Necessity is the mother of invention - and in Africa, where high levels of disease threaten to engulf the continent - the medical profession is having to get creative.
According to Dr Sam Surka, researcher from the Chronic Disease Initiative for Africa (CDIA), a case in point is the recent advances in cellphone technology and Mobile Health, or M-health, which are showing that an answer to Africa’s medical health needs may come from this most unlikely of sources.
Africa has one of the highest HIV/AIDS rate in the world, and an increasing incidence of chronic and non-communicable disease and the associated risk factors. Poor living conditions, over-populated living areas, lack of education and inaccessibility to medical information make this situation incredibly hard to manage. Africa carries more than 24 percent of the global burden of disease but has an average of only two doctors per 10 000 people.
“Healthcare has always been a huge concern in Africa, especially when doctors and hospitals are far from isolated or remote areas where care is often most needed: M-health is potentially the answer to this,” says Surka.
The M-health applications already available offer a wide range of services across the medical spectrum, contributing to a variety of responses to medical needs and conditions, in many cases opening new areas of preventative action previously impossible. Surka is currently working on a first-time project for the CDIA to develop a mobile phone application that calculates a total cardiovascular disease risk score and to investigate how this impacts on screening for cardiovascular disease by community health workers.
“While much has been made of the mobile revolution in North America and its impact on the health sector, M-health is even more important in developing countries where phones are sometimes the only way for people to share and receive information. Through M-health projects, we at the CDIA hope to contribute to bringing its potential to light,” says Surka.
Mobile penetration in Africa is at 65 percent, the second biggest mobile market in the world, with half of all Internet connections in Africa exclusively on mobile technology. South Africa has the second highest smartphone penetration on the continent at 19 percent, after Egypt at 37 percent.
This accessibility means big things for healthcare - cellphones enable education that is more effective and targeted. “M-health is very much a needs-based innovation. While first world countries are leading in the medical technological sphere, there is certainly a gap between international thinking and what is actually needed on the receiving end. M-health gives us the ability to ensure we’re addressing actual needs,” says Surka.
This is done primarily through the collection of data: the most important feature of mobile phone medical applications is that they are patient-focused; the patient is the one engaging. And through the data that the patient supplies, it is possible to see what areas are most in need of support, and for healthcare providers to respond accordingly.
“Importantly, mobile health offers a necessary change to the status quo - for too long the medical sector has been at efforts to switch from doctor centric to patient-focused care. For the last 50 years, this has been happening and the advent of cellphone tech [technology] allows this to an even greater degree,” says Surka.
Some good examples of M-Health include: TxtAlert - a mobile tool that sends unique automated SMS reminders to patients on chronic medication - reminding them to take their medication or perform other necessary tasks. A special tool, called ‘Please Call Me’ allows patients to call their doctors even if they do not have any airtime available by ‘pinging’ their doctor who then calls back.
Young Africa Live is a digital forum where African youths can share stories and get information about HIV and AIDS. It also has helpful numbers and contact details for HIV/AIDS-related organisations, in an effort to de-stigmatise the diseases while also providing clear facts and support groups for African youths.
hiVIVA is an application in early development stages, enabling users to stay motivated and on top of HIV medication adherence, through a smartphone application built on the MIT Media Lab’s online ‘CollaboRythm’ platform. Along with personalised real-time adherence support and reinforcement, users access instant lab results, just-in-time information about HIV, and smartphone-based communication with their provider and support group. One of the developers on this project, Dr Lindi van Niekerk, researcher at the CDIA and the Bertha Centre for Innovation and Social Entrepreneurship at the Graduate School of Business at the University of Cape Town, says that applications such as these represent the groundbreaking potential of M-health.
“Most of these have never been tried before, through any technology - the ‘reminder’ technology alone could make a significant contribution to combating health issues in Africa. Theoretically, the potential benefit of M-health is enormous,” she says.
“However many of the M-health possibilities still need to be tested, with many organisations now moving into research to enable policy makers to make the decisions needed for M-health to reach its next step. Fortunately”, says Surka, “That gap between funders and researchers is narrowing.”
“In Africa in particular, because of the need; we are actually leading in the development of M-health globally. The South African government especially is encouraging M-health development, and putting its money where its mouth is,” he says.
Surka says that we are entering a world where an increasing number of previously marginalised people have access to a mobile phone – a new state of affairs that has brought with it rapid technology development: importantly, powerful, relatively cheap technology that could provide immense relief to the crippling burden of disease on the continent.
“The sky is the limit. We are seeing new technologies available every day, and as more health technicians, service providers, and developers start to roll out M-health initiatives, we will see M-health applications become an integral part of life in Africa, and then we will really start to see a positive change to the health of the continent.”
- Jane Notten is the director at Rothko. For more information contact Zenahrea Damon at firstname.lastname@example.org or call 021 448 9465.