With more than 70 percent of the world’s five billion cellphone users living in low- and middle-income countries, mobile technology is seen as offering the potential to improve healthcare for the poor. The first African mobile health summit held in Cape Town, South Africa, from June 6 to 9 saw the release of the second global survey by the World Health Organisation (WHO) assessing this emerging field, known as “mHealth”.

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The WHO survey showed that eight of 10 countries are using mobile phones to support health services. The most frequently reported initiatives were call centres, toll-free phone services, systems for managing emergencies and disasters, and telemedicine interventions.

African mHealth projects cited as promising include an initiative in the Democratic Republic of Congo where Population Services International (PSI) supports a free hotline to back up its family planning campaigns, and a U.S. university-funded program in Ghana which offers free voice and SMS services around health needs.

The study raised concern that two-thirds of these programs are small and still in the pilot stage. “The dominant form of mHealth today is characterized by small-scale pilot projects that address single issues in information sharing and access,” the report concluded. “There were only limited larger mHealth implementations primarily supported by public-private partnerships.”

No rules exist
Misha Kay, manager of mHealth at WHO, told the summit that mHealth's effectiveness urgently needs to be assessed, as only 12 percent of the projects and services surveyed have been evaluated. Kay said that WHO aims to study global mHealth best practices and conduct cost-benefit analyses to evaluate programs in its study, especially in light of the limited budgets of developing countries.

Kay said that some 40 African countries currently use mHealth services, with larger countries that have several cellphone operators - such as Ethiopia, Nigeria, South Africa and Kenya - at the forefront of developments.

The WHO report singled out poor regulation of the mobile industry as a problem for mHealth development in Africa, noting that “No rules exist, for example, to stop pharmaceutical companies from giving away mobile phones to medical professionals as part of promotional campaigns.”

Mix of optimism and caution
In an opening address, South African Deputy Minister of Communications Obed Bapela told the summit that his government views mHealth with a mixture of optimism and caution.

"We're enthusiastic that technology will help fast-track the delivery of services and reduce transport costs for poor people,” he said. “At the same time, we're cautious about issues of confidentiality and the vulnerability of patients that arises around cyber security issues.”

Bapela voiced concern over the motives of the mobile industry for getting into healthcare, arguing that, “We also need to look at whether the mobile operators are just looking at an opportunity to make more money.”

Indeed the Global System for Mobile Communications Association (GSMA) that sponsored the summit placed great emphasis on the quest for sustainable business models to drive the emerging mobile health care market.

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