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Last month, I wrote mHealth: the Possibilities of the Personal about the importance of capitalizing on people’s personal attachments to and investments in their cellphones as a key to making mHealth programs scalable and widely successful. Then I went to Accra, Ghana for the mHealth Africa Summit, which gave me the opportunity to run this idea by a number of my colleagues from Ghana, Malawi, Kenya, and many other countries throughout Africa.
Like the mHealth Summit in Washington, D.C. in November, the Accra gathering was well-organized and filled with energy. It was also much smaller. This meant that the conversations were intimate and impassioned, and as expected, much more personal. As my colleague Piers Bocock at Management Sciences for Health pointed out in his blog, this conference offered great examples of country ownership. Like Piers, I, too, learned far more at this inaugural and important conference than I felt able to teach. It also offered me a great opportunity to hear more about the ways mobile phones were already being used by health workers, which I think is key to mHealth’s success, traction, and scalability.
For many of us who are deeply immersed in information and communication technology and development, the appeal of mobile phones is the ease with which you can connect. In Accra, however, I heard a striking example of how health workers are already using mobiles to do their work, which had little to do with this connectivity at all. In the United States, many of us own or use multiple electronic gadgets: a camera, a phone, a laptop, an iPod, an iPad… the list goes on. But in many developing countries, the mobile phone is a true convergence of devices, and as such, it is being used in many different ways.
For many people in developing countries, the mobile phone isn’t just their first phone, or their first computing device, but it is also their first camera. While in Accra, I heard the story of health workers in Ghana, Malawi, and other countries who are using their phones to photograph unusual skin diseases and other physical symptoms. They then turn to online services to diagnose these unknown maladies in their patients by comparing the photo with information they can find online. It is an industrious approach, and one I had not heard of before. Yet, I also learned that health workers are frustrated that there are not currently stronger systems in place to receive these images and support their diagnostic needs. But it seems like exactly the type of project an mHealth program could support in a way that is relatively simple and scalable. It would be a program that is driven by the expressed need on the part of the health worker rather than a top-down approach. Many health workers would need less training because they are already using a similar approach, and peer-to-peer mentorship could be established to reinforce the practice. A telehealth expert center could be created to receive the images and provide diagnostic support, track and map particular incidents, and provide epidemiological surveillance for particularly serious or virulent presenting symptoms. Compared to many of the mHealth programs I have heard of, this could be a low-cost, high-value system strengthening activity.
This is but one example of the real uses of mHealth that are already emerging.
For me, the second takeaway message from Accra was the innovative and growing power of the private sector in Africa. Dr. Ladi Awosika, CEO of Total Health Trust, one of the largest HMOs in Nigeria, talked about the ways mHealth technologies are being used in the private sector provider network, and how they may be expanded in both the public and private sectors. For example, he focused on how the emerging mBanking technologies in Africa can be combined with mHealth programs to support health insurance and other provider payments. With health financing a topic of increasing interest, the growing African private sector may offer some innovative solutions for ministries of health and other public sector offices to consider.
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