The majority of people in developing nations don't have access to health care providers, basic antibiotics or even clean water—but many do have mobile phones and can access care through advances in mobile health (mHealth). Innovations range from low-cost medical devices that attach to mobile phones to new delivery models that give patients access to health care providers through short message service (SMS), photos or videos. Let's take a look at 10 transformative examples from around the globe.
About the author: Dr. Joseph Kim is the president of MCM Education, a publishing company that provides continuing education for physicians, nurses and pharmacists, and the founder of MedicineandTechnology.com, MedicalSmartphones.com and MobileHealthComputing.com.
Detecting Cataracts to Prevent Blindness
Cataracts are a leading cause of blindness in many countries. Properly identifying a patient who has a cataract usually requires expensive diagnostic equipment and skilled operators. However, the a simple device attached to a mobile phone may change the way cataracts are diagnosed in the developing nations. The MIT Media Lab has been developing a mobile phone attachment called CATRA that can accurately diagnose and measure cataracts—and can do it at a fraction of the normal cost of diagnosing a cataract. The CATRA project made the Popular Science Best of What's New 2011 list and received two $5,000 awards during the MIT Global Challenge 2011.
Identifying Bacteria in Water
Many developing countries lack clean water. As a result, a growing number of organizations are devoted to helping countries develop the necessary infrastructure for clean water—since bacterial infections from dirty water can lead to life-threatening dehydration. A team at the UCLA Henry Samueli School of Engineering and Applied Science has developed a new cell phone-based fluorescent imaging and sensing platform that attaches to a mobile phone's camera. This device can detect dangerous bacteria in water, including E. coli, and help people identify when water may need to be purified by boiling. The value of this technology isn't just identifying potentially dangerous water; when people know that water is clean, they can save their fuel for cooking.
Conducting Directly Observed Therapy
Diseases such as HIV and tuberculosis, common in the developing world, require medications that quickly lose efficacy if patients skip even one dose. Some countries therefore mandate "directly observed therapy," or DOT, which requires health care professionals to directly observe patients taking medications. This generally means a patient goes to a health clinic every day, waits in line, take pills and then leaves. Mobile phones let DOT happen at home. For example, the Video Cell Phone: Directly Observed Therapy program, a collaboration among the UCSD Division of Global Public Health and the TB Control Programs of San Diego County and the city of Tijuana, Mexico, let patients record and send mobile videos of themselves taking TB medications to DOT workers located elsewhere.
Improving Medication Adherence
People all over the world are liable to forget to take their medication on a daily basis. SIMpill is a "smart" pill box that sends an electronic notification to cell towers when a patient opens the bottle to take a pill. If the patient forgets to open the bottle, then the system alerts the patient and the caregivers with a phone reminder. This technology has been tested in Africa and according to the manufacturer has shown dramatic improvements, with adherence rates at 94% among patients with tuberculosis. Similar devices that also being used in clinical research trials worldwide.
Discussing Family Planning
Women in developing nations often lack information about or access to family planning resources and options. Organizations such asFHI 360, a nonprofit human development organization, are evaluating ways to use mobile phones and text messaging platforms to educate women about family planning. One example is the Mobile for Reproductive Health (m4RH) project, which sends a set of text messages about family planning methods that users can access on mobile phones. This low-cost way to educate patients about contraceptive options has been used in Kenya and Tanzania since 2010 and has reached more than 13,000 users in these countries.
Improving Maternal Childbirth Survival
Though maternal mortality has been halved in the last 20 years, more than 287,000 women died during childbirth in 2010, largely because they lacked access to basic health care and attempted birth at home. Mobile phones have been shown to help women survive childbirth in many ways—by letting them send weekly text messages to caregivers watching for risk factors during their pregnancy, receive money for medical treatment or travel expense via SMS or call an ambulance if advanced care is needed. When Ericsson teamed with mobile telecom firm Zain to give mobile phones to villagers and health workers in Ghana, in an effort driven in part by the Millennium Villages project, maternal mortality all but...
Educating New Moms
How do you educate new moms? Many of us may pick up books or learn from family members, but some new moms lack the resources to know how to properly care for an infant. A free text message program called text4baby launched by the National Healthy Mothers and the Healthy Babies Coalition (HMHB), and a similar program called Text4baby Russia, supported by the Russian Ministry of Health and Social Development, provide useful texts on a variety of topics—obtaining birth certificates, eating healthy, avoiding smoking and drinking during pregnancy, working while pregnant, breastfeeding, maintaining psychological and emotional health, engaging in physical activity during pregnancy, and knowing the key stages of development in an infant's first year.
Improving Vaccination Quality, Recordkeeping
Many parts of the world still rely on paper immunization records. As people and families move, accurate recordkeeping becomes more challenging. To that end, mobile technology is being used in countries such Albania to improve vaccination records. Project Optimize, a collaborative initiative among the World Health Organization, the Program for Appropriate Technology in Health (PATH) and the Albania Institute of Public Health, leverages a digital database of immunization records that can be updated using mobile devices. It also relies on SMS-based alarms to monitor the temperature of a batch of vaccines, since extreme heat can damage the vaccines.
Encouraging Breast Cancer Screening
When you think of breast cancer screening, you probably don't think about the use of mobile phones. However, community health workers in Bangladesh are being trained to use information and applications on their mobile phones to learn proper breast cancer screening techniques. From there, the workers provide health services to women in this densely populated yet rural country. One such screening project has been organized by mPower Social in partnership with the Women's College Hospital at the University of Toronto. Health workers are also able to update patient data on their mobile devices, which helps document the need for follow-up care and a patient's adherence to treatment.
Encouraging HIV Testing
AIDS is still hitting Africa hard. Mobile technology is being used to improve HIV testing. Companies such as Cell-Life are using SMS to send basic informational and motivational messages about the importance of HIV testing. Cell-Life's research has found that those who receive the message are more likely to get tested than those who don't.
Another problem associated with HIV testing is the time delay that can occur when test results are delivered through standard postal mail. Several organizations are addressing this problem by using SMS to transmit HIV test results so patients receive them in seconds instead of weeks.