mHealth in the developing country context is all about getting healthcare to poor people in remote regions. But how do you provide a service through a paid-for technology — i.e. cell phones — to people with zero incomes? This is where the real innovation happens, we heard today. Sexy iPhone apps with videos and images won’t change the world — it’s the programmes that you can run even if you haven’t got any prepaid airtime left on your phone that will really make a difference to the poorest of the poor.
In South Africa, even the poorest can be reached using a service called ‘Please call me’. This allows people without credit to text a ‘please call me’ SMS message with their telephone numbers to the people they need to get hold of. A way of richer South Africans subsidising their poorer friends, perhaps; but also a potent way of reaching people through advertising and awareness campaigns. A billboard can read “If you are looking for advice on staying HIV free, send a ‘Please call me’ to so-and-so”. The individual will then receive advice on their mobile — free of charge.
Of course, there is rarely such a thing as a free lunch. Many so-called ‘free’ services offered by cellphone networks are only available to customers with some money on their account. Another model that is being used in some mHealth initiatives is the concept of ‘freemium’. That is, the service is free for the majority of users, but is funded by the small number of wealthier users that want more and better access. I have a feeling that business models will be at least as much a focus as technological solutions at this summit.
Linda Nordling, SciDev.Net columnist