The most important mission I embark on when I arrive in a new country is finding a taxi driver who can speak English – even if it’s the broken kind. I don’t care too much for his/her driving skills really, as long as he/she can get me from A to B in one piece then I’m happy. But the thing that really gets me excited is when they can speak English and it’s a bonus when they are actually interested in having a conversation with me. With traffic in Africa, you tend to spend much time with your taxi driver and it makes a big difference if this time can be informative or even educational – for both parties. There are a few standard questions that they normally ask me – Where are you from? How long are you staying here? Is this your first time in my country? What do you think of my country so far? My best was when I got asked the last question after only having been in Rwanda for all of 3 minutes, after arriving at 02:00 am, in the darkness of the night. My response was “well so far, from what I can see, you have a lot of trees and I love trees. Let me tell you more tomorrow when the sun is up.”

I have a standard set of questions too (really important ones) – What’s the most popular sport in your country? Are there any cool markets that I should visit (my colleagues can attest to this one!)? What is your favourite food that I have to try before I leave your country? Which music from your country should I be listening to? … This usually breaks the ice and gets the conversation flowing.

Then I ask “do you use mobile money?”

Wait… is this a mHealth blog or what???… Stick with me here. The relevance of this lies in the answer to that question, which unsurprisingly is always “yes”, and the very fact that I never bother asking someone if they use mHealth.

How do you even use mHealth? Most people will never know what mHealth is. Even the people driving this industry will disagree on the very definition of mHealth. Mobile money on the other hand is something very simple and tangible to the end-user – it is money through your phone. This is the on-the-ground definition from my taxi drivers.

What can we do to position mHealth such that, in a year from now, when I meet another taxi driver in Africa, he/she will tell me that mHealth is health through your phone?

I think the first challenge is simplifying the concept of mHealth to the end-user. In comparison to mobile financial services which can be simplified to 4 applications for the end user – mobile money (payments & transfers), insurance, credit and savings, mHealth has 12 various strategies or applications of mobile in extending health to end beneficiaries. This makes it a more complex concept. In reality, many of those are targeted at frontline health workers. In fact, only 3 are targeted directly at the end beneficiaries:

– Behaviour Change Communication (educational health messages/content)
– Health financing (health insurance/savings/other health payments)
– Tele consultation (dial-a-doctor type services)

When positioning a brand of mHealth to the end consumer, we need to simplify mHealth into these 3 focal strategies. This is not saying that frontline health worker strategies are not important, but the continuous uptake of mHealth is dependent on it being recognised as a brand by the end consumer – in our case, the 211 million mothers in Sub-Saharan Africa that we are trying to reach and empower.

The other issue lies in the very term mHealth. Mobile health or mHealth is something that may never be common place in a conversation in Africa.

Short codes on the other hand, short codes are everything.

Having grown up in South Africa, I am very familiar with the concept of short codes. Except, until I started working in the mobile space, these were known to me as the *somethingsomething# codes. I knew them all because I had to know them. Recharging my mobile account, accessing information on certain topics, playing games – all very valuable services to me at the time and so I knew the short code required to access each of these services. And in fact, the short code became the name of the service for me. Just like my driver in Rwanda who could recite the *182# code (for his mobile money) in his sleep, I could list the codes with no effort at all. So how do we achieve this for health?

At the recent mHealth workshop hosted by the GSMA at Mobile World Congress in Barcelona, there were a number of mobile operators sitting around the same table. The most surprising take-away from this workshop was the willingness of multiple mobile operators to offer the same basic health messaging service, accessible on the same short code across all the networks. The idea being that in doing so, the efforts of the mobile operators in marketing such a service would be combined and also that this short code could then become synonymous with health amongst the beneficiaries of these services – consumers would know that if they needed health information through their phone, dialing *healthnumber# would suffice. When asked whether mobile operators would be willing to sacrifice their competitive advantage to deliver the same free service as their competitors, the response was that there is only competitive advantage when something is a recognized brand or perceived by the consumer as valuable. Mobile operators need to work together to create a recognised brand for mHealth which consumers not just want, but realise that they need. Mobile operators can then differentiate each of their services by offering other health products, perhaps even at a small fee, in addition to the free messaging service that is available across all networks.

This conversation was centred on countries where mHealth is not a recognised brand, but there are some countries where consumers know what mHealth is, and are adopting it. Tanzania is a good example – GSMA consumer research indicates that 87% of participants were aware of health tips as a Value Added Service (VAS) offered by mobile networks and 42% of participants were already registered for such services. This was a higher awareness than any other VAS offering. Tanzania boasts the very successful Wazazi Nipendeni with over 550 000 beneficiaries accessing maternal health content across any of the major mobile networks. This is partly because all 4 major mobile networks agreed to zero rate the messages for this maternal health service. In other countries such as Ghana, this level of awareness was only at 33% with only 17% of participants already consuming health tips through their phones. Ghana is yet to produce an mHealth service of the same scale as Wazazi Nipendeni and can definitely learn from the successful partnership model implemented there.

So back to my taxi drivers. I always try to explain, very simply, what it is that we are aiming to do in their country – “We are trying to give women access to basic healthcare information through mobile phones so that they will be educated and empowered to adopt better nutrition practises for themselves and their children. We are trying to prevent unnecessary deaths amongst women and children.” Their response is always very enthusiastic, to the extent where one driver actually asked me for the short code – “How can I access this for my sister?” The question is no longer “Is there a need or a desire to access health information through phones?” but rather ”How do we simplify this into something the end consumers can understand, access, and share with ease?”

Here’s to health for all… through their mobile phones!

Feel free to reach out to me for any further discussion on this blog, or simply if you’re looking for reliable and interesting taxi drivers in any of our 10 mNutrition countries. Give me a shout – I happen to know a few great ones! For more entertainment, I recommend that you read about our 10-hour journey with our taxi driver Luca in rural Tanzania!

For more information on GSMA Mobile for Development mHealth, please see here or contact us on [email protected].