Tag Archives: SMS

Knowledge needed where tools are given

David Kulick, ICT and Innovation Program Officer with Johns Hopkins University Center for Communication Programs, addressed a problem integral to the analysis of many development projects. That problem is assuring that when tools or resources are delivered to communities, knowledge of use needs to be delivered as well.

This made me think about our discussions on One Laptop Per Child because this was a case in which large assumptions were made of the connection between a tool and results without anything in between. It may be true that a laptop can be a road towards improving education, but there has to be more to it than just delivery of the tool.

Kulick explained one assumption concerning people’s knowledge of malaria. He noted a project that delivered bed nets to keep out mosquitos, but questioned whether people got the connection between the bed nets and prevention of disease.

One program Kulick brought up as an example of closing these knowledge gaps is The ReMiND Project. Catholic Relief Services partnered with Dimagi, a technology innovator, to provide a service for new mothers to prevent newborn deaths and improve maternal health. The goals of The ReMiND Project are “Phone-based job aids for government community health workers and midwives; Real-time data tracking and SMS reminders to health workers to conduct home visits in the first 24 hours after birth with alerts to supervisors for missed visits; and Mobile phone birth announcements and health messages for fathers to generate demand for services and encourage healthy practices.” (source) This is an example of an eHealth practice to reduce newborn deaths.

The interesting contradiction is in the material I read about The ReMiND Project  I didn’t once come across anyone addressing if the people had a way to receive SMS messages.

ICT For Health and Behavioral Change: An Overview

ICT for health initiatives are widely popular interventions for disease control and prevention in developing contexts, and have been increasingly employed on both the patient side and for medical professionals over the last decade. Approaches of ICT for health cover logistics, telemedicine, supervision, data exchange, medicine reconciliation, and emergency notifications. They are also employed through a variety of mediums, including SMS services, mobile gaming, television programs, open-source software, and even voice and audio applications. Yesterday, David Kulick from the John’s Hopkins Bloomberg School of Public Health related to our class the ins and outs of developing ICT health related initiatives. The Hopkin’s Center for Communication Programs combines forces with the Bloomberg School to formulate projects devoted to changing behavior on a community and individual level, and has been active since 1988 in more than 30 countries. ICT initiatives for behavioral change, as compared with other ICT for health approaches, work to find “new, participatory ways to reach audiences with persuasive messages” that can transform ways of thinking and interacting to make a society healthier as a whole (jhuccp.org). An example of such a CCP program is MAMA, or the Mobile Alliance for Maternal Action. This initiative, which is active in Bangladesh, India, and South Africa, uses SMS during weeks 5-42 of pregnancy and the first year of a baby’s life to inform a mother about antenatal care, nutrition, and even insecticide treated bed-nets to improve health outcomes. These techniques are used by many ICT for health projects, and are an important intervention that can provide beneficiaries with critical information in a short amount of time.

An interesting dilemma facing the ICT for health field is the stratification of beneficiary access, which is in turn reflected in the results of a given project. Mobile phones and televisions are commodities, and the poorest members of a community who made need such ICT interventions the most may not be reached due to cost limits. In addition, gender biases in many societies can restrict women’s ability to use applications; for example, many times a woman’s husband or male family member controls a phone, and a pregnant woman may not be able to view SMS messages concerning maternal health or she may be afraid that the messages will result in an invasion of her privacy. Another key problem with ICT for health applications is an issue that reverberates across development projects in general: their “one size fits all” model decreases their effectiveness in getting at the root of the problem. Mass SMS programs that intend to respond to health queries are not yet sophisticated enough to take into account demographic differences such as sex, age, or economic status, and thus may provide irrelevant and unusable advice to beneficiaries in need. ICT for health programs such as those maternal health applications developed by the CCP have made strides in decreasing maternal and infant mortality, but future health projects should look towards innovations that make applications more individualized towards the recipient. Changing behavioral norms is quite difficult, but ICT has the ability to harness changing technology to find cutting edge solutions to health issues and to apply these lessons to other sectors of development.

MAMA: An mHealth Initiative

mHealth, an abbreviation of mobile health, is a broad term generally used to describe health programs and initiatives operating primarily through mobile devices.  Mobile device use is on the rise, and it is now estimated that up to 85% of the world’s population is covered under some mobile subscription. In rural areas with limited access to physical clinics, doctors, and resources this type of program can have far-reaching benefits. Because of the nature of mobile devices, applications, etc. mHealth initiatives are able to cover a wide range of health topics including general health information, diagnosis, and disease tracking.

To me, mHealth has a huge potential for use in developing nations. While researching the topic, I came across MAMA (Mobile Alliance for Maternal Action). This program operates mainly through SMS messages and simple voice reminders.  MAMA currently operates in 69 countries and reaches nearly 141 million women. Their messages are based on WHO and UNICEF guidelines and provide information about what to expect from their babies at certain ages and reminders to get checkups or vaccines. To learn more about MAMA, check out their website below.


This is just one of many examples of mHealth initiatives focusing on developing nations. Of course maternal health has always been a focus, but what other ares do you think mHealth could have a major impact in? Do you see any challenges for these initiatives in the future? I think they are a wonderful example of just how much potential technology has in developing nations.

ICT4C: Information and Communication Technologies for Cows


Source: iCow’s website

iCow is a subscription-based digital platform that allows Kenyan farmers to enhance their productivity. Farmers can access the platform by mobile phone and the web. iCow started as an SMS mobile phone application and has developed into a digital platform with a large array of services. The platform helps farmers keep track of their cows’ gestation calendar and also provides farmers with valuable nutrition and illness prevention tips to take good care of their herd.

According to iCow’s website, there are approximately 1.6 million Kenyan farmers, most of whom use “rudimentary methods to manage their cow’s estrus cycle and milk production.” iCow was developed by Su Kahumbu after she realized how small farmers in poor communities struggled to provide their most precious assets, cows, the care they need.

I grew up in a small farm in rural Panama and I remember how much time my father spent taking care of our cows. The Ministry of Agriculture conducted many workshops in our town with the intention of teaching farmers the best practices of the “cow care industry.” Unfortunately, farmers in lower income countries don’t get the support they need from their governments to increase their herds’ productivity. Thankfully tech entrepreneurs are paying close attention to the challenges of the agriculture sector and are coming up with creative solutions, such as iCow, to tackle such problems.


Former ICT4D Student Blogs about Cell Phones in Africa

As part of her internship with Food Tank, former IDEV4100:ICT4D (Fall 2011 semester) student Suzannah Schneider authored this blog entitled “Five Ways Cell Phones are Changing Agriculture In Africa.” The post lists some familiar ideas, such as using mobile phones to access market prices and weather information, as well as receive useful information via SMS messages. However, it also mentions some more specific and innovative ideas such as iCow and micro-insurance. Based on your experiences in our class, what are your thoughts on these 5 applications of mobiles for agricultural development?

More information about Food Tank can be found in this video: “The Food Think Tank Trailer

The Links Between Agriculture, Advice, Radio, and SMS

An installment from the National Geographic series Digital Diversity that shows how “mobile phones are being used throughout the world to improve, enrich, and empower billions of lives” greatly coincides with the report by Farm Radio International, “The new age of radio: how ICTs are changing rural radio in Africa”. Both the report and the article state that radio is extremely important for agriculture and increases awareness  productivity  and knowledge. The article stated an interesting point that having other farmers speak on the radio creates a sense of community as well a larger impact. Rural farmers are more apt to take advice from people they can relate to and trust (like a fellow farmer) than a radio producer or radio host. The FRI report stated that there were some concerns about the availability of the shows since they are not always accesible, but the article states there is a higher chance of the farmers listening if they air them at night when they are relaxing in their homes.

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The “two way” versus “one way” communication was also mentioned in the FRI report, letters being the only option for farmers to contact the hosts or programs, though the article shows that many are utilizing their mobile phones and texting in questions and comments (around 20 texts a week per program). The FRI report states that there are more listeners when the program sends out text alerts around 30 minutes before hand. Both these usages of SMS are beneficial, quick, and painless. The benefits of radio are not only seen in agriculture, many could be seen seen in other sectors such as health. For instance, how farmers find out how to prevent or treat poultry disease can be transferred for human diseases and treatments. Overal the widespread penetration, accessibility, and affordability of radios’ make them great for less developed nations and should be utilized more often.

Neustar Pushes Government SMS Use for Disaster Management

Neustar, a provider of real-time information and analytics for the Internet, telecommunications, entertainment, and marketing industries, published mGovernment: How Government Agencies Can Use SMS , a paper on the benefits of SMS for governments to communicate with their citizens. They argue the availability of SMS is a key component of its value. Citizens do not need expensive data plans or smart phones to communicate. Additionally, because mobile phones have taken the place of land-lines, mobiles are an incredible tool to use as a means to provide information. The final argument Neustar makes is “since most consumers have their mobile phone within reach and keep the device always on, government agencies can make public information and government services accessible to the population anytime and anywhere”.

A crucial component for governments to use SMS is for disaster management. Neustar provides case studies of disaster management implementation through SMS. The paper mentions Oman, a country that is mostly desert, and ways they use SMS for disaster management. Oman sends out texts to citizens when it is raining heavily via The National Committee for Civil Defense. An example of a text is the following:

“’Despite the low precipitation yesterday, some casualties were recorded due to some people’s venturing through wadis. We exhort you to be extremely cautious. NCCD.’”

The idea of disaster management is different from disaster relief, however the use of ICTs is one in the same. Spreading knowledge, whether that be pre or post disaster is important. Allowing citizens to understand conditions of disasters prior to their occurrence can help prevent relevant dangers to citizens. Oman is just one of many countries using SMS for disaster management. It is evident this concept is universal and should be implemented across the globe.

Shrinking the Digital Divide to Improve Health

An article titled “Health education and the digital divide: building bridges and filling chasms” argues that “lack of access to information technology can have profound negative implications for one’s economic, social and physical health and well-being,” and I agree with this point. They believe that ICTs have the capability to improve health outcomes for the world because ICTs allow people to access health information. Today, many people in the world get their health information from ICTs: they seek out information on the internet, or are sent health information by organizations/ services they subscribe to via email or SMS messaging. People often use this information that they find online to make educated decisions about their health care. The ideas presented in this article are consistent with what I have learned in my Public Health and International Development classes at Tulane.

This article opens up a conversation about how beneficial ICTs, especially access to the internet, could be for developing countries. Since many citizens of developing countries often do not have the resources to visit a doctor whenever they want to, it would be extraordinarily helpful for them to be able to receive or search for health information online to determine whether the symptoms they are experiencing are worrisome or not, so they can decide whether to access health services or not. Working to extend the internet and mobiles to under-served communities will give the poor an opportunity to improve their health. Failure to address the digital divide and get ICTs to the citizens in developing countries and under-served in developed countries will widen health disparities between the developed and developing world.

Although internet access for all is the desired goal to shrink the digital divide and improve health according to the article above, many organizations and countries are taking steps in the right direction by starting initiatives to provide health information to under-served communities via SMS text messaging on mobile phones. This idea has proved to be a great alternative for communities that have no access to the internet. For example, the World Health Organization came up with the “M-check project” which is a system designed to decrease maternal and infant mortality in developing countries. Essentially, when a pregnant woman accesses a health center her phone is registered with the “M-check project” and she is sent SMS messages containing ‘safety checklists’. These checklists include danger signs for mothers look out for in themselves and their infants in the week or two after delivery. The system also sends daily reminders to the mothers to check their safety lists. There is also a feature that allows women to call the ‘M-check’ info system, where they are connected with help to work through any questions or concerns that they have, and they can also be connected to an ambulance and taken to a local health service if necessary. This system is using ICTs to change the way that mothers are able to promote and protect their health. This project is contributing to the closure of the digital divide and health disparities by allowing people in need to access health information via ICTs. Clearly, even relatively simple ICTs can improve health outcomes for the developing world.

Cloud Computing in ICT4D: Vietnam

         In class this week, we discussed cloud computing as one of the top emerging trends in Information and Communication Technology today. Broadly, Cloud Technology is using computer resources that are delivered over a network, without needing the necessary hardware or software making it a great option in developing countries. I was interested in looking at how this was specifically applied in developing countries and came across this blog describing a pilot project in Vietnam. This project was developed to help sugar cane farmers communicate with factories about deliveries and payment. Due to the sensitivity of time between the time the sugarcane is harvested and when it is received at the factory, it is crucial for farmers to communicate with the factory to discuss pick up times and amount of cane needed. Previously, farmers were attempting to call the factories and had trouble with their calls going through or not getting the information in a timely manner. Cloud computing allows the farmers to receive a response in 1-2 minutes. By beginning their texts with a keyword such as NATL, the SMS messages are routed appropriately and can be responded to with the requested information. The diagram below details the exact mechanism of the message response and delivery.

          Fred Chong, the author of the blog and one of the main computers on the project identifies SMS messaging as being critical to the success of a project like this in developing areas due to the remaining spottiness of service making phone calls difficult, low costs of sending SMS, the large availability of cellular network infrastructure in rural areas, long mobile battery life as opposed to computers, and suitability for rugged, roaming lifestyles of farmers. This program has led to higher quality sugar cane and greater profits for these Vietnamese Farmers. Chong looks forward to a bright future in this work and calls it “one of the most fulfilled computing project I’ve ever done”. Check out the video in the blog for more information and to hear from the farmers themselves!


Txteagle: Incentivizing Participation in Disaster-Preparedness Surveys

Txteagle is an interactive data collection platform that is incredibly innovative in its techniques.  They received funding to set up an application for nurses in rural Kenya to text in blood supply levels at local hospitals.  At first, the application was very successful, but within a few weeks, participation declined to close to nothing.  To counteract the decrease in engagement, Nathan Eagle, the program’s founder, created an incentive system.  Safaricom, the local Kenyan mobile operator, gave Eagle access to their mobile billing system.  This allowed him to reward participation in his application with minutes of mobile airtime.   So, for each text they sent containing data about blood supply levels at local hospitals, nurses received one minute of airtime.  This incredibly simple incentive system was wildly successful—almost immediately, all of the nurses began participating again!

This incentive program is applicable to a plethora of other data collection applications.  Eagle eventually integrated his system with Safaricom’s partners, so that 220 mobile operators worldwide were able to use his billing and compensation platform.  To put this in perspective, Safaricom and its many partners have access to 2.1 billion active numbers in 80 different countries.  Consumers need only to complete an opt-in process to begin sending information in exchange for mobile minutes.

More recently, Txteagle has begun working with the Global Network of Civil Society Organizations for Disaster Reduction.  This network, consisting of 300 nonprofit organizations worldwide, focuses on increasing the resilience of affected people to disasters along with minimizing the impact of the disasters themselves.  Txteagle’s platform is used to send survey questions to vulnerable communities in order to improve disaster preparedness.  To initiate communication, a “blanket SMS” invitation is sent out to a community; if a person opts-in, he or she is given the option to complete a survey via SMS text or online – either way, airtime compensation is still received.

I think that this is an awesome idea.  By incentivizing inputs, Txteagle is ensuring a much greater level of participation, thus enabling its partners to more effectively give aid to those in need.  Txteagle also works with the operators to provide incentives for them as well.  Because both the operators and the end users are being compensated for their participation, this program has a great chance of long-term sustainability.  It can be applied to so many aspects of development beyond just disaster relief, so future growth seems inevitable.

Source: http://realitymining.com/pdfs/hcii_txteagle.pdf