A Doctor in Your Pocket: Health Hotlines in Developing Countries

Abstract

Afiya lives in the rural Sylhet region of Bangladesh. For two days, her youngest daughter, Rubina, has been complaining of fatigue and has felt warm to the touch. Taking the child to the nearest clinic would cost Afiya a day's lost wages, round-trip bus fare, and clinic fees of Taka 200 (U.S. $3). Instead, Afiya and her husband use the family's mobile phone to dial " 7-8-9, " the Healthline hotline service set up by TRCL, Ltd., a telemedicine firm, and GrameenPhone, the country's largest mobile network operator. The family quickly reaches Dr. Quadri at Healthline's call center in Dhaka. After asking a few questions, Dr. Quadri tells her to give Rubina small regular doses of paracetamol, available at neighborhood shops. For the three-minute call, Afiya pays only Taka 15 (U.S. $0.21) from her family's GrameenPhone prepaid talk-time balance. Afiya is not the only person seeking basic medical advice and information by calling a health hotline. Telephone-based nurse triage, primary care, and health information have been offered in developed countries since the late 1990's, and Gautam Ivatury is a founder of Signal Point Partners, an investment and advisory company for mobile services in emerging markets, and a Strategic Advisor to CGAP, the global microfinance resource center housed at the World Bank. Between 2003 and 2008, Gautam led CGAP's work in microfinance and technology, including a flagship program co-funded by the Bill and Melinda Gates Foundation. Jesse Moore is Director of the GSM Association's Development Fund, with a specific focus on mServices. Previously, Jesse worked with Vodafone on M-PESA, a mobile payment service targeting Kenya's un-banked population. From 2002 to 2006, he founded and directed CARE Enterprise Partners, the division of the large NGO CARE that provides venture capital to businesses in the developing world.