Be He@lthy, Be Mobile: Mobilizing the Global NCD Response

By Katie Dain, Executive Director of the NCD Alliance

 

Let’s be clear: noncommunicable diseases (NCDs) are on the rise. Health systems are straining at the seams, already unable to cope with the tide of people suffering from these conditions and their complications. NCDs cover a broad range of health problems: diabetes, cancer, cardiovascular disease, chronic respiratory diseases, and mental and neurological disorders. Cries from citizens and politicians for increased health system funding or restructuring of service delivery too often go unanswered in developed and developing nations alike. If these trends are to be reversed, we need to look at using a dual approach of micro and macro forces: empowering individuals to make good health choices, and creating environments which allow them to do so.

Mobile health interventions are a unique resource to help people take control of their own health by empowering them with the right knowledge at the right time, developing personal decision-making and positive behaviour change. With 7 billion mobile subscriptions worldwide, and usage rising fastest in low-and middle-income countries, there is no comparable means to directly transmit information tailored to an individual. This puts mHealth in a good position for reaching people whose personal schedules and lifestyles leave limited time for healthy behaviours, or who face physical or economic barriers to accessing health services. mHealth is transforming the way health services are delivered, putting the patient at the centre and providing continuous support and motivation for individuals already living with a condition, and those at risk of developing one.

For people already living with an NCD, SMS message services can help them adhere to treatment routines by providing regular reminders to take their medication. In terms of either primary or secondary risk reduction, subscribing to mHealth messaging services can help people avoid or reduce their exposure to key risk factors for NCDs through their daily behaviours. This includes helping them find new ways of incorporating physical activity into their daily routines, providing tips on healthy eating, and raising awareness of the effects of smoking or excessive alcohol consumption.

Effective mHealth interventions must draw together expertise from multiple sectors, requiring input from experts in behaviour change, health promotion, medicine, information and communication technology (ICTs), government policy, along with industry regulators, telecom operators, and local delivery partners. In 2013 the World Health Organization (WHO) and the International Telecommunications Union (ITU) founded a joint initiative on using mHealth to control NCDs, Be He@lthy, Be Mobile. The partnership is the first global program to focus on scaling up mHealth for NCDs, and a leading example of multisectoral collaboration. They hold official partnerships with nine countries, implementing mHealth programs for a number of user groups and diseases. Highlights include:

India: mTobaccoCessation

Clinical trials indicate that SMS cessation services can be almost 70% more effective than traditional cessation services alone, meaning the impact on reducing tobacco use could be huge. In 2016 India saw mHealth services launched for both tobacco cessation and diabetes prevention. The mTobaccoCessation service helps people who either smoke or chew tobacco to quit its use by sending them regular texts via SMS with quit tips, support and advice, offered in both English and Hindi. Within the first week 160,000 people registered to use the service, and as of December 2016 over 2.1 million people have registered.  In the past 5 years national tobacco cessation clinics have managed to service around 35,000 individuals – in 8 months mobile technology has expanded this reach by almost 57 times (1).

Senegal: mDiabetes

In Senegal, over 74% of the country’s estimated 498,000 cases of diabetes go undiagnosed every year, prompting the Government to focus on improving population awareness of the disease. The Holy Month of Ramadan is a particularly challenging time of year for people with diabetes, given the spikes in blood sugar levels caused by religious fasting. The government of Senegal has been working with the Be He@lthy, Be Mobile initiative to develop and run national campaigns to help people with diabetes manage their condition during Ramadan (mRamadan). In 2016, approximately 50,000 individual users signed up to this SMS-based information service which provides people with information on a regular basis to help avoid dangerous fluctuations in blood glucose levels, and thus avoid hospitalizations and complications.

The progressive partnership structure of the Be He@lthy, Be Mobile initiative draws together the technical leadership and global good practice collated by WHO and ITU, with cutting-edge innovations from the private sector; the strengths of civil society partners, including the NCD Alliance, in advocacy and capacity development; and essential contextual insights from regional and local partners. By combining these assets, the initiative serves to ensure that the highest quality information empowers the greatest possible number of people around the world: something we will need if the ambitious targets of the SDGs are to be met.

 

BIO: Katie Dain is Executive Director of the NCD Alliance. Her experience has included organisational and strategic development; global advocacy and policy-making; and programme design and capacity-building in low- and middle-income countries. The NCD Alliance is proud to have been the first NGO partner of the ‘Be He@lthy, Be Mobile’ initiative.

References:

1. Murthy P, Saddichha S. “Tobacco cessation services in India: recent developments and the need for expansion.” Indian J Cancer. 2010;47(Suppl):69–74.