During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 1-10, we will be featuring the role that Science, Technology & Innovation plays in Global Health.
Last month, I had the chance to visit a clinic in Nigeria just outside of the Federal Capital Territory where approximately 70 pregnant women were waiting to receive prenatal care. Being a big fan of impromptu focus groups, I asked the women to raise their hands if they had a cell phone. Hands shot up around the outdoor meeting space, many of them proudly clutching mobiles phones of all shapes, sizes and varieties. This was an exciting moment for me, a clear representation of just how ubiquitous mobile technology has become in low-income countries. The GSM Association estimates that the mobile penetration rate in developing countries is now 89%.
There is no doubt that the pervasiveness of mobile technology has made possible innovative new ways to deliver health information and services. mHealth projects throughout the world are harnessing the power of mobile to do everything from registering births to supporting health workers to raising awareness about disease prevention (and a great deal in between!). Mobile phones have also become valuable tools for empowering women: more than 1 billion women have access to a mobile phone in developing countries, and 9 out of 10 women who use mobile phones say they feel safer and more connected with friends and family.
Women, as mothers and health workers, are commonly the beneficiaries of mHealth projects. But even as we acknowledge the potential power of mobile phones to improve their health and wellbeing, it’s important to recognize that they are rarely equal participants in the development of these interventions or the policies that govern access and use.
I believe firmly that mHealth projects, especially those related to reproductive, maternal, newborn and child health, must take into account social, cultural and gender norms in order to produce improved health outcomes. This belief led me to work with my colleague, Madhu Deshmukh, who is seconded to the mHealth Alliance from CARE – a leader in the movement to promote the empowerment of women and girls – to develop a Gender Analytical Framework (PDF). Through this framework, mHealth implementers can better understand the nuances and implications of gender issues, and then design or modify their projects accordingly.
When developing the framework, we interviewed a number of organizations working on mHealth projects, including VillageReach, one of our grantees bringing a toll-free maternal health hotline to scale in Malawi. What VillageReach told us is that they have experienced first-hand the challenges of taking gender into account when designing mHealth programs, for instance when they realized men were calling into the service on behalf of their families. By creating this framework, the mHealth Alliance is providing mHealth implementers like VillageReach with a powerful tool that will help ensure women and men not only have access to mobile technology but that it is being harnessed in a way that truly benefits the health of pregnant women and their families, as well as the male and female health workers that serve them.
Returning to my unofficial Nigerian focus group, my second question to the women was how many had used their phone to obtain some sort of health information. Remarkably about half of the hands went up. When I probed, many shared that they used their phones to either call a family member or a health worker to seek advice about their pregnancy, though it wasn’t necessarily through a formal service.
In Nigeria, the government has recognized this power of mobile phones to empower citizens, health workers, and the health system through the Saving One Million Lives initiative. They have also highlighted equity and gender, specifically, as key to ensuring that the full potential of mobile is realized to reach targets for significant reductions in maternal and child deaths and improvement in health and wellbeing.
As more services to provide access to health information are implemented by programs such as VillageReach and the Mobile Alliance for Maternal Action (MAMA), I fully anticipate that more women will be empowered to better care for themselves and their children. On my next visit to Nigeria, I hope to see the number of raised hands rise dramatically, due in no small part to mHealth implementers and designers applying a gender lens to their work.
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