CPC report by Andrew Spieldenner
The session was packed, as people were clearly excited about getting information on the use of mobile technology in public health. While nearly everyone has access to a mobile phone and many prefer mobile phones to other communication channels, there has been little in the development of prevention and health packages that include new media.
Eunice Namirembe presented on the use of mobile phones in Uganda, where a generalized HIV epidemic is taking place. Mobile phones have been used in telehealth and M-health initiatives in tuberculosis, family planning, data collection and medical adherence. In HIV, the M-health initiative has put quizzes on basic HIV knowledge through mobile phones. The cost per person is less than $1 USD. Text messaging has been useful in organizing people for HIV testing, leading to a 100% increase in voluntary counseling and testing in the week the text was sent. One of the lessons learned was that text messaging must exist within a larger initiative of communication channels.
Dr. Peter Benjamin showcased a project that used M-health in vertical transmission initiatives. By using a variety of text messaging themes, the initiative gave information to women on a range of health issues, including vaccines, breastfeeding, bonding, hygiene, clinic attendance and postnatal concerns. Dr. Benjamin pointed out that every trial has shown that people like messaging, but the studies have thus far had small impact. The great potential is actually more hype than reality, and there is a major issue of going to scale. The pilot studies fail to account for the fact that sustainability requires 2-3 years of embedding the program within the local community.
Dr. CI Azih discussed the Swaziland initiative. Dr. Azih pointed out that the ideal intervention must be simple and easy to implement, of high impact and at a low cost. In addition, the population to be served must have high mobile phone ownership, broad network coverage and high literacy. At the systems level, the use of M-health requires extensive training and buy in of clinical staff over the technology and confidentiality concerns.