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Katrin Verclas
New York, NY
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Katrin commented on the article |Nate -- health is definitely the leader in mobile deployment. For any of the apps and implementations in the field to scale to go beyond small rural hospitals, we need a lot more, though. And it's not tech, it's political will, resources, and lcoal, in-country, appropriate tech and participatory design-- all of which are only now beginning. I sure hope that we are not satisfied with a few hospitals -- that would be a bad failure for 2009.
What is needed is to systematically and thoughtfully, with local leadership, move from disparate pilot/tiny-scale efforts to those that are connected and work in tandem with a national health infrastructure (for supply chains, for patient telemedicine, for medical records management) that take advantage of economies of scale, a growing 3G infrastructure, an influx of donor interest, and a spike in senior local leadership getting on the mobile bandwagon -- such as in Ghana and Mozambique, for example, where the health ministries AND the key carrier are taking an active interest in exploring how mobiles can be used in health management and delivery. In other words, this field is getting serious and is growing up - and it's about time.
My two predictions and one plea for 2009 are thus:
1. Health will see the greatest influx of money and scale in mobile deopployment with health ministries in certain countries taking an active role, together with development organizations to roll out much more robust solutions and large-scale implementations.
2. Mobile content will be a greater part of the discussion -- the tech is largely there or will be there but we have not had a serious conversation about what is actually delivered over mobiles. We are keen on a much more substantive discussion about that.
3. If we are not careful, we will see the very same problem that have plagued the ICT for dev field -- pro-poor solutions developed in the West that have little cultural, behavioural, or local support or context. There is virtually no discussion about local solutions that make sense in a given country, no discussion or systematic attemps by donor or Western organizations about local leadership and participation in design and deployment, and few systems for developing and scaling local, indigenous solutions that are promising. We need to do better, much better here or we are bound to repeat the telecentre-failures of the past -- projects and apps that are not locally developed, not scaleable, have no users (as we are seeing already with quite a few of the much-hyped mobile apps out there) that ultimately draw resources and attention away from what really works in a given region or country.
Katrin -
Katrin commented on the article |Very interesting comments, and great post, Ed! I knew I was asking you for a reason -- thanks so much!
I am elaborating more on why these pro-poor efforts commented upon and outlined above in the end are not sustainable or maybe even desirable over at MobileActive.org: http://mobileactive.org/discussion-about-future-mobile-apps-hope-and-why-pro-poor-will-never-work. Ken is right - geeking out on the details is nice and fine, but per-poor - those originating in poor communities by people in those communities -- efforts are elusive here. All of the projects are by Northern white boys with nary an idea of user-centric and participatory design. Which probably explains that despite much digging, all of the Frontline, Ushahidi, RapidSMS (fill-in-the-blank) efforts lack any significant numbers of users despite serious investments -- once you start really looking.
Katrin -
Katrin commented on the article |
And I am with you, Isaac -- there should be a healthy ecosystem of mobile apps focused on different needs (as it's already developing). What I think we'll see, though, is niche apps or highly modifiable and open apps that conform to certain standards, such as OpenMRS or standards around election monitoring, to take it out of the health field, etc, that can be tweaked for the particular locale and needs.
This means that relevant tools have to be realtively open, modifyable, and that standards are agreed on. I am actaully editing, as we speak, a review of data collection applications on MobileActive.org - stay tuned! -
Katrin commented on the article |
Nathaniel -- Excellent comment. A few thoughts on what you wrote:
"I would imagine one of the major issues you're all dealing with is
interoperability and data transport?"
Many (but not all) of the data collection tools using mobiles utlize SMS as the main method of communicating data. SMS is universal - the difference lies in the backend database receiving and parsing the incoming SMS, and the software used to send out SMS. There are many of those, of course - both commercial and NGO-focused. Your point about interoperability is a good one but it's nuanced and probably deserves a bit more of a a post, so bear with me! (will pick this up on the MobileActive.org blog as well)
First of all, as with much humanitarian relief and development work, the problem lies not so much in the integration of technology as with organizational turf - the human aspect of the work. After all, a sql database or Excel spreadsheets that many of the mobile data collection tools utilize can be integrated with little effort. But relief managers and administrators of varying and often competing development and relief efforts are much harder to get on the same page.
Secondly, there are efforts under way to make the process of open sourcing promising tools and enabling technology integration easier -- most notably Open Rosa on the medical data collection side, and the Open Mobile Consortium, a consortium of organizations and tool developers committed to open sourcing their tools, and to collaborating. Led by Instedd, it incudes key people and leadership from Ushahidi and UNICEF's RapidSMS -- both of which are open source applications, that is, the source code is shared and modifyable. So far, despite repeated announcements that Frontline SMS would be open sourced as well last fall, this has not happened, though Ken is also part of the Open Mobile Consortium. Ken may shed light on when Frontline code is finally available.
Both the Open Mobile Consortium as a coordinated group working on knowledge-sharing, and collaborating to the greatest extent possible, and Open Rosa, aimed at developing a set of best practices and standards around mobile medical data collection, are steps in the right direction, that, even though they are just beginning, will inevitably increase as more mobile apps become available, and more significant deployments begin to happen.
I can say that this is where we like to see this going -- at least as long as we at MobileActive have anything to do with this field where we'll strive to convene and bring together the relevant people to advance coordination, and where appropriate, collaboration.
Thirdly, your comment "For example, what happens when a
cholera epidemic spreads from an area where people are working with FrontlineSMS to an area where RapidSMS is deployed? Or even more than that, what happens when CARE uses Ushahidi and MSF uses something similar by an entirely different group?" assumes that there is widespread deployment of these tools. This is not the case so far -- deployments are still mostly small pilot projects with very limited reach. We found, for example, only very few in-the-field deployments of FrontlineSMS, despite a lot of downloads, that, sum total, probably have not involved more than a few thousand individuals (and it is unclear whether there has been any impact at all in those projects as evaluations have not been done). Similarly, RapidSMS has been deployed only twice so far late this year, with similar numbers and so far only anectotes about any impact. Some other deployments focused on medical and public health data collection have been a bit larger as they have been going on longer, most notably in Uganda, South Africa and Southeast Asia, using different back-end applications and SMS -- but, bottom line is, deployments, in the scope of things (and needs) have been ridiculously small so far. This field is just starting out -- a perfect time to bring people together, to collaborate on standards and tools, and to scale the work to really begin to make a difference.
Best,
Katrin -
Katrin commented on the article |
Nate -- nice post! We just wrote about UNICEF's work in Ethopia and Malawi preventing famine with rapid monitoring of feedinc center using RapidSMS, another mobile data collection and rapid reponse tool. See http://mobileactive.org/preventing-famine-mobile.
It turns out that enterprise applications like RapidSMS are more scaleable than smaller, lower-end solutions like Frontline in delivering reliably larger amounts of data delivered via SMS, so for your scenario, a more scaleable, robust mobile/SMS reporting, monitoring and delivery platform is probably adviseable :) For more software reviews such as RapidSMS (a finalists in the recent USAID Development 2.0 Challenge) and Frontline, among others, see http://mobileactive.org/wiki/Mobile_Tool_Reviews.
There are also numerous mobile data collection tools out there that we are reviewing. There are many options - and for your forward-looking scenario, you'll need something that truly scales!
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