From pilot to scale: Towards an mHealth typology for low-resource contexts

Abstract

The paper classifies mobile phone based solutions for Health Information System (HIS) in low-resource contexts into four types: interactive voice response (IVR); plain-text SMS; locally installed handset and SIM-applications; and browser-based solutions. The resulting reference typology details the strengths and disadvantages associated with each solution type along four dimensions: robustness to low-resource contexts; flexibility for organisational and functional change; usability; and financial cost. The paper demonstrates how the strengths and disadvantages associated with each solution type become more evident when implementations are intended to scale in low-resource settings. Early decisions about whether or not to leverage health workers own handsets, initial arrangements with mobile operators and requirements regarding the solution's capability to support offline work may shape the choice of solution type and have long lasting implications. The typology is produced through involvement with longitudinal action research projects, including the statewide implementation of an application-based solution in one Indian state. © 2012 Fellowship of Postgraduate Medicine.