Public Health Seminar

1. Seminar on
mHealth: Advancing health care/services
through mobile technologies
Presented by:
Binod Poudel Kshetri
Exam roll no.: 16370145
School of Health and Allied Sciences
Pokhara university
1
Under the cordial guidance of
Hari Prasad Kaphle
Associate Professor (Public Health)

2. 2

3. Introduction
• mHealth refers to the use of mobile computing and communication
technologies in health care and public health.
• mHealth services use mobile electronic devices (MEDs), such as
personal digital assistants(PDAs) and mobile phones.
• It facilitates the health information sharing like clinical decision, health
awareness.
• Mobile health services are used by the healthcare professionals for data
collection and supporting health behaviour change and chronic disease
management by patients in the community
3
Patrick K et al. Health and the Mobile Phone. Am J Prev Med 2008;35(2)

4. Cont.
• Use of the mobile technology help to connect and share information in
the rural and hard to reach areas.
• It is also used for re-visits and consultation with health professionals.
• M-Health is a component of eHealth
4

5. Cont.
mHealth projects throughout the world are generating benefits including:
• Increased access to healthcare and health‐related information, particularly
for hard‐to‐reach populations
• Increased efficiency and lower cost of service delivery
• Improved ability to diagnose, treat, and track diseases
• Timely more actionable public health information
• Expanded access to ongoing medical education and training for health
workers.
Kallandar K et al. Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community
Health Workers in Low and Middle-Income Countries: A Review. J Med Internet Res 2013;15(1):e17) 5

6. Developments in mhealth care
• Use of the mobile technologies in health began from 1990s.
• Mhealth care/services are broad in present situation that covers the devices
like:
oMobile/cell phones
oSmart watches
oTablets
• Google play store and apple store are two biggest stores for mobile
applications.
• Apple app store had around 35,000 Health & Fitness applications and
27,000 Medical applications till September 2014.
• Google play store have 8,000 medical applications
Xyanj Y. Mobile technology in health information systems – a review. European Review for Medical and Pharmacological
Sciences. 2016; 20: 2140-2143
6

7. Global scenario and practices
7

8. • A study in Kenya looked into malarial treatment adherence across 107 rural
health facilities.
• Over 6 months, two SMS messages were sent daily to health workers,
containing messages on key outpatient management of malaria in an effort
to improve the quality of treatment delivered.
• Results shows that treatment adherence improved by 31.7%
• Indian governmental launched a public-private partnership program called
‘104 mobile’ in 2008.
• The MMUs worked as the bridge between the health professionals and the
patients.
Charles S. Hall, Edward Fottrell, Sophia Wilkinson & Peter Byass (2014)Assessing the impact of mHealth interventions in low-
and middle-income countries – what has been shown to work?, Global Health Action, 7:1, 25606, DOI: 10.3402/gha.v7.25606
8

9. • Short message service (SMS) interventions for disease prevention in various
countries:
9
Intervention Country Disease Description
UNICEF Central
African
Republic
Measles,
malaria,
diarrhoea
Multimedia campaign used SMS to encourage
vaccination, use of long-lasting insecticidal
nets, and hand washing.
Text Me!
Flash Me
Ghana HIV/AIDS Clients who text in “HELP” were referred to
live helpline counsellors, who called back
within 24 hours.
Condom
Campaign
India HIV/AIDS Condom use promotion and HIV/AIDS
awareness campaign among young men with
(1) SMS opinion to vote on HIV/AIDS issues,
(2) condom-themed mobile phone ringtone
using SMS to get a push in reply.

10. Deglish C et al. Short Message Service (SMS) Applications for Disease Prevention in Developing Countries. J Med Internet Res
2012;14(1):e3) 10
Intervention Country Disease Description
Indian
tuberculosis
campaign
India Tuberculosis Public awareness campaigns used SMS for
tuberculosis information.
Global Hand-
washing
Day/UNICEF
Nepal Diarrhoea Public awareness campaign used SMS to
encourage hand-washing
It begins with
you
30
African
countrie
s
HIV/AIDS asked viewers to share what they have done
to advance an HIV-free generation, and
encouraged all Africans to
start by knowing their HIV status.
Cont.

11. Overview of selected mobile applications for health.
Fredfield C et al. Participatory Epidemiology: Use of Mobile Phones for Community-Based Health Reporting. PLoS
Medicine.2010. 7:(12) 11
Organization/a
pplication
Implementation and
location
Use
Frontline/SMS-
2005
Many applications, including
health & emergency alerts
and disease control. Malawi,
Honduras
Two-way communication via SMS –
only requires mobile phone connection,
no Internet, between people whose
contact information is known.
Goechat-2007 Natural disasters in Thailand,
Cambodia and other
locations.
Designed as a group communications
technology for use between members of
crisis response team
Asthmapolis-
2010
Asthma attack and inhaler
usage tracking. Pilot tested in
USA.
Results of patient inhaler use
information will be made
available to patient and physicians.

12. Regional scenario and practice of mhealth
• Mhealth was used in the 21 developing countries to improve the
vaccination of children.
• Text message and phone calls were practiced to alert the parents about
the child vaccination.
Alam M et al. Patients’ and Doctors’ Perceptions of a Mobile Phone–Based Consultation Service for Maternal, Neonatal, and
Infant Health Care in Bangladesh: A Mixed-Methods Study. JMIR MHealth Uhealth 2019;7(4):e11842) 12

13. Trend of the medical journal in European region
Beruigett S et al. Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile Phone and Web-Based Text
Messaging in Mental Health. Journal of medical internet research. 2016;18(6):e135 13
0
2
4
6
8
10
12
14
16
2006 2007 2008 2009 2010 2011 2012 2013 2014
n
Axis Title
n
Above shows the trend of article search related to mobile technology and
health for the systematic review research.

14. Aponjon service in Bangladesh
• Aponjon is mHealth service that provides weekly voice or text
messages to pregnant women, new mothers, and family members on
various aspects of maternal, neonatal, and infant health.
• 3894 subscribers accessed the service for health consultations.
• Rural households and pregnant mothers were mostly facilitated.
• Callers found the consultation service trustworthy, cost-effective, and
convenient.
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15. National scenario and practice of mHealth
• Matri-suman is a capacity building and phone text intervention to increase the
MCH services.
• This study was done among the 334 pregnant women of Dhanusha district.
• Regulate the text message through phone in every fortnight in preferred
language (Nepali or Maithili).
• Package of messages of 160 letters was prepared for all participants in the
intervention containing messages about:
• routine antenatal care, place of delivery,
• postnatal care and diversified dietary intake including
• how frequently they consume such diet.
Kumar J, kandel R. ‘MATRI-SUMAN’ a capacity building and text messaging intervention to enhance maternal and child health service utilization among pregnant
women from rural Nepal: study protocol for a cluster randomised controlled trial. BMC Health Services Research (2018) 18:447 https://doi.org/10.1186/s12913-018-
3223-6
15

16. Use of mobile phones during the NDHS 2011 data
collection
16

17. • Medic Mobile’s Muvuku software was used by CHWs to assess the
information on diarrhoea and respiratory diseases in Accham district.
• A special type of parallel sim card was used to reduce the connectivity
issue.
• The data was then transferred to the server through internet.
Meyers DJ, Ozonoff A, Baruwal A, Pande et al. (2016) Combining Healthcare-Based and Participatory Approaches to
Surveillance: Trends in Diarrheal and Respiratory Conditions Collected by a Mobile Phone System by Community Health Workers
in Rural Nepal. PLoS ONE 11(4): e0152738.
17

18. Mobile phones use in academic study purpose
• A study was conducted to evaluate the use of mobile phones in
learning among the medical students of Kenya.
• 292 respondents were included out of which 88% of respondents
owned a smart device.
• 65% of the respondents used at about 1-5 medical mobile
applications.
Masika M et al. Use of mobile learning technology among final year medical students in Kenya. Pan African Medical Journal.
2015; 21:127 18

19. Research Findings Related to the Use of Mobile
Technologies in Emergencies
• Access to Emergency Transportation and Services
• Point of Emergency Care Support
• Telemedicine
• Remote Patient Monitoring and Emergency Alert Systems
• Natural Disaster Management and Recovery
Patricia M et al. Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: Policy White Paper. Earth institute
Columbia university 2010 19

20. Challenges of mhealth
• Low network coverage
• Policy barriers: IT rights and regulations
• Lack of IT knowledge
• Lack of infrastructures and equipments.
Patricia M et al. Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: Policy White Paper. Earth institute
Columbia university 2010 20

21. Ways to forward
• Collaboration: government should collaborate with private
organization to advance technology in health.
• Financing for mhealth
• Infrastructure: faster network, high performance devices
• Community engagement and human resources.
• Develop technology friendly rules and regulations.
Patricia M et al. Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: Policy White Paper. Earth institute
Columbia university 2010 21

22. Bibliographies
• Patrick K et al. Health and the Mobile Phone. Am J Prev Med 2008;35(2)
• Kallandar K et al. Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of
Community Health Workers in Low and Middle-Income Countries: A Review. J Med Internet Res 2013;15(1):e17)
• Xyanj Y. Mobile technology in health information systems – a review. European Review for Medical and
Pharmacological Sciences. 2016; 20: 2140-2143
• Charles S. Hall, Edward Fottrell, Sophia Wilkinson & Peter Byass (2014)Assessing the impact of mHealth
interventions in low- and middle-income countries – what has been shown to work?, Global Health Action, 7:1,
25606, DOI: 10.3402/gha.v7.25606
• Deglish C et al. Short Message Service (SMS) Applications for Disease Prevention in Developing Countries. J Med
Internet Res 2012;14(1):e3)
• Alam M et al. Patients’ and Doctors’ Perceptions of a Mobile Phone–Based Consultation Service for Maternal,
Neonatal, and Infant Health Care in Bangladesh: A Mixed-Methods Study. JMIR MHealth Uhealth
2019;7(4):e11842)
• Fredfield C et al. Participatory Epidemiology: Use of Mobile Phones for Community-Based Health Reporting. PLoS
Medicine.2010. 7:(12)
22

23. • Beruigett S et al. Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile
Phone and Web-Based Text Messaging in Mental Health. Journal of medical internet research.
2016;18(6):e135
• Kumar J, kandel R. ‘MATRI-SUMAN’ a capacity building and text messaging intervention to
enhance maternal and child health service utilization among pregnant women from rural Nepal: study
protocol for a cluster randomised controlled trial. BMC Health Services Research (2018) 18:447
https://doi.org/10.1186/s12913-018-3223-6
• Meyers DJ, Ozonoff A, Baruwal A, Pande et al. (2016) Combining Healthcare-Based and
Participatory Approaches to Surveillance: Trends in Diarrheal and Respiratory Conditions Collected
by a Mobile Phone System by Community Health Workers in Rural Nepal. PLoS ONE 11(4):
e0152738.
• Masika M et al. Use of mobile learning technology among final year medical students in Kenya. Pan
African Medical Journal. 2015; 21:127
• Patricia M et al. Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: Policy
White Paper. Earth institute Columbia university 2010
23

24. Thank you!!!!
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