mHealth – a healthcare perspective in Africa

The growth of mobile health care across Africa and the need for effective mobile messaging to support its delivery

 

Reaching the majority of people across Africa with effective health care has always been a major challenge. The emergence over the past couple of years of groundbreaking mobile health care – mHealthcare - services and mechanisms marks a turning point in improving the lives of Africa’s population.

 

While the growth of mobile communications and mobile broadband has enabled this development, the implementation by mobile network operators (MNOs) of the right messaging and value added services (VAS) platforms, more specifically, is essential to the delivery of the new and potentially life-saving, messaging-based mHealthcare applications and services

Across the expanse and varied geography of Africa the delivery of satisfactory healthcare to millions of people has always been a challenge. Men, women and children in remote regions in need of treatment have often had to travel – typically walking – great distances to visit a health care centre. Very often staffed by nursing professionals rather than doctors, correct diagnosis has not always been possible on the spot and therefore correct and immediate treatment has not been possible. In recent years, telemedicine has gone a long way towards improving the situation through the real-time transmission of images from field medical centres back to major hospitals where qualified specialists could advise the health worker on the ground of the correct diagnosis and course of treatment.

Now, through the advent of mobile broadband, cost-effective satellite backhaul and the unstoppable growth of smartphones, mobile health care has emerged in the past couple of years offering to change the face of effective health care delivery to the African diaspora.

mHealth – apps for real applications

Health-specific mobile service strategies driven in some cases by pharmaceutical companies trying to differentiate themselves from their competitors, and in others by public-sector health services, are adopting new approaches such as direct-to-patient relationships enabled by communications services.  SMS is already being used to remind patients of appointments or to take their medicine at the right time. The big online and mobile app developers, such as Google and Microsoft, are launching their own mobile medical apps. Google Health and Microsoft Health Vault, for example, both deliver consumer medical-record applications. Other mHealthcare services being trialed by a range of players include:

  • messaging-based drug-logistics applications,
  • disease/lifestyle-management services,
  • epidemiological studies and projects,
  • drug-verification applications.

In the latter case, a patient enquiry by SMS sends a drug serial number to a central register, which will verify if the purchased drug is fake or real.

 In Tanzania, a drug stock management project, SMS for Life,has recently been undertaken by the Tanzanian Ministry of Health and Social Welfare aimed at helping pharmaceutical company Novartis meet high demand for anti-malarials during seasonal increases in the incidence of malaria cases in the country. Together with Vodafone, the Roll Back Malaria Partnership, and IBM, the project relied on the use of SMS to track the stock levels of anti-malarial drugs in 129 of the country’s rural health centres.  Automated text messages requesting stock information were sent to health workers’ mobiles, with mobile phone credits offered as an incentive to respond. Collected by a centralised web-based program, response data was accessible via SMS, or any Internet-enabled device, by district medical officers who could redistribute drugs around the country to points of need.

At the end of six months 99 per cent of health centres had anti-malarial drugs available for use compared with 76 per cent at the start of the project. This meant that a simple mobile messaging solution to the problem had increased the number of Tanzanians with immediate access to anti-malarial treatment from 264,000 to 888,000.

At Imperial College, London, the Department of Infectious Disease Epidemiology has developed a web-based mHealth solution with corresponding smartphone app, Spatialepidemiology.net and EpiCollect.net, respectively. These are now being used in Africa and around the world, to contribute to a wide range of epidemiological studies into the spread of infectious diseases in both human and animal populations. Almost anyone can get involved in contributing to an epidemiological study in the field using a high-end or low-end smartphone to enter data. Users in small and large communities can provide hitherto impossible-to-gather, real-time data on disease incidence among their populations. The android-based, EpiCollect app geotags data and uses Google Maps and Google Earth to analyse and display data. It also uses Google’s app engine to store the information from each mhealth project. Current uses in Africa also include drug administration monitoring and, in Kenya, 3.5G connectivity has enabled some of the most effective uses of the technology. All these applications rely on the full power of the mobile messaging domain in order to function.

mHealth – a mobile communications perspective

As African MNOs look to maximise and protect their messaging and VAS revenues, there is an immediate need to focus on innovation and ingenuity around messaging and VAS-related services. The African market provides operators with a unique opportunity to offer new and much needed market-relevant services over proven delivery platforms, such as SMS, MMS, USSD, IVR, which will also help them drive ARPU (Average Revenues Per User) growth and reduce their churn levels; effectively, a win-win situation for the whole community.

One exciting aspect of these developments is that the delivery platforms, the essential enablers for these applications, require very little investment by MNOs to deploy, as the necessary ICT infrastructure associated with them is typically already in place, and ‘good old SMS’, the mainstay non-voice service on almost every network, remains the largest revenue-generating access mode for mobile VAS in growth markets.

To date, new market-relevant services, such as mobile banking, person-to-person payments and agricultural market/produce information and prices, have been very successful in both their uptake by subscribers and the everyday benefits they have delivered to those users, their families and their communities as a whole.

However, operators are now looking to build on such successes in new and emerging areas. The lighter side of mobile application and service development in the form of mobile social networking is really taking off across the countries of North Africa, and places like Nigeria, Kenya and South Africa. However it is mobile health care which is easily the most socially important new branch of the mobile ecosystem to emerge.

A messaging vendor’s success

East Africa has been one of the most successful emerging markets for the introduction of innovative and pioneering messaging and VAS-related services of the kind which support the delivery of mHealth services. In Kenya, where messaging specialist Jinny Software has an established service team, one Kenyan mobile operator, in particular, is leading the way in this regard.

As well as growing mHealth activity on the network, one of the cornerstones of its success has been its support for the mobile money transfer market. Through its platform introduction and services, mobile-based, person-to-person remittances, bill payment, airtime top-up, ATM withdrawal and mobile wallet services have been facilitated, with over 20 per cent of the country’s population now using this service, compared to only 10 per cent, who have access to traditional banking services.

Being one of the operator’s trusted partners means that Jinny actually delivers 80 per cent of the country’s messaging and VAS services across its platforms and, as a result, most of the money transfer messaging traffic in the country and growing mHealth services will be supported by Jinny’s messaging infrastructure.

Final message

An array of new mobile services is already beginning to make the day-to-day lives of the average African family easier and will contribute, undoubtedly, to social and economic development in the region’s growth markets in a major way.  With SMS, MMS, USSD and IVR platforms being the important enablers that will deliver applications and services such as mHealthcare, whole communities are relying on their mobile network operators to implement the right technologies to ensure ‘the diagnosis is right first time and the correct drugs are available and don’t run out’.

 

By Ludovic Patraud, Head of Product Management, and Laurence Doyle, Senior Product Manager, Jinny Software.

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