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  • Rural medics to get mobile advice 'hotline'


A pilot initiative to provide rural community health workers, nurses and doctors with advice on diagnosis and treatment via mobile phones is to launch in Ghana later this year.

The project will enable rural health workers to call specially-trained doctors at a call centre, providing the daily support that health workers in richer countries take for granted.

"Rural health workers often are trained once and receive limited support and supervision for their day-to-day activities. They often feel isolated," says Patricia Mechael, mobile-health and telemedicine advisor for the Millennium Villages Project, a large-scale rural development initiative coordinated by the Earth Institute at Columbia University in the United States.

A health worker might ring for advice on whether a child they have visited at home should be referred for more testing or treatment, for example.

The health hotline is one of many mobile-health (m-health) pilots run by the Millennium Villages Project.

A number of such hotlines have sprung up in countries such as Bangladesh, India, Mexico and Pakistan — many of which aim to provide consumers rather than health professionals with advice and diagnosis from doctors.

Health hotlines could have tremendous potential because about two thirds of mobile phone users worldwide live in developing countries and many have limited access to health services, says Gautam Ivatury, a consultant specialising in mobile services and development.

"It has a chance to be the primary way that people get medical information," he says.

A survey of callers to the Bangladeshi HealthLine service found that more than half live below the poverty line or in rural areas.

Health hotlines have taken off faster than other m-health applications — such as using mobile devices to record and transmit disease surveillance information — because they earn money, says Ivatury. In future new applications such as text-based prescriptions and remote monitoring for patients with chronic disease could be added. 

Such services might create sustainability because call charges can cover costs. But evidence from Bangladesh and India suggests prices — of around 20 US cents for a three-minute call — are still too high for the poorest.

Hotlines are also easier and cheaper to deploy than applications that require specialist handsets, software and training. Mechael says rural health professionals often need training on how to use the data functions of a mobile phone. 

But while they may not necessarily generate revenue, such specialist applications are key and have "the potential to support healthcare workers and improve health outcomes", says Mechael.

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