mHealth in developing countries emerges as a means of providing greater access to larger populations segments, as well as improving the capacity of health systems in such countries to provide quality healthcare. Within the mHealth space, projects operate with a variety of objectives, including increased access to healthcare and health-related information; improved ability to diagnose and track diseases; timelier, more actionable public health information; and expanded access to ongoing medical education and training for health workers. For more information and practical examples of mobile apps or text messaging in the developing and developed world, please visit http://www.mhealthsolutions360.com.

1. Mobile Health Applications for the Developing World
May, 2014
Copyright © 2014 by Synegys s.r.o.
This report is solely for the use of client personnel. No part of it may be circulated, quoted, or reproduced for distribution outside of the client organization without prior written approval from Synegys
Improving patient health, quality of life and well-being by sending personalized, timely automated messages that educate, motivate or instruct

2. 1
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
In developed countries, mHealth will be a key factor to help address escalating healthcare costs associated with an increasing incidence of chronic diseases and an aging population.
mHealth, the practice of medicine and public health supported by mobile devices, is driven by different motivations in the developed and developing world
1 Growth rate is average exponential rate of growth between 2005 – 2010
2 Sub-Saharan Africa
Source: wikipedia, November 2012, GSMA, ITU, esa.un.org (2011), WHO / UNICEF Joint Monitoring Program for Water Supply and Sanitation (2012)
Developed Countries
African Countries
In Africa, poor and inconsistent healthcare delivery infrastructure and the challenge to manage prevalent communicable diseases increases reliance on mHealth.
Developed Countries
African Countries
Population Growth (2005-2010)1
0.42%
2.47%
Population growth in Africa continues to expand, whilst industrialized nations are faced an increasing incidence of chronic diseases and an aging population.
Median Age (2010)
39.9 years
19.2 years
Life Expectancy
(2005-2010)
76.9 years
55.6 years
Disability Adjusted Life Year (DALY)
Baseline
5x Baseline
Africa has a high burden of communicable disease prevalence (e.g. malaria) as compared to developed nations.
% Rural (2011)
22.3%
60.4%
Africa has a large rural community
Density of Health Workers / 1000 (2009)
2.6
0.64
Africa has a low healthcare workforce.
Access to Improved Sanitation facilities
95.7%
29.6%2
The wide prevalence of mobile connections stands out in sharp contrast to the lack of basic services that provide wellness and health.
Mobile Penetration (2012)
128.2%
63.5%

3. 2
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
The promise of mobile to extend the reach of health services has resulted in Africa being home to the largest number of mHealth projects
Source: November 2012, GSMA

4. 3
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
mHealth offers many opportunities – ranging from health education, disease prevention, disease treatment, healthcare and health support applications
Demand
Generation
Registration
Health
Worker
Supply
Chain
•Prevention
•Promotion
•Participation
•Drive Demand for Services
•Behavior Change
•Incentives
•Awareness
•Enlisting patients for specific programs
•Identify and Track Patients
•Mobile & Health Identity
•Patient Records
•Data Accessibility
•Improve Quality & Efficiency
•Extend Hospital Services
•Quality Assurance & Reporting
•Best Practice
•Job Aids
•Ensure Supply meets Demand
•Stock outs
•Facility Management
•Authentication
•Extend Hospital Services
•Drive Accountability
•Reminders
•Surveillance
•Diagnostics
•Referrals
mHealth Service Architecture
Service Area Service Function Examples
Source: GSMA
Adherence / Monitoring

5. 4
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
mHealth can be realized through Synegys’ mobile Health Services Management (mHSM) portfolio of services
Demand
Generation
Registration
Health Worker
Supply
Chain
Adherence /
Monitoring
mobile Health Solutions Management (mHSM)
mHSM consists of services which can work independently or be combined to address any mHealth Service Area.
Portfolio of services based on business intelligence combined with either mobile app or text messaging technology to educate people, support and promote treatment management and automate tasks
mHealth Service Areas

6. 5
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
Demand
Generation
Health Registration
Health Quizzes
Synegys’ mHSM can complement existing technology initiatives, be scalable and offer sustained capabilities to address health challenges
Illustrative mobile Health Applications using mHSM
Use of mobile and SMS-based health info and education to inform patients of preventive care & treatment – in this case, influence behavior change associated with HIV.
Use of mobile and SMS-based health info and education to inform patients of preventive care & treatment – in this case, inform people of AIDS support.
Demand
Generation
Registration
Health
Worker
Health Worker - Job Aids / Education Material
Supply
Chain
Reinforce health training, assess knowledge and provide performance support to healthcare workers.
Health
Worker
Source: Synegys mHSM

7. 6
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
Synegys’ mHSM can complement existing technology initiatives, be scalable and offer sustained capabilities to address future health challenges
Report Submissions and Reminders
Adherence /
Monitoring
Supply
Chain
StockOuts of ACTs and other Meds
Management of inventory and supply chain steps by mobile tracking and communication.
Collection and analysis of patient data; information to help health worker prioritization.
Source: Synegys mHSM
Illustrative mobile Health Applications using mHSM

8. 7
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
Services can also be offered through mobile apps used on smartphones; however the ubiquitous nature of phones capable of sending / receiving SMS should be considered when rolling out any mHealth initiative
Checking the Veracity of Medicine
Medical “App”
Custom built healthcare application on smart devices
Basic SMS & Mobile Internet
Using lowest common denominator devices to communicate to patients and clinicians

9. 8
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
Improve Communications Reach
•Delivering actionable info for preventive care & treatment.
•Providing job aids and health education to remote populations.
•Collecting remote data for disease surveillance and treatment.
Improve Adherence / Monitoring
•Influencing behavioral changes by sending reminders & motivation messages associated with treatment guidelines
•Performing interventions if, for example data is not submitted
•Authenticating drugs.
Reduce Costs
•Automating data collecting processes will cut paper and data- entry costs, and cut travel costs for both doctors and patients.
•Authenticating medicine will minimize the number of hospital visits due to complications arising from using fake medication.
Improve Reporting
•Checking stock levels to minimize stock-out of key combination therapy medications for malaria, TB, and HIV.
•Providing timely updates to Health Workers for immediate follow-up / intervention.
mHSM delivers significant benefits
•HIV/AIDS, tuberculosis, malaria and pregnancy-related conditions account for 3 million deaths in Africa every year.
•Poor and inconsistent access to healthcare services.
•Reaching remote populations with health information and services is very challenging.
•Acute shortage of healthcare workers.
•In some sub-Saharan African countries, as much as 50% of medication in the market is fake. 700,000 people die annually from fake malaria and TB drugs alone.
•Healthcare delivery systems will need to be upgraded to manage non-communicable diseases as well in addition communicable diseases.
Health Issues in Africa
Synegys’ mHSM Solution Benefits
Source: PWC, ITU

10. 9
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
Synegys’ mHSM provides a cost effective, scalable and sustainable solution to address both the obstacles to healthcare today and future health challenges.
Source: Gutierrez-Robledo, L.M. Looking at the Future of Geriatric Care in Developing Countries. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57:M162-M167, 2002.
•Communicable diseases
•Lack of immunizations
•Lack of safe water sources
•GDP growth increases spending on healthcare
•Traditional diseases controlled (TB, smallpox) and new diseases appear (SARS, avian flu)
•Aging population mean increase in death from non-communicable causes
•Declining birth rate and climbing life expectancy
•Adoption of ‘developed country’ behaviors
•Current health care picture issues continued
•Shift from ‘late stage treatments to prevention and early detection
•Increased focus on health issues of elderly
•Continued health worker shortages and distribution inequalities
Tomorrow’s
Healthcare Picture
Current
Healthcare Picture
Global & Demographic Changes
mHSM can be used to address emerging health needs, focusing on prevention and early detection today, and can be leveraged to address tomorrow’s problems relating to late-stage treatment and non-communicable diseases
Emerging mHealth Services for Evolving Health Needs

11. 10
© 2014 Synegys. All rights reserved.
CONFIDENTIAL – For Discussion Purposes Only
About Us
Synegys is a full service mobile solutions company providing delivering mobile application solutions all over the world. Our firm grasp of what drives business and marketing ROI, our distinctive combination of creativity and diligence, and our objectivity enable us to consistently exceed the high levels of quality and innovation our clients expect.
mHealth Solutions, a division of Synegys, is a mobile health solutions provider supporting academic institutions, research organizations, bio-technology and pharmaceutical companies, contract research organizations (CROs) and healthcare professionals to improve, innovate and transform how the healthcare industry works.
If you have any questions or would like further discussion, please contact either:
Europe & Africa:
•William Eng, Managing Director: +420 736 767 732 (william@synegys.com) Americas & Asia Pacific:
•Denny Amirault, Director: +1 403 708 3910 (denny@synegys.com)