What is mHealth?
mHealth stands for the provision of health-related services using mobile communication technology. Modern information and communication technologies (ICTs), such as the internet, are not yet commonly available in resource-poor settings. The mobile phone is a notable exception as it is the first ICT tool that has reached even remote areas in low- and middle-income countries (LMIC). The coverage of mobile networks is increasing rapidly all over the world and the number of subscribers has by far exceeded the number of fixed-line connections in many LMIC in recent years.
This growing coverage provides health systems with new possibilities to address problems in accessibility, quality, effectiveness, efficiency and costs of health care. Despite the recent emergence of mHealth, already a vast number of mHealth projects has appeared in LMIC.
Clients of health services make and receive phone calls or text/voice messages related to health education, treatment adherence, contacting health workers or organizing transport to health services. Health care workers receive diagnostic support, consult with colleagues, communicate with clients, enhance their skills and gather and analyze data using mobile devices.
As yet these initiatives mainly consist of pilot studies or local projects with a limited scale and scope. Due to the ease of access to this technology and varying levels of documentation in terms of quantity and quality, it is impossible to create a complete overview of projects and resulting experiences.
While there is still a lack of evidence-based research into the effectiveness and efficiency of mHealth interventions, the body of grey and scientific publications is growing and suggests mHealth as a promising development for the provision of improved health care services to poor people and to those living in marginalized areas. Some of the current barriers that need to be overcome for the wider implementation of mHealth in health systems in LMIC include:
•the enduring need for rigorous research and evaluation of costs, benefits and actual mHealth outcomes;
•insufficient knowledge of the appropriate integration into health systems;
•the lack of local ownership and involvement;
•not enough sharing of experiences, adoption of best practices and implementation of collaborative approaches.
(see also the list of Top Ten Lessons Learned on mHealth that summarizes the experiences by a group of mHealth experts).