The timeline of an optimist

Digitally-enabled health care, or mHealth, is one area that has been slow to emerge, because it is difficult to build a great platform and then convince everybody in a health system that it is worth using. If some health workers use cellphones to send information to a central database, but others do not see the value, the digital system is incomplete and thus just as flawed as the current paper system.

The most promising mHealth project that I have seen, called Motech, focuses on maternal and child health in Ghana. Community health workers with phones visit villages and submit digital forms with vital information about newly pregnant women. The system then sends health messages to the expectant mothers, such as weekly reminders about good pre-natal care. The system also sends data to the health ministry, giving policymakers an accurate and detailed picture of health conditions in the country.

Those working on AIDS, tuberculosis, malaria, family planning, nutrition, and other global health issues can use the same platform, so that all parts of a country's health system share information and respond appropriately in real-time. This is the dream, but it works only if frontline workers are inputting data, health ministries are acting on it, and patients are using the information that they receive on their phones.

I realized that things were taking off when our partners on Motech started talking about burdensome network costs and simplifying the user interface. The application was really being used in the field, and the stickiest challenges were presenting themselves which meant that the system had proved that it was valuable enough for people to put in the work to solve problems as they arose, instead of just reverting to the old system. This digital approach is now being extended to other regions, including North India.

A decade ago, people said that this would happen quickly. It didn't, because the pieces just were not there. Now they are starting to come into place. It will take a decade to get certain applications into a lot of places, but the momentum will build and we will learn as we go. In the long run, the results will be just as transformative as we hoped, if not more so. Ultimately, when people are truly empowered, they will begin to use digital technology to innovate on their own behalf, building solutions that the established software-development community never considered.

The author is co-chair of the Bill & Melinda Gates Foundation.

Project Syndicate

(China Daily 01/04/2013 page9)