Cellphone adoption and mHealth in developing countries

In the United States, mHealth was made possible by the widespread adoption of cellphones and smartphones. As more people around the world start to use cellphones, what are the possibilities for mHealth in developing countries?

It’s hard to overemphasize how quickly cellphones have become common in developing economies. In 2000, just 4 percent of the 5 billion people living in low- and middle-income countries had access to a mobile phone. By 2015, that number had skyrocketed to 94 percent. As a data scientist at the World Bank put it, more people in low- and middle-income countries now have access to a mobile device than to water and electricity.

This rate of cellphone adoption roughly mirrors the United States ten years earlier. In 1990, there were about 2 cellphone subscriptions for every 100 Americans. Twenty years later, that ratio was over 90 percent.

Cellphone adoption in the U.S. allowed mHealth to blossom into a huge industry expected to be worth nearly $50 billion by 2020. Along with this market have come nifty apps for patients and physicians, but more importantly mHealth creates opportunities to make healthcare more efficient, effective and intelligent.

What form will mHealth take with the widespread use of cellphones in developing countries?

A 2016 report from the World Health Organization (WHO) provides some insights. The findings come from a survey conducted by the WHO Global Observatory for eHealth, which focused on the use of eHealth to support universal health coverage.

The WHO reports that 87 percent of countries have at least one mHealth program, including 80 percent of low-income countries. These programs cover a range of mHealth applications, from telephone helplines and text message appointment reminders, to mobile telehealth and access to electronic patient information.

The most common mHealth programs were free telephone hotlines for health emergencies and health call centers. But most countries also reported having at least one program that uses mobile devices to send appointment reminders, manage patient records or monitor patients.

Just about half of WHO member countries had mHealth programs to administer health surveys, monitor treatment adherence, and assist with clinical decision support.

The most common mHealth programs - things like hotlines and text message reminders - will clearly benefit from the widespread adoption of cellphones in developing countries since 2000. But mHealth is still far from realizing its full potential. As the WHO reports:

“There has been a substantial increase in the number and range of solutions, particularly with the advent of mHealth. However, the process of embedding eHealth everywhere still has a long way to go, both in terms of coverage and functionality.”

A bright spot is the expanded possibilities that come with wider adoption of smartphones. Over the next 10 years, low-cost smartphones could give virtually everyone everywhere access to the more than 100,000 mHealth apps on the market.

According to the WHO, widespread smartphone use in developing countries could vastly expand access audiovisual examples of best (global and local) practices for improving health behaviors and clinical decision-making.