Ecosystem factor: The rise of ‘informal’ mobile systems
‘Formal’ (top-down) mHealth systems have faced significant challenges in Africa, regarding both scalability and sustainability. According to a recent scientific study, issues include ‘the patchy and unsustained nature of formal mHealth provision’ combined with factors such as ‘unsustained funding, insufficient financial/infrastructural support, and equipment failure.’
In contrast, the ‘informal’ model of healthcare staff using personal mobile phones for work-related purposes has dramatically increased. For example, over 97% of healthcare workers surveyed in Africa reported using the ‘informal’ personal phone system but only 15% reported using ‘formal’ mHealth applications.
But while this emergent ‘informal’ health system has the possibility to be responsive to local needs, it is not without drawbacks. Healthworkers in Africa report challenges such as being overwhelmed with calls on repetitive topics, needing to spend their own money on purchasing phone credits to send messages, losing battery power at critical times, etc.
Our competitive advantage: The Micromedia Modular Database empowers ‘informal’ systems in multiple ways. First, it enables healthcare workers to save time by not needing to provide information repetitively on basic topics (that could also be handled by sending pre-determined text or audio messages from the database instead). Second, messages coming directly from a database – rather than from a healthcare worker’s personal phone – handle the issues of phone credits and battery power.
Ecosystem factor: Inclusive, sustainable… or not?
Many digital health innovations in Africa aimed at pursuing Universal Health Coverage goals have in fact proven to be non-inclusive and unsustainable.
The distinction often is whether the goal is to scale towards new international markets or national healthcare systems and populations. This challenge is especially critical in East Africa which has long been characterized by ‘NGOised, fragmented and vertical healthcare systems and heavy dependence on foreign capital.’
An example is the M-TIBA digital platform ‘health wallet’ accessible through a mobile phone, which had originally targeted Kenyans with low-incomes to enable healthcare savings. When that business model did not work, M-TIBA changed its focus to targeting those with higher incomes instead.
In addition, the pandemic has demonstrated that coordination and interoperability of existing solutions can be far more important to healthcare sustainability in last-mile settings than new technology. For example, in East Africa, established methods such as mobile phones and WhatsApp messaging have proven critical in the distribution of COVID-related public health information.
Our competitive advantage: The Micromedia Modular Database does not aim at reinventing the wheel. Rather than creating a technical product which will be largely inaccessible to the disadvantaged and those in last-mile settings, our innovation lies in increasing access to existing information channels and improving the related technical integration.