Despite the strong promise demonstrated by mHealth tools and applications, the current landscape of mHealth development in developing country contexts is characterized by a proliferation of unsustainable pilot projects that often expire once initial funding is exhausted. For example, in Uganda alone there were 23 mHealth initiatives in 2008 and 2009 that did not scale up after the pilot phase. In India, there were over 30 mHealth initiatives in 2009 that did not go beyond the pilot phase.
Current policy environments, business models and funding schemes around mHealth have fueled the proliferation of pilot projects without enabling them to scale up in a meaningful, replicable way. An additional, and perhaps most significant, obstacle to improving and scaling the implementation of mHealth initiatives is the lack of monitoring and evaluation (M&E) and use of meaningful, consistent indicators and rigorous evaluation methods.
Given the obstacles within the current landscape, this white paper was commissioned by Advanced Development for Africa (ADA) to assess current implementations of successful mHealth programs in developing country contexts. The objective is to identify elements necessary for successfully scaling up, with the aim of highlighting best practices and specific programmatic, operational, policy and global strategy recommendations that can promote scale up of mHealth.
Profiled in this report are several select mHealth programs that have been piloted and are currently in the scale up phase, and have proven enough success that they should be considered as models for other initiatives to follow. As the following case studies will demonstrate, through more accurate and timely data, disease surveillance, decision support and health information management, mHealth can effectively inform policy-making and planning within healthcare systems and improve the health of local communities, particularly remote populations. The scale up of mHealth within national health agendas should be supported by all departments within the Ministry of Health and across other relevant ministries and agencies including Telecommunications. Both internal stakeholders, such as end-users and beneficiaries, and external stakeholders, such as mobile network operators and donors, should be engaged in the planning and business model design and scalability assessments. The primary goal of this white paper is to provide evidence and recommendations that will allow mHealth initiatives to better plan their own scale up beyond successful pilot phases.