Every week, I’m learning about new and effective ways that mobile phones are being deployed to address intractable development challenges. I’ve written previously about how cell phones are combining with mobile money to provide poor people with access to financial services, increasing savings and creating entrepreneurial opportunities even in remote areas. They are also being used to promote various health initiatives by providing information to those who most need it. Now I’ve just come across an exciting new development combining m-health and m-money to address the scourge of fistula in Tanzania. Due to limited transportation, poor infrastructure, a lack of skilled birth attendants, and poorly equipped medical facilities, thousands of pregnant women in Tanzania develop fistula during childbirth. Approximately 3,700 women are diagnosed with obstetric fistula every year in Tanzania, but only 1,000 women are treated. Although fistula surgery is free at some health care facilities, women still face daunting transportation costs. In 2009, UNFPA partnered with Tanzania’s largest provider of free fistula surgery, the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), to use mobile technology to overcome these transportation barriers.
Using M-PESA (a mobile phone-based money transfer system), CCBRT texts money to “fistula ambassadors” throughout Tanzania. These volunteer “ambassadors”—typically doctors, nurses, or NGO workers—locate women in need of fistula surgery and use the transferred money to buy them bus tickets to the fistula hospital. Since the launch of the initiative, the number of women receiving fistula surgery at CCBRT has increased by 65 percent, from an average of fourteen surgeries a month to twenty-three.
In Afghanistan, mobile phones are being tested as a way to increase the quality of care provided by health workers, even in remote areas. In 2008, Jhpiego, in partnership with Roshan—the largest mobile provider in Afghanistan—launched its SMS4Learning program. This initiative uses SMS to provide direct follow-up with doctors, nurses, midwives, and community health workers who receive health care training from Jhpiego. The project reinforces best practices and maintains skills acquired by participants during trainings. For example, community health workers receive text messages reminding them to remember to wash hands with soap and water between patients to reduce spreading germs. The goal is to reinforce learning. A preliminary survey conducted in 2010 of project participants showed that roughly 80 percent were satisfied with the initiative and over 50 percent forwarded the messages to their colleagues to improve levels of service.
In South Africa, Project Masiluleke interacts directly with the general public, using text messages to deliver health information regarding HIV. South Africa has more HIV positive citizens than any country in the world, yet less than 25 percent of the population has been tested. Project Masiluleke seeks to change this. One of its programs, “Please Call Me” reaches virtually 100 percent of the adult and adolescent population of South Africa through SMS, connecting recipients to a network of government-funded HIV call centers, where callers can receive information on HIV and referrals to local free clinics. Research shows that Project Masiluleke’s “Please Call Me” campaign has tripled the average daily call volume to the National AIDS Helpline in Johannesburg.
These are just a few of the ways mobile technology is being tested to improve health across the developing world. I will continue to explore these types of initiatives on my blog so stay tuned for further posts and I look forward to your comments.