In most other countries where mobile money is strong, e.g. East Africa, when you send money to someone at another network, that money can only be cashed out at the sending service’s agent network. So instead of potentially triggering further electronic transactions, sending money “off-net” in their case means that no further electronic transactions will happen. With this recent move, Indonesia becomes the first large market to go live with an interoperable solution, a solution that enables more transactions to take place even after off-net transfers, and creates one connected environment of mobile money in the market.

We had a chance to speak with Yessie Yosetya, Head of XL Tunai, and she explains further: Prior to this, each operator only allowed mobile money transfers within its operator, e.g. XL Tunai to XL Tunai only, or Telkomsel Tcash to Telkomsel Tcash, or Indosat Dompetku to Indosat Dompetku. After 15^th of May, subscriber from XL can transfer their m-money to either Telkomsel or Indosat subscriber; and vice versa.

In a previous post, we discussed the importance of industry collaboration among mobile money providers in their market. In Indonesia the operators started regular industry discussions among themselves in December last year, and they have been meeting weekly since then.  During this time, a common SOP (Standard Operating Procedure) was agreed among all operators for handling customer care and fraud issues across the operators.

The technical development to enable the platforms to talk to each other took about four months. The chosen technical solution was to establish secure direct connections and communicate through a web service, using WSDL, with each platform. It was decided that the funds will be settled bilaterally on a regular basis, starting monthly, but will be   adjusted depending on the volumes that will be transferred. 

Yessie explains why this is happening in Indonesia before other markets: Each of the operators in Indonesia have been trying on its own to educate and drive the adoption in the market. It is in everybody’s interest to move the market forward and we see P2P interconnection as an enabler for this. Our common goal of m-money interconnection is to drive adoption, using the analogy of sky-rocketing adoption of cellular service after SMS was opened for off-net transactions. We calculate that this will increase up to 20% of P2P transactions.

Network theory tells us that, in theory, this number could be much higher as transactions could grow exponentially with the increased number of nodes and connections possible within the system. This initiative shows us that Telkomsel, Indosat and XL are all committed to making mobile money succeed in Indonesia. This commitment together with the recently launched enabling regulation will hopefully help propel Indonesia’s mobile money industry to a rapid growth.

Photo: By smagdali, via Flickr.

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Of the three billion people who live on less than the equivalent of $2 per day, one billion have no access to the healthcare system. In some cases, this is because healthcare facilities are too far away; in others, because services are prohibitively costly. Mobile finance has emerged as an important tool to address both of these challenges – enhancing healthcare accessibility and affordability among base-of-the-pyramid consumers.

Kenya, the “home of M-PESA,” has been a hub for innovation at the intersection of health and mobile financial services (MFS). With M-PESA providing the infrastructural “rails” upon which value-added services can be built, a variety of health-related mobile finance offerings have emerged in Kenya and Tanzania. From pre-paid savings to health insurance, mobile platforms are striving to ensure affordable healthcare is not solely a luxury; but rather, a universal right.

Mobile Health Insurance for the Base-Of-The-Pyramid

Frustrated by the lack of health insurance options for low-income Kenyans, Zack Oloo and Samuel Agutu devised an innovative solution: creating a medical smart card that could be used to save money for future medical expenses. Developed by their company Changamka Microhealth Ltd., the card can be purchased from local shops without registration (a barrier to acquiring traditional insurance), and loaded periodically with money via M-PESA. These funds can eventually be put towards any healthcare expenses, from doctor’s visits to medicine.

“With the advent of M-PESA, we saw an opportunity to spread the access and availability of healthcare, either as insurance, or as a non-insurance health plan,” said Oloo, Chairman and Co- Founder of Changamka, in a recent interview. Targeting those with the greatest need for health insurance – individuals earning $2 per day or less – Changamka was able to sell 13,000 cards during the first year and a half of operations following its launch in 2009.

Despite the need for health savings, however, getting people to sign up was not always easy. According to Oloo, saving for healthcare was not something that people had done in the past, so acquiring customers required significant behavioral change communication. In an IPS News article, Samuel Agutu, Changamka CEO and Co-Founder said: “We are simply telling families that health care is as essential as food and other basic necessities. Just as they save up for other needs, they need to save for medical care.”

In addition to their Smart Card, Changamka has recently launched the Linda Jamii platform, in partnership with Safaricom and Britam insurance company, which offers mobile micro-insurance to lower-income individuals. Through the platform, customers can save money on their phone, and purchase health insurance once a certain savings threshold is met. Another innovative Changamka platform, implemented with funding from the Saving Lives at Birth consortium managed by Grand Challenges Canada, provides a subsidy m-voucher that women can use to access peri-natal care and facility delivery, one of a growing number of health-related MFS platforms catering to women.

Mobile Money for Women’s Health

As we creep closer to 2015, the deadline for reaching benchmarks set out in the UN Millennium Development Goals (MDGs), a variety of MFS platforms have emerged to improve maternal health, one of three health-focused MDGs. Other mobile money offerings similarly address specific healthcare challenges afflicting low-income, rural women by leveraging the M-PESA infrastructure. From maternity to basic outpatient care, MFS has become a key way to ensure that women have affordable access to essential health services.

One example is maternal healthcare platform Mamakiba, winner of the USAID “Apps 4 Africa” contest, which uses M-PESA as the “rails” upon which to offer value-added community services, including a patient-facing SMS savings calculator and prepayment tracking tool. Upon meeting with a Mamakiba healthcare worker, low-income, pregnant women in peri-urban areas of Nairobi can establish a savings target that will cover the costs of their pregnancy, from ante-natal care to delivery. They can further set up a savings plan that will allow them to meet that goal, and begin payments via their M-PESA accounts.

In a number of emerging market countries, the cost of transport to health facilities is a key barrier to healthcare for rural women. For women living with fistula, a debilitating childbirth injury commonly caused by obstructed labor, accessing timely medical care is particularly essential. Leveraging mobile banking, organizations in Tanzania and Kenya have removed barriers to care for low-income fistula patients.

The Freedom from Fistula Foundation in Kenya, for instance, provides free fistula screenings, and arranges logistics to a Nairobi hospital for repair, sending funds for transportation via M-PESA as necessary. Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT) incentivizes field “ambassadors” to send more fistula patients for care using M-PESA. The ambassadors are tasked with identifying potential patients, calling CCBRT, and distributing funds for transportation. They are then sent a financial incentive from CCBRT “as a gesture of appreciation and an incentive to send more fistula patients for care.”

The potential for mobile money to transform healthcare accessibility among base of the pyramid populations is immense, tapping into extensive mobile infrastructure to reach the 1.7 billion people who have mobile phones, but no bank account, according to an mHealth Alliance report. The key is developing more robust mobile financial services catering to the unbanked or underbanked, which can then be leveraged for healthcare accessibility, as these examples from East Africa illustrate.

AT&T, Sprint and Verizon have waived all overage charges for text, voice and data for affected areas up until June 30^th.  AT&T is deploying additional back up- resources including personnel and COWs (cell-on-wheels) and COLTs (Cell on light transit) and recently announced that it would be making a $100,000 donation to the American Red Cross as part of its Network Disaster Recovery Programme. Sprint’s Emergency Response Team will distribute handsets, satellite COLTS to support interoperable voice and IP data communications, and volunteers to support first responders and government officials.

According to a Verizon spokesperson, the network is operating at almost 100% following earlier congestion and COWS and COLTS have been dispatched to support relief efforts. Additionally, Verizon will deploy disaster relief vehicles equipped with “Wireless Emergency Centres” to the most badly affected areas which are intended to provide charging stations, emergency phones, internet access, support for emergency response agencies and drinking water. T-Mobile announced that 97% of their network in the affected area was operational and that they have dispatched network engineers equipped with COWs and microwave backhaul in areas where service has been impacted to ensure that communication networks are fully functional.

Heavy congestion was reported as the storm approached and carriers are encouraging customers to “text not talk” through their press releases and via social media. FEMA is also encouraging those affected to be “tech ready” and has issued guidelines for back-up device charging solutions and reducing pressure on the network by only making calls to emergency response agencies

The American Red Cross is encouraging residents to use its Tornado app to let loved ones know they are safe through it’s “I’m Safe” feature. The app contains emergency first aid information, response instructions and guidance on positions of Red Cross shelters and relief supplies which are accessible on devices even if mobile networks are down. It also features a warning siren for impending tornados which is activated even if the app is closed.

Additionally, all carriers are providing a mobile donation platform linked to the Red Cross to facilitate contributions to relief efforts. 

Photos: [Top] By Ks0stm (Own work) [CC-BY-SA-3.0 or GFDL], via Wikimedia Commons; [Bottom] By Sgt. 1st Class Kendall James, Oklahoma National Guard, via Flickr.

The Ministry of Women’s Affairs (MoWA) and the Ministry of Communications and Information Technology (MCIT) hosted a conference today in Kabul celebrating women’s benefits from recent technological innovation in the Afghan mobile market. The conference featured presentations on mobile technology programs specifically designed for women, such as a distance-learning literacy program, a family hotline facility, an SMS service for teachers and students to fast-track their progress in education, and mobile health applications during pregnancy. More than 200 women participated, along with representatives from mobile companies, the international donor community, and Afghan and the U.S. Government officials.

“There are many mobile solutions to common problems Afghan women face. Mobile technology empowers women and provides more access to important information,”  said MOWA Minister Husn Banu Ghazanfar in her opening speech.

Echoing Minister Ghazanfar’s remarks, MCIT Minister Amirzai Sangin emphasized amazing advances in mobile technology this last decade in Afghanistan.

“Today, 88% of the population lives within the combined network coverage of the four largest mobile operators: AWCC, Etisalat, MTN and Roshan,” said Minister Sangin.

U.S. Embassy Coordinating Director for Development and Economic Affairs Ambassador Hilda Arellano highlighted the important role the Afghan Government’s regulatory framework plays in the increase of women’s access to mobile technology, and urged all conference participants to go further.

“Mobile technology is a powerful tool for progress and development. If used correctly, it can give a voice to the voiceless, vastly expand access to information and education, and lead economic innovation,” said Ambassador Arellano.

Photo Credit: Jawad Jalali / AFP

Dambulla: An agricultural hub being transformed by mobile

• Topic: mAgri, Connectivity
• Region: South Asia

Dambulla is the central farming district of Sri Lanka, playing host to the largest convocation of growers and brokers in the country. Its markets feed the capital, and neighbouring towns and villages. Here, we speak to farmers who describe how access to mobile and mobile services are transforming traditional farming techniques and enabling entrepreneurs to reinvest the time and money savings that mobile confers back into their businesses.

This video was supplied to us courtesy of Mobile World Centre and was made from Mobile for Development video content. More info: http://mobileworldcapital.com/mobile-world-centre/

Faced with poor reading outcomes on national literacy assessments, Cambodia’s Ministry of Education, Youth, and Sport (MoEYS) shifted to a phonics-based approach to teaching reading in 2011 and recently rolled out new reading textbooks for grades one through three. The newness of the curriculum means that many teachers are unfamiliar with it. World Education, Inc. (WEI) is playing a valuable role in helping schools successfully adjust to the new curriculum and promoting early grade reading through their Total Reading Approach for Children (TRAC) project. Made possible through the generous support of an All Children Reading [1] grant, WEI is working closely with local partner Kampuchean Action for Primary Education (KAPE), as well as collaborating with MoEYS to implement TRAC in three provinces in order to improve early grade reading among Cambodian children.

While many reading projects only focus on one area of a child’s reading environment (such as materials or teachers, etc.), TRAC is an innovative approach that addresses reading both at school and at home. TRAC has collaborated with MoEYS to develop short interval reading benchmarks in order to regularly assess students’ progress in acquiring reading skills. The project has also identified and trained literacy coaches for each target school who will work with teachers to assess the children and determine the skill areas in which they need more practice to achieve mastery. The coaches then act as a liaison between the schools and the parents to provide students with the learning support they need by administering TRAC’s Rapid Response System (RRS). The RRS includes garnering parental engagement and support; a Reading Toolkit that includes games, books, and other materials and is linked directly to the MoEYS reading textbooks and benchmarks; and a Khmer language mLearning application for mobile devices that is also directly linked to the MoEYS textbook and benchmarks.

The smartphone market in Cambodia is surging, with 26% of mobile devices subscriptions being for smartphones. Smartphone penetration is expected to increase substantially over the next few years, which will allow TRAC’s mLearning application to reach a significant number of children.

The mLearning application is not only an important component of TRAC, but it will also be the first Khmer language education app for the primary grades. To create this app, WEI has partnered with education software developer Smart4Kids LLC. WEI has divided the grade 1 and 2 curricula into 31 units that are aligned with the assessment benchmarks that TRAC has created as described above. For each unit WEI and MoEYS have identified and provided the appropriate educational content to include in the stories and games on the app (e.g., phonics, sight words, supporting visuals, audio), and then Media One, a local NGO and partner of the TRAC project, provides the illustrations and audio. This material is passed on to Smart4Kids, who integrates it into the app to create engaging learning games and stories.

The open-source app runs on the Android platform. A web-based version of the app has been completed, and a group of students recently tested it out and provided useful feedback. An Android version will be finished for testing in the next quarter, and the final version is expected to be completed by August: Just in time to be downloaded on to the tablets and smartphones that TRAC provides to each target school and on to families’ personal smartphones before the next school year begins.

Photos: Courtesy of the author.

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Mobile health (mHealth) deployments have grown dramatically in recent years, particularly in emerging markets, where base-of-the pyramid populations often lack access to basic health services, but possess a mobile phone. However, despite the proliferation of mHealth platforms, many remain limited in scale and are poorly integrated into existing healthcare systems. Introducing mobile financial services (MFS) within these platforms may offer a way to drive reduced costs and enhanced efficiency – resulting in more affordable, inclusive healthcare systems.

The Emergent mHealth Sector

According to the GSMA mHealth Tracker, there are currently over 900 planned or deployed mHealth products and services globally, with the majority concentrated in Africa and over 100 in East Africa alone. Over the next few years, the global mHealth market is expected to exceed USD $30 billion, according to a recent GSMA mHealth report, as stakeholders look to reduce costs, add value and enhance the reach of health services.

However, despite projections of dramatic growth in the mHealth sector, particularly in low and middle-income countries, current offerings face many challenges. The GSMA report, for instance, suggests that many mHealth services remain limited in scale and lack commercial viability. According to Patricia Mechael, Executive Director of the mHealth Alliance, in a recent interview: “This inability to scale-up is often due to a lack of alignment with national health priorities,” and the lack of clarity within a range of areas, including: responsibility for financing, technology standards and policies to protect patient privacy.

Another key challenge to developing sustainable mHealth programs in emerging markets, according to Mechael, is establishing reliable financial systems with which to pay for the services. While healthcare spending consumes an average of 10 percent of GDP in OECD countries, low-income countries only devote around 5 percent of their GDP to health. Accordingly, health systems in low and middle income countries are often “overburdened and underfunded,” said Mechael, with broken supply chains, under-trained health workers and unequal access to basic life-saving information and transportation.

Harnessing Mobile Financial Services to Improve Health Systems

In the emerging market context, integration of MFS into healthcare offerings can play an important role, contributing to the development of more sustainable business models (among for-profit healthcare providers), higher quality of care and greater access to care, according to Menekse Gencer, founder of mPay Connect, in a recent interview. From governments to private health service providers, harnessing mobile money technology can benefit a range of healthcare stakeholders.

For instance, healthcare providers – both public and private sector – can use mobile money as a means to better control financial flows and shift towards more transparent payments for health worker salaries. According to a recent mHealth Alliance report, of which Gencer was the lead author, current cash or check payment systems can be cumbersome and insecure, creating unnecessary costs for both workers and the provider. Disbursing salaries into mobile money accounts can reduce costs and enable providers to devote more resources towards serving patients.

Mobile financial services can further be used as a tool to incentivize improved performance among community healthcare workers, enhancing the impact of health services. In Pakistan, for instance, the non-profit Indus Hospital, “Pakistan’s First Paperless Hospital,” used mobile money to disburse financial rewards to health workers who screened for tuberculosis (TB) in their communities. The initiative led to a dramatic increase in reported TB cases, which more than doubled during the six months following its launch.

Tapping into expansive agent networks and mobile network infrastructure, integrating MFS may also enable healthcare providers to reach more patients. For example, mHealth providers can leverage MFS agent networks to accomplish shared or redundant tasks, such as signing up users, checking ID and registering phone numbers, according to the mHealth Alliance report.

Private sector stakeholders, such as for-profit healthcare providers, mobile operators or financial institutions, can also benefit from the integration of MFS into the health ecosystem. According to Gencer, leveraging MFS can support more sustainable business models for mHealth providers – boosting revenue through new value chain participants, and lowering costs incurred as a result of cash management, fraud, and settlement of remote payments for diagnostics and other services. Mobile operators looking to bolster revenues, further, may find value in offering health-focused mobile money products (such as the mobile health insurance product offered in partnership with Safaricom in Kenya).

Enhancing Health Access through MFS

Integrating MFS into healthcare systems in emerging markets further holds broad benefits from low-income, mobile phone-toting patients. According to Mechael, “Mobile money can provide a secure, easy way to pay for health services in developing countries, where most healthcare spending comes out-of-pocket.”

Additionally, providing low-income populations with alternative mobile financial services, such as savings, insurance or loans, can better enable them to afford health services, according to Gencer. In Part II of this blog series to be published next week, we profile a few companies that leverage the M-Pesa infrastructure to offer these alternative financial resources.

Resistance to Change

Integrating new technology into established systems is not always easy, and existing players may be resistant to changing the status quo. Barriers to adoption may include issues of privacy, security of clinical data and limited evidence or research regarding how integrating technology (such as MFS) can improve health outcomes, according to a Vodafone mHealth report. Government healthcare providers, specifically, with their layers of bureaucracy, may be slow to transition from paper-based to mobile payment systems, despite the promise of a long-term pay-off.

Further, while mobile money is growing at a rapid pace, “it is still not ubiquitous,” said Gencer. Accordingly, she suggested: “any decision to use MFS for health must be accompanied by a full understanding of the extent of the MFS infrastructure in that market.” According to an mHealth Alliance report published in March 2012, leveraging MFS for health initiatives can have prohibitive set-up costs, due to the cross sectoral and highly fragmented nature of the mobile money industry.

Mobile financial services hold tremendous promise for transforming existing healthcare systems in emerging markets, benefiting all stakeholders, including patients. However, limited scalability among existing mobile health offerings suggests that this potential has yet to be fully capitalized upon. Achieving effective platforms will require key healthcare players to proactively research and adopt these new technologies. Further, innovators will need to continue developing user-friendly, interoperable services that reach those who need them most.