mHealth for Rural India; are we ready?

What is mHealth?

mHealth India

mHealth is generally viewed as the delivery of healthcare services or information with a mobile phone. The services available today in global markets vary greatly in their level of sophistication. Some provide static information about a disease or illness, while others move considerably up the value chain by providing comprehensive healthcare management beyond what could be delivered by only a face-to-face interaction with a healthcare provider. As mobile networks cover new swaths of the world and reach more people, the cost of mobile phones and airtime is declining. Meanwhile, continual innovation in technology infrastructure means mHealth can reach communities in ways that health services and other communication tools cannot.

mHealth drivers
mHealth barriers

Current scenario in India

In India, there is considerable potential to leverage mHealth (mobile health) as an alternative healthcare delivery channel. India has only 0.7 Doctors, 1.3 Nurses and 1.1. Hospital beds per 1000 population thus creating a need for alternative channel like mHealth for delivery of healthcare. Additionally, there are some worrying statistics on the Indian healthcare ecosystem. In fact, a large segment of the population is deprived of even primary healthcare facilities. It is imperative to leverage newer ways to make quality and affordable healthcare accessible to everyone.

Dr. Rana Mehta, Partner & Leader, Healthcare, PwC India said, “If mHealth is adopted completely in India, it has the potential to play a critical role in improving the healthcare outcome for the country. We can expect that through mHealth, an additional 12-14% of the population will gain access to healthcare. India’s population is around 1.3 billion and if we take a conservative estimate of 6-8%, we can expect to provide access to healthcare to an additional 79 to 105 million people.

In India’s rural communities, heart disease and related illnesses, such as diabetes, account for a very large proportion of all premature death and disability. These chronic conditions strike at a much younger age in India than they do in the West as a consequence, they are now the most common killers of people of working age, as well as the most common causes of catastrophic personal and family expenditure on emergency medical care. Not surprisingly, therefore, these diseases represent a rapidly growing cause of poverty in India today.

snapshot of Indian health ecosystem

Challenges to mHealth

Unfortunately, most people in rural India do not have reliable access to the healthcare required to prevent and manage serious chronic diseases. For example, most people with heart disease in rural India receive no regular medical care whatsoever. In India, there is considerable potential to leverage mHealth as an alternative healthcare delivery channel. Structural, financial and behavioural factors have created a significant need for such a channel. The structural issues are basic. The Indian patient base is rising and distributed. Access to even basic healthcare is a challenge because the supporting infrastructure and resources are inadequate. Financial constraints like rising healthcare costs and limited budget allocation for healthcare by the government further constrain the healthcare ecosystem in India. Behavioural factors such as change in lifestyle have resulted in newer types of diseases, which require access to specialists who are few in number and cannot be reached through traditional means of healthcare delivery. Also, the population is getting more tech-savvy and demanding easier and convenient means to receive care.

key barriers of mHealth
top barriers to adopting mHealth

Positive future for mHealth

Unless there is an interest or demand, mHealth is unlikely to succeed. According to data gathered from Google Trends, a tool which helps understand the relative interest in a particular search term, India ranks among the top five countries for search terms like “mobile health”, “health apps”, “medical apps” and “mHealth”. This confirms that the Indian population is interested in mHealth. India needs newer and innovative ways like mHealth to provide care and compensate for the deficiencies of the healthcare workforce and infrastructure. The country does not meet the minimum WHO recommendations for healthcare workforce and bed density. A large segment of the population resides in rural areas, where the numbers are even worse. In particular, the low-income group lacks access to quality healthcare.

India can benefit significantly from mHealth. Identifying relevant use cases to target by leveraging the available technology is key to driving mHealth adoption and improving care outcomes. Grassroots networks in rural India are an effective solution to the issue of technology access. Community driven programmes which match mind sets and technology should form the helm of development for mHealth technologies. India’s Ministry of Health and Family Welfare announced the national roll out of two MOTECH-powered programs developed by BBC Media Action, Mobile Academy and Kilkari, both aimed at addressing health challenges that result in high infant and maternal mortality rates. Under the Kilkari programme, pregnant women and mothers are contacted on their mobile phones and given crucial health information related to their stage of pregnancy or their infant’s age. Mobile Academy uses Interactive Voice Response (IVR) messages on mobile phones to train front-line health workers in maternal and infant care. The village they serve, and are central to India’s strategy to improve maternal and child health selects the health workers, known as ASHAs (Accredited Social Health Activists). the Swastha Bharat mobile application for information on diseases, symptoms, treatment, health alerts and tips; ANMOL-ANM online tablet application for health workers, e-RaktKosh (a blood-bank management information system) and India Fights Dengue.

mHealth related searches in India

Conclusion

For mHealth to succeed in rural areas a community-based strategy will be needed. Unlike more common mHealth partnerships that establish a link between a wireless carrier and a healthcare provider, rural mHealth may require a more complex model. A previously presented model, designed to address an array of mHealth barriers in rural areas, recommended a combination of using human resources, improving supply chains, providing micro-insurance and using low-bandwidth applications. Resources must be shared to lower per user costs and foster community involvement.

While there are huge opportunities for mHealth in theory, bringing them to fruition will not be easy. The first step is to create awareness about the various possibilities, available technology, successful implementations, as well as the possibility of partnerships with foundations, government organisations, telecom operators, etc. There is also an urgent need to recognize the elephant in the room in the form of wilful participation of all stakeholders of the healthcare industry-public and private. mHealth can potentially transform the healthcare landscape in India by improving healthcare access for the vast under-served rural market and enhancing patient care for urban consumers. However, rural and urban markets in India have distinct requirements.

References

Consumers Are Ready to Adopt Mobile Health Faster than the Health Industry is Prepared to Adapt, Finds PwC Study on Global mHealth Adoption. Retrieved January 07, 2018, from https://www.pwc.in/press-releases/global-mhealth-adoption.html

How mHealth can revolutionise the Indian healthcare industry. (2017). Retrieved January 07, 2018,from https://www.pwc.in/assets/pdfs/publications/2017/how-mhealth-can-revolutionise-the-indian-healthcare-industry.pdf.

Lunde, S. (2013). The mHealth Case in India. Wipro Council for Industry Research. Retrieved January 7, 2018, from http://www.wipro.com/documents/the-mHealth-case-in-India.pdf

Nationwide launch of Mobile Health Program in rural India signals new era of mHealth for emerging economies. (2016, January 15). Retrieved January 07, 2018, from https://www.grameenfoundation.org/press-releases/nationwide-launch-mobile-health-program-rural-india-signals-new-era-mhealth-emerging

India’s healthcare sector: A look at the challenges and opportunities faced by $81.3 billion industry. (2017, June 12). Retrieved January 08, 2018, from http://www.firstpost.com/india/indias-healthcare-sector-a-look-at-the-challenges-and-opportunities-faced-by-81-3-billion-industry-3544745.html