The Journal of mHealth Vol 2 Issue 4 (August) - Page 40

mHealth in Developing Countries Continued from page 37 affordable, accessible, and available. For the purposes of this paper, we will focus exclusively on mHealth. mHealth, as a subset of eHealth, differs from eHealth in a variety of ways. At its core, the distinction between mHealth and eHealth is often thought of as the use of mobile devices (PDAs, 2G cellular phones, smartphones) versus desktop computers or laptops and web/internet connection. In this sense, mobile technology is a lot more widespread. There are more people on this earth with access to a cellular device and a cellular network, even in lowincome regions, than there are individuals with a stable and reliable connection to the Internet and a personal computer. As a result, mobile health technology is more widespread and is more personal, as a user can use the functions of their mobile device to personalize their mobile healthcare. Additionally, developing nations do not have the infrastructure or the money to set up the infrastructure necessary to support 20th century information technology such as powerful computers and strong web access. Therefore, they have bypassed this level of technology and have gone straight to mobile solutions. Network connectivity is widely available, and costs significantly less than a stable Internet connection. Additionally, mobile devices are inexpensive and oftentimes free (recycled use). mHealth in Low-Income Countries While availability of and access to healthcare are challenges in developing nations, access to mobile phones is rising rapidly. As of 2010, the World Bank reports that developing nations experience more mobile use than developed nations. Mobile phone users in developing nations account for 77% of the population.8 Fast-forward to 2013, the ICT reported that mobile penetration rates in developing countries have reached nearly 90%. More people have access to a mobile signal than they do to electricity or water.9 The accessibility of mobile phones and cellular networks in developing countries has led the way to eHealth, specifically mHealth, as a low-cost solution to healthcare issues in these nations. mHealth Innovations In Developing Nations Disease Management In South Africa, the spread of Tuberculosis (TB), a communicable disease that attacks the lungs, is a critical issue. Even more concerning, there are patients in South Africa with highly-resistant forms of TB that are being sent home and therefore becoming a greater risk to the spread of the disease simply because they are being discharged from the hospital due to a lack of treatment options. The existence of this high-resistant form of TB is due in part to the mismanagement of the disease.11 SIMPill, a mHealth innovation developed in South Africa in response to this mismanagement of TB, is a pill bottle with a device attached to it that includes a transmitter and a SIM card (Exhibit 2). When the pill bottle is opened, an SMS message is sent to a central server. When the pill bottle is not opened during a set tolerance period, an SMS reminder is sent to the patient (or other caregivers). If the patient still does not adhere, a health worker will contact them directly. In its first study in 2005, 97% of patients said SIMPill helped them take their medicine, while treatment adherence increased almost 10%. In a larger pilot in Exhibit 2: SIMPill 38 (image source: August 2015