The experience of Kenya's Safaricom is that finding partners is the best way to avoid the fragmentation that results from separate, non-interoperable mobile health initiatives, said Judy Njogu, product manager for ehealth & elearning with Kenya’s Safaricom.
“Lots of little fragments cannot scale so we have worked with development and government partners so they can achieve what they do best,” said Njogu, who was speaking during GSMA Mobile for Development’s webinar on how to maximise the effect of mhealth services for maternal and child health. It is widely agreed that fragmentation is an obstacle to the deployment of large-scale mobile health services.
Safaricom has launched eight mobile health services to date and is about to offer an additional one targeted at mothers and children.
Njogu’s comments highlighted the importance of government among all partners. The operator has relationships with various departments and institutions such as Kenya’s director of public health, says Njogu: “You cannot achieve scale unless you are working with the government.”
Lobbying also gets easier with co-operation, a point made by Joanne Stevens, consultant to NGO Mobile Alliance for Maternal Action (MAMA) South Africa. “It’s easier to request endorsement from government if everyone is working together rather than disparate groups.”
Stevens says MAMA pulls in partners into local consortia for national markets. Engaging with partners in this way can lead to greater alignment. One of MAMA’s local partners was persuaded to drop its own branding in favour of MAMA’s, illustrating a move towards what Stevens described as "technology and branding convergence".
Avoiding fragmentation was one of four trends discussed during the webinar. The others were how to achieve scale; how to achieve replication of a successful service across other countries; and how to make sure all partners find some value in mobile health services.
George Held, Etisalat’s VP of commerce, said the integration of money and health services is central to the operator’s strategy for achieving scale. Its best-known health service is called Mobile Baby.
“We believe mobile money is the main driver which means for instance a midwife gets paid directly. That creates a sustainable business platform. Mobile money is a foundation for various verticals such as health and education”.
Alice Fabiano, senior program officer and advisor with Johnson & Johnson, said the traditional dividing line is between letting creativity flourish with many initiatives and “taking big strategic bets on a couple of initiatives”. The latter approach seems to be winning out at the moment, she indicated.
She also highlighted the trend for public-private initiatives which come with the aim of the so-called shared-value double bottom line, which basically means trying to marry profit-taking with the delivery of public health goals. This is a relatively new concept said Fabiano and as such might work for mobile health, itself a new area.
Mentioned earlier by Etisalat’s George Held, the importance of a mobile money platform to health services was emphasised by Safaricom’s Njogu. The Kenyan operator is well-known for its M-Pesa mobile money service, which also helps the spread of health services.
For instance, M-Pesa is used by government for distributing e-vouchers to rural users who can redeem them for anti-natal care. The government also transfers funds to health field workers using M-Pesa. Individual users can also use the mobile money service to pay for health insurance.
While mobile money might be one route to building scale, Alice Fabiano warned that “people think mobile is a luxury not essential”. The industry needs first to build some working services, she said. Once it’s working in small examples then you can replicate, she explained.
Potential investors are bound to ask “If I put US$1 into mhealth, am I getting bang for my buck? I think it is but it still remains to be seen,” she said. The industry “had better be able to back it up,” she said, if mhealth is putting itself forward as an alternative to conventional healthcare.