By Laura Raney (Co-Founder – mHealth Working Group) and Sean Blaschke (UNICEF)

Participants at the inaugural Global mHealth Forum, co-located with the mHealth Summit in DC, held during the week of December 8th in Washington DC, discussed a number of pressing public health opportunities, issues, and challenges – including emerging best practices in health systems architecture, civil and vital registration services and electronic health records, and on the Ebola response.

But are these the issues that matter most to citizens of the global south that this Forum was intending to address?

Using a new, free SMS tool called U-report, UNICEF directly asked over 100,000 Nigerian citizens via SMS for feedback in real-time. Over the course of the Forum, 17,271 Nigerians responded to the series of U-report survey questions. At the closing plenary of the Global mHealth Forum, Sean Blaschke of UNICEF reported back on the Nigeria U-report poll results.

Young Student Journalists from Lagos after signing up from U-report
Young Student Journalists from Lagos after signing up from U-report
National Youth Service Corps signing up for U-report at the end of a batch training in Abuja, Nigeria.
National Youth Service Corps signing up for U-report at the end of a batch training in Abuja, Nigeria.

Responses included:

  • “I registered with m-health mobile service with MTN and thereafter subscribe for monthly service where I have one on one discussion on health issues with d expert. It has been very helpful in resolving some of my family health challenges.”
  • We send SMS to pregnant mothers on the important and benefit of attending ANC and TT immunization ad only to those coming to our facility seeking for care and nutritional advises, we do capture their phone numbers at back of their file folder.
  • (Government and partners could) reduce cost/liberalize access to mobile phones; and secondly through bringing doctors and patients together through mobile phone technology.
  • Individually should be periodically asked on state of health facilities around their communities to enable feedback system to government thereby improving on such facilities

Of the poll respondents, 60 percent already use their phone to talk about or report health issues.

U-report data coming in in real-time from Nigeria
U-report data coming in in real-time from Nigeria
U-report data coming in in real-time from Nigeria
U-report data coming in in real-time from Nigeria

The most important health issues identified include malaria, sexual and reproductive health (SRH), HIV/AIDs, Ebola, and the growing challenges of non-communicable diseases (NCDs) such as cancer, high blood pressure and diabetes.

U-report data coming in in real-time from Nigeria
U-report data coming in in real-time from Nigeria

Interestingly, these health concerns were not the ones receiving the most attention in terms of presentations at the Global mHealth Forum. While there were multiple presentations on Ebola, there were few presentations on SRH and none on NCDs among the 150+ presenters from over 77 organizations and 27 countries. Why the disconnect?

UNICEF Nigeria’s take on the situation: “Never underestimate the power of the voices of people no matter from who, no matter how small they are. These voices are key for developing and maintaining any progressive and democratic society. U-report is the most brilliant tool for harnessing those voices.”

It’s clear that true participatory dialogue, using locally appropriate tools such as SMS at scale, can help ensure meaningful participation of young people in policy, planning and programme monitoring. With U-report present in 11 countries and expected to be launched in many more more during 2015, it’s time to start more proactively engaging the real concerns of ordinary citizens and match these with the focus of the mHealth professionals implementing programmes in the global south.

Presenting the voices of tens of thousands of Nigerian U-reporter results was staggering for the audience attending the Global mHealth Forum, not only in terms of the sheer numbers of people replying to the polls, but also in terms of capturing and responding to real-time concerns of regular citizens who finally have a voice.

With over 530 attendees from 50+ countries, the Global mHealth Forum is the largest gathering of mHealth implementers working in developing countries anywhere in the world. It brought together representatives from the international mHealth community to share successes, challenges and lessons learned from global implementations of mHealth projects. The presentations and discussions at the Forum focused on delivering tangible information to governments, donors, NGOs, not-for-profit organizations and social entrepreneurs about designing, implementing, scaling, and evaluating mHealth initiatives in low and middle income countries (LMICs).

We can expect future Global mHealth Forum’s to increasingly include more interactive engagement with citizens throughout the world who do not have the luxury of participating. With tools like U-report capturing and sharing – in real time – the needs of average citizens from the global south with those who are implementing projects that may or may not be the best fit for the citizens’ needs, perhaps we can enhance the way we design and implement development assistance using more human centered approaches.

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