Today I attended the first day of the mhealth conference at University College London on ‘How can mobile technology improve health in low and middle income countries?’. Here are just a few thoughts based on the presentations and discussions I heard today!

Some key points from the day

– Account for disabilities in mhealth interventions: they can be easily overlooked, even low eyesight which we may not think of as a disability needs to be addressed in text-based interventions

– Governments and Ministries of Health are key players – especially good if ‘early adopters’ are in charge

– Motivation to get people to use mhealth tools in the long term can be increased through:

  • Incentives (monetary or other)
  • Feeling valued and trusted (e.g. by giving them the mobile device)
  • Regular checks, especially when data shows there is drop in usage
  • Empower some as ‘experts’ or ‘supervisors’ to help others with technical aspects

– We need to get better at describing what exactly interventions do in research papers – and if any of the people who voiced that concern are reading this – could you give examples of studies who do it well?

Further thoughts

Content vs. tech evaluation: There were quite a few questions about the content of some of the mhealth interventions that were presented (e.g. motivational messages for community health workers (CHW) or the maternal health messages for families in Bihar). Both speakers made it clear that their messages had gone through a lot of testing and, for the messages in Bihar, had been approved by a government committee. Sandeep Ghosh from BBC Media Action also made the point that their intervention has shown very positive results, which in a way shows the success of the content. While this is great, and I’m sure that for both projects, they had very capable people (and the budget to get these people on board) where is the learning for other organisations and charities, who want to replicate this type of project? I think that additional research specifically on content would be beneficial.

Health outcomes: Throughout the whole day, it became clear that the focus on health outcomes is crucial in the field of mhealth evidence, as process and usage data only gets us that far. However, I see that if you are a big research institution like UCL, focussing on health outcomes is great. Yet, what can smaller NGOs do when their M&E budget doesn’t allow for a sensible sample size to measure all these health indicators? How can research institutions reach out more to NGOs?

Health communication: I felt that a lot of the discussions were about mhealth as a way to strengthen health systems, while health communication wasn’t center stage. I think it would be interesting to look a bit more at health communication interventions which use mobile devices, and their evidence.

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