Reality check from The Anova Health Institute and HIVSA seminar
Early in August, our mHealth team attended a two-day mHealth seminar hosted by The Anova Health Institute and HIVSA in Johannesburg, South Africa : The new frontier: Including mHealth in strengthening South African Health Systems with the main focus on advances and developments in mHealth.
The main objective of this seminar was to share research and best practice models of using mHealth initiatives in the context of strengthening health systems in South Africa with focus on the following topics:
- mHealth – Where does it fit into the National eHealth strategy and what does it mean?
- mHealth – Supporting Health System Strengthening
- Mother Neonatal and Child Health – can mHealth be a game changer in this field?
- mHealth – Innovative technology and Public, Private, Partnerships
- mHealth evidence based research and best practice models – what will inform the future?
Dr Peter Barron from National Department of Health opened the conference with the presentation: The Promise of mHealth for the South African health System. He started the presentation with the promise of mHealth by quoting Andrea Monteiro from Mobile Health Africa, a 2012 conference: “Africa carries more than 24% of the global burden of disease but has an average of only two doctors per 10000 people – a statistic that adds to the challenge of providing healthcare for the majority of people in Africa”; stressing further the potential for the evolution of mHealth services: “The country has a brilliant telecoms infrastructure, both in terms of service provisioning and technology and is home to several entrepreneurial NGOs currently investing in mobile technologies”. [1]
Potential for mHealth? More Evidence Needed
Dr Barron outlined various areas where he sees the potential [2] for mHealth however he concludes his presentation with reality check: by quoting different articles: “We found very limited evidence that in certain cases mobile phone messaging interventions may support preventive health care, to improve health status and health behaviour outcomes. However, because of the low number of participants in three of the included studies, combined with study limitations of risk of bias and lack of demonstrated causality, the evidence for these effects is of low to moderate quality. The evidence is of high quality only for interventions aimed at smoking cessation. Furthermore, there are significant information gaps regarding the long-term effects, risks and limitations of, and user satisfaction with, such interventions”. [3]
And: “While enthusiasm for effective mHealth interventions in Sub-Saharan Africa is high, little is known about their efficacy or effectiveness …” [4]
5 Key Levels of Evidence for Scale in Health System
Peter Benjamin from mHealth Alliance presented 5 key levels of evidence for scale in health system that the industry needs to focus on:
- FUNCTIONING: Does the system function properly
- USABILITY: Will people use it? Will people keep using after 6 months?
- IMPACT: Does it have any impact?
- SCALE: Will it work at large scale?
- ECONOMIC: Is it cost-effective?
Today, we as an Industry, need to step together and start working on evidence that will showcase the potential and more importantly the value of mHealth for various stakeholders in mHealth eco-system.
Presentations from the seminar can be downloaded here.
Photo Credit: From a presentation by Peter Benjamin, mHealth Alliance, presented at the two-day mHealth seminar. Used with permission.
[1] GSMA will publish South African Country Feasibility Report by the end of the month where you will be able to read more about the potential of mHealth in South Africa.
[2] Potential for mHealth was also presented in Peter Benjamin’s presentation: Towards Coherent mHealth in South Africa
[3] Mobile phone messaging for preventive health care. Vodopivec-Jamsek V, de Jongh T, Gurol-Urganci I, Atun R, Car J. Cochrane Database Syst Rev. 2012
[4] Scaling Up mHealth: Where Is the Evidence? Tomlinson, Rotheram-Borus, Swartz and Tsai.