Daily Archives: 16 October 2012

M-Health in Egypt: Utilizing Smart Phones

A recent  surge in m-Health and e-Health ICT4D initiative are popping up in Egypt and the Middle East.  Many of these projects focus on smartphones, 3G networks, wireless internet, and apps to improve health services throughout the region.

Qualcomm, a technology company, is is leading a pilot program in Egypt to see if eHealth and mHealth initiatives will be successful in the region, and there are bigger plans to overhaul the health care system in Egypt (and other North Africa and Middle East countries) to rely more heavily on ICT.  Here’s an article about one pilot project (focused on utilizing 3G mobile network to diagnose skin conditions remotely) that is a small piece of the overall vision for the region.   According to this article: “The Ministry of Communications and Information Technology has facilitated the integration of ICT in health services and the provision of telemedicine to the remote and rural areas of Egypt,” said Dr Hoda Baraka, first deputy to the Minister of ICT. “The Egyptian Teledermatology initiative, using mobile health technology, is inspired by pursuing equal opportunities for health services anywhere in Egypt and expanding medical insurance to all citizens. E-health programs bring better diagnostic and health services to a wider segment of the Egyptian society.”

In researching this pilot project more, I’ve found another article that points out an overall vision of mhealth for the region. Apparently, ” Qualcomm is working with regional governments and mobile operators in the Middle East to create country-wide mobile health systems within the next three to five years, according to a report in Reuters. Qualcomm is currently looking into opening offices in both Saudi Arabia and Egypt in mid-2011.”  This is a very ambitious ICT4D initiative that could revolutionize health in the region. However, it is important to focus on possible limitations, infrastructure, environment, and usage of ICT in the region to assess the plausibility of such projects.  The same article that sites the plan for implementing a country-wide mobile health system that relies heavily on smart phones, apps, wireless internet, and 3G network access also noted a very important piece of information: Egypt only has 6-7% smartphone penetration.  This seems like a very large problem for the m-health project.  A national health plan that relies on patients having access to smartphones may lead to many unintended consequences.  Digital divide that exist among the target populations may turn into to major divides in access to health care, which could exacerbate cycles of poverty and exclude already marginalized populations.  I think this project deals with many of the topics we have discussed in class and relates to many of the readings.  I am interested to see what classmates think about the positives and negatives of these initiatives.  Will these mhealth efforts help improve medical care in rural areas or will it widen inequalities?

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Text4Health: More effective in the states than in Developing countries?

One of the articles we read this week, Found Here, “Text4Health: A Qualitative Evaluation of Parental Readiness for Text Message Immunization Reminders”, by Olshen Kharbanda and colleagues, takes note of some of the challenges of and successes of Text4Health initiatives. This trial in particular, took care to; send text messages in both spanish and english to reach a wider audience, as well as including a wide demographic of ethnicities and educational attainment levels. Yet, most of the people they drew statistics from were based in an urban area, and it does not address the cost and difficulty of using cell phones for older parents who aren’t as well acquainted with similar technologies, and extremely low income families who do not have access to multiple cell phones or even one cell phone.

The article also noted that reminders about vaccines should be simple, short, and personalized- this would definitely be more effective, yet is not practical for a huge mass vaccination campaign. Another thing to consider is that if the texts sent are simple and short, simply getting across that one or more family member is due for a vaccination, doesn’t underscore to a family that does not have a lot of access to healthcare services or healthcare information, the important of getting a vaccine in a child’s life, and what the consequences could be if the kid did not get vaccinated in time. It also doesnt take into consideration issues that would be at the forefront in developing countries- whether there is enough infrastructure for the family to reach a healthcare provider, whether the specific vaccine requires multiple visits, which may not be possible, and whether in order to get their child to the clinic, if the parent will miss a day of work (meaning a day of productivity, and a lost paycheck). Large  international organizations like WHO have started utilizing door to door vaccination campaigns, taking out the middle man and making sure that each and every person is vaccinated. This would be effective on a small scale, but on a larger scale, a text4health initiative might be able to reach a broader audience- if that audience can access the right technologies and can access the vaccines themselves.