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[OXFORD] New technologies in healthcare delivery will fail to curb Africa's disease burden unless local governments and citizens are motivated to play their part, a conference has heard.

Muntaqa Umar-Sadiq, senior technical advisor to Nigeria's health minister, presented the medium-term results of Nigeria's Saving One Million Lives initiative at the Pan African Conference 2013, held by the Oxford University Africa Society last weekend (4 May).

The project, launched last October, aims to prevent a million deaths by 2015 by improving women and children's access to essential primary healthcare in the country.

"So far, we have saved 433,000 lives," Umar-Sadiq said during a panel session on innovation in healthcare delivery. "To achieve our final goal, we must take advantage of the newest technologies, but we must also focus on local governments' empowerment and citizens' awareness."

Making health delivery more innovative, he said, "is not only about tech and drugs: we also need to inspire a change in people's mindsets".

In Nigeria, too often people fail to take advantage of healthcare because it is too expensive or they distrust modern medicine. "As a result, many mothers still die in childbirth," Umar-Sadiq said.

Mobile technology is seen as a way to make healthcare more accessible, but the newest frontiers of research in this field involve 'cultural planning'.

"Technologies shouldn't just be effective, they also need to be usable and affordable," Andrew Wyborn, managing director of Greenmash and a panellist at the conference, told SciDev.Net.

Greenmash is a company that provides innovative mobile health devices. It is involved in several health delivery and monitoring schemes across Sub-Saharan Africa.

"In Africa, there are between 650 and 800 million mobile subscribers, and mobile technologies are widely used for every sort of service, from banking to insurance to data gathering," Wyborn said.

Greenmash's software Mango enables healthcare operators to quickly and easily collect and process data. The platform can be configured to receive and interpret text messages and offline data collected by hand-held devices, online forms and speech recognition systems.

"We are trying to facilitate decisions based on real-time data. For instance, when managing a drug supply chain, it is crucial to know the stock's level in a facility in order to deliver what is needed, when it is needed," Wyborn said. In many current stock systems in developing countries, data are collected manually, put into a spreadsheet and transferred multiple times, hence before reaching the final stage of being ready to use they are already out of date because these steps take so long.

With software such as Mango taking advantage of the penetration of mobile phones, healthcare centres across Sub-Saharan Africa can now receive weekly reports on drug stock levels, helping them to tackle shortfalls promptly. Mango is now widely used in different aid schemes, including SMS for Life, an initiative aiming to address the problem of stock-outs in the Democratic Republic of Congo, Ghana and Kenya.

However, uncertainty remains about this technology's potential effectiveness. "As long as information is not used intelligently, technology itself is never enough," said Wyborn. He believes that the next big step is to use data correctly so that actions are based on evidence.

"It is important to involve people in an active conversation," he said. "As part of one of our programmes in Kenya, we assigned phone credits as a reward to those who had participated in data collection by sending an SMS. To our surprise, after a monitoring process we discovered that people preferred to receive feedback on the outcomes of the research rather than money."

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