The Journal of mHealth Vol 2 Issue 4 (August) | Page 40

mHealth in Developing Countries
Continued from page 37

affordable, accessible, and available. For the purposes of this
paper, we will focus exclusively on mHealth. mHealth, as a subset of eHealth, differs from eHealth in a variety of ways. At
its core, the distinction between mHealth and eHealth is often
thought of as the use of mobile devices (PDAs, 2G cellular
phones, smartphones) versus desktop computers or laptops and
web/internet connection. In this sense, mobile technology is a
lot more widespread. There are more people on this earth with
access to a cellular device and a cellular network, even in lowincome regions, than there are individuals with a stable and reliable connection to the Internet and a personal computer. As a
result, mobile health technology is more widespread and is more
personal, as a user can use the functions of their mobile device
to personalize their mobile healthcare. Additionally, developing
nations do not have the infrastructure or the money to set up
the infrastructure necessary to support 20th century information technology such as powerful computers and strong web
access. Therefore, they have bypassed this level of technology
and have gone straight to mobile solutions. Network connectivity is widely available, and costs significantly less than a stable
Internet connection. Additionally, mobile devices are inexpensive and oftentimes free (recycled use).
mHealth in Low-Income Countries
While availability of and access to healthcare are challenges in
developing nations, access to mobile phones is rising rapidly. As
of 2010, the World Bank reports that developing nations experience more mobile use than developed nations. Mobile phone
users in developing nations account for 77% of the population.8

Fast-forward to 2013, the ICT reported that mobile penetration
rates in developing countries have reached nearly 90%. More
people have access to a mobile signal than they do to electricity or water.9 The accessibility of mobile phones and cellular
networks in developing countries has led the way to eHealth,
specifically mHealth, as a low-cost solution to healthcare issues
in these nations.
mHealth Innovations In Developing Nations
Disease Management
In South Africa, the spread of Tuberculosis (TB), a communicable disease that attacks the lungs, is a critical issue. Even more
concerning, there are patients in South Africa with highly-resistant forms of TB that are being sent home and therefore becoming a greater risk to the spread of the disease simply because they
are being discharged from the hospital due to a lack of treatment
options. The existence of this high-resistant form of TB is due
in part to the mismanagement of the disease.11
SIMPill, a mHealth innovation developed in South Africa in
response to this mismanagement of TB, is a pill bottle with a
device attached to it that includes a transmitter and a SIM card
(Exhibit 2). When the pill bottle is opened, an SMS message is
sent to a central server. When the pill bottle is not opened during a set tolerance period, an SMS reminder is sent to the patient
(or other caregivers). If the patient still does not adhere, a health
worker will contact them directly. In its first study in 2005, 97%
of patients said SIMPill helped them take their medicine, while
treatment adherence increased almost 10%. In a larger pilot in

Exhibit 2: SIMPill

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(image source: http://www.esato.com/news/simpill-418)

August 2015