most progress in adopting information and communications technology, according to a new report by the International Telecommunications Union (ITU). In its annual flagship report, Measuring the Information Society 2012, the UN agency notes that Rwanda, Kenya and Ghana have increased efforts to bridge the so-called “digital divide.” 

Meanwhile, the overall cost of ICT services is down by 30 per cent, reports the agency. Although fixed-broadband Internet services showed the biggest decline in average prices, by 75 per cent, mobile broadband continues to display the sharpest growth. Over the past year, mobile broadband grew 40 per cent worldwide and 78 per cent in developing countries, the report notes. 

Despite the surge in mobile- broadband subscriptions, notes Brahima Sanou, director of ITU’s Telecommunication Development Bureau, prices still remain too high in low-income countries. “For mobile broadband to replicate the mobile-cellular miracle and bring more people from developing countries online,” he says, “3G network coverage has to be extended and prices have to go down even further.”

Meanwhile, Rwanda continues to enjoy its standing as number one in East Africa, as ranked by the UN Broadband Commission for Digital Development. In 2012 it took seventh place among all African countries with active mobile-broadband subscriptions. Rwanda’s policy is to increase mobile connectivity in rural areas and make it affordable to the masses. A government-run portal, the Rwanda Development Gateway, says that the country is “determined to take full advantage of the digital revolution” to grow the country’s economy. 

Using mobile apps to spur social change

New mobile phone applications are making it easier for citizens to alert officials to problems, expose corruption and prompt reforms.

Photo: Africa Media Online / Sandy Bailey

Want to report a problem to an elected official in your community? There is a mobile application, or “app,” for that. Want to bring attention to a pothole that needs fixing? There’s an app for that too. With the explosion of mobile phones in Africa, Africans are catching the app fever. (An app is a piece of software that can run on electronic devices like mobile phones, computersor MP3 players). 

In Kenya, under the slogan “fix my community,” people are using an app named Huduma to denounce inadequate or missing public services. With it they can send a text message from their phones to alert elected officials and community activists to problems such as broken water pipes or report a doctor who is absent from a public hospital. Huduma’s popularity has grown to the point that members have meet-ups, organized through the social-networking tool Facebook, to talk about pressing issues. The citizen-driven platform, created by the Kenyan-based company Sodnet-Infonet (Social Development Network Innovations), has recently been extended to Uganda, Mozambique and Nigeria. 

Another app that is changing how ordinary Africans interact, connect and engage with their educational system is Not in My Country. The Ugandan-based user-generated platform, relying on data contributed by individual website users, is an untraceable and anonymous online space to report corruption at university campuses. Since reporting corruption can be risky, the founders of Not in My Country hide their identities, but remain active on social media sites like Facebook and Twitter to encourage audiences to report incidents — and thus improve the quality of higher education in Uganda.