David Kulick, ICT and Innovation Program Officer with Johns Hopkins University Center for Communication Programs, addressed a problem integral to the analysis of many development projects. That problem is assuring that when tools or resources are delivered to communities, knowledge of use needs to be delivered as well.
This made me think about our discussions on One Laptop Per Child because this was a case in which large assumptions were made of the connection between a tool and results without anything in between. It may be true that a laptop can be a road towards improving education, but there has to be more to it than just delivery of the tool.
Kulick explained one assumption concerning people’s knowledge of malaria. He noted a project that delivered bed nets to keep out mosquitos, but questioned whether people got the connection between the bed nets and prevention of disease.
One program Kulick brought up as an example of closing these knowledge gaps is The ReMiND Project. Catholic Relief Services partnered with Dimagi, a technology innovator, to provide a service for new mothers to prevent newborn deaths and improve maternal health. The goals of The ReMiND Project are “Phone-based job aids for government community health workers and midwives; Real-time data tracking and SMS reminders to health workers to conduct home visits in the first 24 hours after birth with alerts to supervisors for missed visits; and Mobile phone birth announcements and health messages for fathers to generate demand for services and encourage healthy practices.” (source) This is an example of an eHealth practice to reduce newborn deaths.
The interesting contradiction is in the material I read about The ReMiND Project I didn’t once come across anyone addressing if the people had a way to receive SMS messages.
ICT for health initiatives are widely popular interventions for disease control and prevention in developing contexts, and have been increasingly employed on both the patient side and for medical professionals over the last decade. Approaches of ICT for health cover logistics, telemedicine, supervision, data exchange, medicine reconciliation, and emergency notifications. They are also employed through a variety of mediums, including SMS services, mobile gaming, television programs, open-source software, and even voice and audio applications. Yesterday, David Kulick from the John’s Hopkins Bloomberg School of Public Health related to our class the ins and outs of developing ICT health related initiatives. The Hopkin’s Center for Communication Programs combines forces with the Bloomberg School to formulate projects devoted to changing behavior on a community and individual level, and has been active since 1988 in more than 30 countries. ICT initiatives for behavioral change, as compared with other ICT for health approaches, work to find “new, participatory ways to reach audiences with persuasive messages” that can transform ways of thinking and interacting to make a society healthier as a whole (jhuccp.org). An example of such a CCP program is MAMA, or the Mobile Alliance for Maternal Action. This initiative, which is active in Bangladesh, India, and South Africa, uses SMS during weeks 5-42 of pregnancy and the first year of a baby’s life to inform a mother about antenatal care, nutrition, and even insecticide treated bed-nets to improve health outcomes. These techniques are used by many ICT for health projects, and are an important intervention that can provide beneficiaries with critical information in a short amount of time.
An interesting dilemma facing the ICT for health field is the stratification of beneficiary access, which is in turn reflected in the results of a given project. Mobile phones and televisions are commodities, and the poorest members of a community who made need such ICT interventions the most may not be reached due to cost limits. In addition, gender biases in many societies can restrict women’s ability to use applications; for example, many times a woman’s husband or male family member controls a phone, and a pregnant woman may not be able to view SMS messages concerning maternal health or she may be afraid that the messages will result in an invasion of her privacy. Another key problem with ICT for health applications is an issue that reverberates across development projects in general: their “one size fits all” model decreases their effectiveness in getting at the root of the problem. Mass SMS programs that intend to respond to health queries are not yet sophisticated enough to take into account demographic differences such as sex, age, or economic status, and thus may provide irrelevant and unusable advice to beneficiaries in need. ICT for health programs such as those maternal health applications developed by the CCP have made strides in decreasing maternal and infant mortality, but future health projects should look towards innovations that make applications more individualized towards the recipient. Changing behavioral norms is quite difficult, but ICT has the ability to harness changing technology to find cutting edge solutions to health issues and to apply these lessons to other sectors of development.
mHealth, an abbreviation of mobile health, is a broad term generally used to describe health programs and initiatives operating primarily through mobile devices. Mobile device use is on the rise, and it is now estimated that up to 85% of the world’s population is covered under some mobile subscription. In rural areas with limited access to physical clinics, doctors, and resources this type of program can have far-reaching benefits. Because of the nature of mobile devices, applications, etc. mHealth initiatives are able to cover a wide range of health topics including general health information, diagnosis, and disease tracking.
To me, mHealth has a huge potential for use in developing nations. While researching the topic, I came across MAMA (Mobile Alliance for Maternal Action). This program operates mainly through SMS messages and simple voice reminders. MAMA currently operates in 69 countries and reaches nearly 141 million women. Their messages are based on WHO and UNICEF guidelines and provide information about what to expect from their babies at certain ages and reminders to get checkups or vaccines. To learn more about MAMA, check out their website below.
This is just one of many examples of mHealth initiatives focusing on developing nations. Of course maternal health has always been a focus, but what other ares do you think mHealth could have a major impact in? Do you see any challenges for these initiatives in the future? I think they are a wonderful example of just how much potential technology has in developing nations.
Source: iCow’s website
iCow is a subscription-based digital platform that allows Kenyan farmers to enhance their productivity. Farmers can access the platform by mobile phone and the web. iCow started as an SMS mobile phone application and has developed into a digital platform with a large array of services. The platform helps farmers keep track of their cows’ gestation calendar and also provides farmers with valuable nutrition and illness prevention tips to take good care of their herd.
According to iCow’s website, there are approximately 1.6 million Kenyan farmers, most of whom use “rudimentary methods to manage their cow’s estrus cycle and milk production.” iCow was developed by Su Kahumbu after she realized how small farmers in poor communities struggled to provide their most precious assets, cows, the care they need.
I grew up in a small farm in rural Panama and I remember how much time my father spent taking care of our cows. The Ministry of Agriculture conducted many workshops in our town with the intention of teaching farmers the best practices of the “cow care industry.” Unfortunately, farmers in lower income countries don’t get the support they need from their governments to increase their herds’ productivity. Thankfully tech entrepreneurs are paying close attention to the challenges of the agriculture sector and are coming up with creative solutions, such as iCow, to tackle such problems.
As part of her internship with Food Tank, former IDEV4100:ICT4D (Fall 2011 semester) student Suzannah Schneider authored this blog entitled “Five Ways Cell Phones are Changing Agriculture In Africa.” The post lists some familiar ideas, such as using mobile phones to access market prices and weather information, as well as receive useful information via SMS messages. However, it also mentions some more specific and innovative ideas such as iCow and micro-insurance. Based on your experiences in our class, what are your thoughts on these 5 applications of mobiles for agricultural development?
More information about Food Tank can be found in this video: “The Food Think Tank Trailer“
An installment from the National Geographic series Digital Diversity that shows how “mobile phones are being used throughout the world to improve, enrich, and empower billions of lives” greatly coincides with the report by Farm Radio International, “The new age of radio: how ICTs are changing rural radio in Africa”. Both the report and the article state that radio is extremely important for agriculture and increases awareness productivity and knowledge. The article stated an interesting point that having other farmers speak on the radio creates a sense of community as well a larger impact. Rural farmers are more apt to take advice from people they can relate to and trust (like a fellow farmer) than a radio producer or radio host. The FRI report stated that there were some concerns about the availability of the shows since they are not always accesible, but the article states there is a higher chance of the farmers listening if they air them at night when they are relaxing in their homes.
The “two way” versus “one way” communication was also mentioned in the FRI report, letters being the only option for farmers to contact the hosts or programs, though the article shows that many are utilizing their mobile phones and texting in questions and comments (around 20 texts a week per program). The FRI report states that there are more listeners when the program sends out text alerts around 30 minutes before hand. Both these usages of SMS are beneficial, quick, and painless. The benefits of radio are not only seen in agriculture, many could be seen seen in other sectors such as health. For instance, how farmers find out how to prevent or treat poultry disease can be transferred for human diseases and treatments. Overal the widespread penetration, accessibility, and affordability of radios’ make them great for less developed nations and should be utilized more often.
Neustar, a provider of real-time information and analytics for the Internet, telecommunications, entertainment, and marketing industries, published mGovernment: How Government Agencies Can Use SMS , a paper on the benefits of SMS for governments to communicate with their citizens. They argue the availability of SMS is a key component of its value. Citizens do not need expensive data plans or smart phones to communicate. Additionally, because mobile phones have taken the place of land-lines, mobiles are an incredible tool to use as a means to provide information. The final argument Neustar makes is “since most consumers have their mobile phone within reach and keep the device always on, government agencies can make public information and government services accessible to the population anytime and anywhere”.
A crucial component for governments to use SMS is for disaster management. Neustar provides case studies of disaster management implementation through SMS. The paper mentions Oman, a country that is mostly desert, and ways they use SMS for disaster management. Oman sends out texts to citizens when it is raining heavily via The National Committee for Civil Defense. An example of a text is the following:
“’Despite the low precipitation yesterday, some casualties were recorded due to some people’s venturing through wadis. We exhort you to be extremely cautious. NCCD.’”
The idea of disaster management is different from disaster relief, however the use of ICTs is one in the same. Spreading knowledge, whether that be pre or post disaster is important. Allowing citizens to understand conditions of disasters prior to their occurrence can help prevent relevant dangers to citizens. Oman is just one of many countries using SMS for disaster management. It is evident this concept is universal and should be implemented across the globe.