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Barriers to mHealth adoption in Sub-Saharan Africa

In Uganda, and Africa at large, the
populace face many challenges with regard to health including but not limited
to; poor facilities, poor social infrastructure, energy shortage especially
electricity and limited access to education. Despite Government’s effort to improve
on the health system, very few individuals, companies and organizations are
tapping into the potential of mobile Technologies for health, even when the
benefits are obvious to populations whose most accessible tool for communication
is a phone. Below are some of the reasons that I personally think contribute to
the little uptake of mhealth.
 
Photo Credit: Edward Echwalu
1.     
Content
The absence of
readily available mobile health related content on specific thematic areas is a
big barrier. Most organizations that implement mhealth projects have to develop
their own content based on the area of focus. eg HIV, Malaria, maternal health
etc. There is also no central database where this content is put for future
reference or to avoid duplication of already implemented mhealth issues. This
leaves room for data redundancy and duplication to target groups.
 
2.     Skills
Because of the
tremendous growth in phone penetration especially in sub-Saharan Africa, there
is a great demand for training in mhealth education. One cannot simply rely on
the assumption that because every at least many people own phones, they can
ably use them for mhealth campaigns. They need to be trained on how to operate
the phones, say for health related surveys or how to respond to health quizzes.
This is still lacking. Unless the mhealth campaigns are inform of interactive
Voice Responses (IVRs), the adoption will still remain slow with the use of
interactive SMS messages especially among the elderly populations.

3.     Gender
Although this
is an issue that is often under looked, it plays a key role in either the
success or failure of mhelath project. It’s obvious that the biggest percentage of those who bear
the burden caused by conflict ,disaster are women and children and they are the
key stakeholders in promoting good health and building stable, self-reliant
communities. Also most mhealth related campaigns target mainly women on issues
like maternal health, child mortality, HIV/AIDs, abortions etc. but ownership
of phones is predominantly male who control what kind of information comes
through the phone, whose mobility is not restricted and who are better economically
empowered to afford maintaining the phones especially in rural areas. Therefore,
Making these projects gender sensitive and involving men right from the onset
of the projects will reduce the barriers.
 
4.     Access/Affordability
This could be viewed in terms of
access to the actual handset especially for the rural folks in rural Africa and
affordability in terms of maintenance such as paying to have the phone charged.
Many people cannot afford a 30USD handset yet most mhealth implementing organizations/companies
only want to work with folks that already own phones. It’s a barrier because
you reach fewer people.

5.     Infrastructure
A lot of mhelath projects in Africa
depend so much on Telecom companies which are responsible for the general
telephony infrastructure eg masts for access to network, distribution of short codes
for those that intend to use SMS etc. In the event that an area does not have
access to a mast, then it is obvious that even if there is a genuine health
need to be addressed through the use of mobile phones, it does not get
attention simply because there are issues of network connectivity. This is one
of the biggest barriers for rural Africa. Also the issuing of short codes by
the Telecoms through communications regulators is bureaucratic.

6.     Attitude
Traditionally
especially in Africa, mobile phones are known for verbal communication. But
with mhealth projects comes a new paradigm shift to the use and application of
phones for accessing health information through SMS. Accepting this change and
adjusting accordingly can be a barrier to SMS based mhealth project. IVR
related mhealth campaigns could be more successful than SMS because voice
messages cut across literacy levels.

7.      Language
This is a barrier because of the fact that the commonly used
language for SMS is English yet sub-Saharan Africa is so diverse. However, this
barrier can be solved through voice messages and using community radios along side the mobile phones.

8.     Political
Will
The success of any project depends on the
positive political will and government support. Often times, mhealth initiatives
by NGOs are meant to compliment already existing government health services and
therefore they must work closely with Government. However, many initiatives
have been destroyed because the Government has not played its role. A case in
point is the moratorium that was issued in Uganda from the Ministry of Health
halting the implementation of all electronic and Mobile Health projects that
were not approved by the Director General. While this was a great initiative to
reduce on duplication of projects and to encourage wider coverage and eliminate
unnecessary pilots, the Ministry did not make the vetting process smooth. It
would take months to have the technical working group at the ministry meet and
approve the projects. This is a source of frustration for projects that have
defined timelines.

CTA celebrates 25th Anniversary .

A silver anniversary marks a milestone for any organization. It seemed appropriate then, that the 25th anniversary of CTA’s existence was celebrated in style in Brussels, Belgium during the CTA seminar whose theme was “The role of Media in the agriculture and rural Development of ACP countries.” A total of 150 participants from Africa, the pacific and Caribbean attended the annual seminar which took place in Brussels. Representatives from the ACP and EU embassies based in Brusssels were invited to the ceremony which was held at the historical palais des colonies in Truven Brussels. The CTA annual seminar 2009 was characterized with a number of Panel discussions which were usually followed by instructive discussions on the role of Journalists in Agricultural development. Scientists, researchers and heads of media houses from Africa, the Pacific and Caribbean had a feeling that Journalists always majored on reporting politics, scandals and sports rather than Agriculture. They added that the journalists mainly did it to satisfy politicians. The response from Journalists was quick, they said that the logic applied to current events and the information collection and processing techniques are universal, in other words, they are not specific to any given sector. The media which is one of the strategic links in the information dissemination and transmission chain between the various stakeholders in agriculture and rural development in African, Caribbean and pacific countries is key in information dissemination on agricultural issues. At the 2009 CTA seminar a number of topics were tackled on how the media can be brought on board to report on Agricultural issues. These topics included: 1. Mainstreaming Media in development: The way to go. 2. How can media better serve rural communities? 3. Media and ARID issues 4. Media and climate change 5. Media and Gender equality 6. Contribution of media to Agricultural policy programming and knowledge management. 7. Building the capacity of media in Agriculture and rural development 8. Media, emerging and new media service and ICTs. Women of Uganda Network (WOUGNET), one of the participating organizations from Uganda had the privilege to make a present on the role of web 2.0 tools for sustainable agriculture in Uganda. This panel presentation which was derived from a broad topic of “Media, emerging and new services and ICTs” was very important during this seminar. It was noted that web 2.0 tools/technologies were a new form of media not only in Africa but also in the pacific and Caribbean. The web 2.0 tools that were mainly discussed included twitter, YouTube, Face book, RSS, blogs, wikis, word press and Google alerts. The presentation focused on how these various web 2.0 tools can be used by farmers for sustainable agriculture and what potential they had in terms of increasing production, diversifying productivity and reducing risks. However, participants from various organizations were cautioned to only use web 2.0 tools that the promote cause of the organization’s goal if the benefits are to trickle down to the users. This is because web 2.0 tools are too many and more are emerging. With this year’s theme “The role of media in agricultural and rural development of ACP countries” it was clearly noted that sustainable agriculture is the only basis on which humanity can be sustained meaning that if agriculture is unsustainable, then the human species in unsustainable too and involving the media in information collection, sharing, packaging, and dissemination was very important in achieving sustainability of Agriculture in ACP countries. The seminar took place at a time when the rest of the world was participating and celebrating in two key agricultural related events of Blog action day with the theme “Climate change” on 15/10/2009 and world food day with the theme “Achieving food security in times of crisis” 16/10/2009. For more details about the CTA seminar please visit their website: http://www.cta.int Follow CTA on twitter at: http://twitter.com/Media4Dev Written By Maureen Agena.

Fast Internet connection will improve journalism

By Maureen Agena

THE installation of fast Internet marks a new era for communication between Africa and the rest of the world. Operated by an African firm SEACOM, the optic fibre will connect South Africa, Tanzania, Kenya, Uganda and Mozambique to Europe and Asia.

The project comes at an opportune time to increase on the application of citizen journalism, a practice still limited and understood by only a few. Citizen journalism, also known as “participatory journalism” is a kind of journalism where ordinary people can publish news globally on news websites or media houses. An act that has so far been the province of established journalists and media companies.

The idea behind citizen journalism is that people without professional journalism training can use the tools of modern technology and the global distribution of the Internet to create, augment or fact-check media. This means that anyone with access to the Internet or even a cell phone can report, start a blog or chat.

As a result, it is becoming cheaper and easier for individuals and organisations with the right skills to publish their own newsletters, produce both audio and video materials in addition to hosting public chats. However, it is vital to not that while the media scene is changing in Uganda, mainstream media still carries weight and has influence in setting the public agenda.

One of the initiatives aimed at promoting citizen journalism is the Citizen Journalism in Africa (CJA) project.

The project aims at building the capacity of civil society organisations to use online and offline instruments as a means of publication, lobby, networking and knowledge sharing with their constituencies.
Fifteen organisations in Uganda are benefiting from this initiative led by Women of Uganda Network, an organisation that empowers women through use of ICTs and Busoga Rural Open Source and Development Initiative.
Ugandans should, therefore, effectively utilise the faster and cheaper connectivity for informative reporting on the situations and issues that affect them. Ugandans have more room to report about their environment as well as participate in information sharing.
The writer is an information officer with Women of Uganda Network.Read more Newvision

Talking,Listening and Responding

By Annetjie van Wynegaard and Gabi Falanga

People using digital media are not nameless entities sitting behind a computer, but personalities with complex identities. Yesterday’s panel discussion “Gender, Civil Society
and Digital Media” focused on the social aspects of the digital citizen. The conversation was led by Maureen Agena and Nthateng Mhlambiso as part of the Digital Citizen Indaba
at Rhodes University.
Agena is the information officer of Women for Uganda Network (Wougnet). She spoke about how specific technology for women is being implemented in rural areas of Uganda.
Social online networking tools are limited in rural Uganda due to high costs, poverty and lack of skills. She said: “The biggest media being used is radio and telephone because
Uganda is a verbal community.” Radio and telephones enable citizens to communicate in their own languages, such as the Luo spoken in Northern Uganda.
Telecentres have been set up in parts of Uganda where citizens are able to access emails and the Internet. Wougnet provides practical skills training for women. “They are
very eager to participate although they don’t have the skills.
They want to talk, they want to listen, they want to respond.” Agena said that “women should be in a position to make use of available media opportunities to improve their
livelihoods”.read more on Highway africa