Smartphones for Better Healthcare in East Africa
“The Challenge”
In low-income countries, sexually transmitted infections (STIs) constitute a large health and economic burden: 75 to 85 percent of the estimated 340 million annual new cases of curable STIs occur in low-income countries, and STIs account for 17 percent of economic losses due to illness. In a 2006 household survey in Uganda, 39 percent (945/2,576) of respondents reported possible STI symptoms one or more times but only a third (373/1,019) of these sought any care. A major reason is possibly due to the affordability of treatment. But donors seeking to subsidize treatment often find that resources given are not matched by expected gains.
The Uganda Output-Based Aid (OBA) project seeks to address incentive gaps by paying healthcare providers directly for effective services rendered instead of paying for the service provision up front. The program treats sexually transmitted infections (STIs), reimbursing providers for the diagnosis and full course of treatment only after the patient is seen.
However, program management for OBA is information intensive, necessitating considerable paperwork and data entry to track and reimburse payment claims. One of the key applications for information technologies in healthcare is efficient management of healthcare information, both within and between healthcare institutions. In Africa, however, most health clinics and many hospitals do not have the appropriate infrastructure to support the traditional computers required to access and enter the information.
“The Opportunity”
Due to their size, portability, low power consumption, and ability to operate with limited infrastructure, mobile phones are a much better computing platform for rural areas than traditional computers. Their wide availability for communications solves the problem of connectivity and also ensures that the appropriate maintenance infrastructure will be available. The use of mobile phones as more than a voice communication device opens up the possibility of revolutionary new applications for health care in developing countries. (Right: UC Berkeley Grad Student Melissa Ho Demonstrates Smartphone, Kampala, Uganda)
In collaboration with the Output-Based Aid (OBA) project, this initiative will deploy smartphones as a health information platform, with dual goals of reducing claim processing time and improving communication between the health care providers and the management agency running the OBA project. The project currently serves about 1000 patients per month; the mobile platform will help the project scale sustainably to serve over 50,000 patients a year across five additional districts.
“The Response”
The primary goal is to develop a hardware and software solution to support claims processing in the OBA project, including a self-validating dynamic claim form for mobile phones, various power solutions (e.g. solar, batteries) to address unreliable or absent grid power, and a platform for leveraging available communications infrastructure (e.g. GPRS over the mobile phone network). From this experience researchers hope to gain a better understanding of the role of smartphones as both a computing platform and a communications platform for rural health clinics. Team members will test the smartphones platform in a one year pilot beginning summer 2008, eventually handing off maintenance and training to local partners for uptake in a expanded OBA program.
Participating Faculty
Eric Brewer, Professor, Electrical Engineering and Computer Sciences (Principal Investigator)
Participating Students
Melissa Ho, PhD Student, School of Information, 2011
Sonesh Surana, PhD Student, Computer Science, 2008
Ben Bellows, PhD Student, School of Public Health, Epidemiology, 2008
Partnering Organizations
Microcare Insurance
Marie Stopes International
Kreditenstadt for Wiederaufbau (KfW)
Uganda Ministry of Health
Geographical focus
Southwestern Uganda (Mbarara, Ibanda, Kirihura and Isingiro districts)