M-health innovations as a health systems strenthening tool?

Dr Torooti MwirigiMBcHB, MBA, IMIS

AghaKhan University Hospital 9th May 2014

Picture Source: FHI360

Agenda• Introduction• Health Care End Game• Kenya’s Health Sector Status• Kenya’s Technology status• Mhealth: myths & Realities• The way forward

Dr. Torooti Mwirigi• Diploma in IMIS, MBchB from UON & MBA from

Strathmore BS“Health Economics Of Using Mobile Phone Technology In Managing

Hypertension”

• Worked on technology and health for the last 8 years.

• Business Development Director at AskADoc & EMED Solutions

• Programme Manager Mhealth at AAR and Pharmaccess Foundation

Quick Poll• How many of you have phones? (16)• Used MPESA in the last week? (87%)

– For Health payments? Relative/yourself (none)

• Used their phone to “google” medical reference? (68%)

• Have you received an SMS/Call “Social”? (68%)• If Yes: You have used M-Health

Healthcare: End Game

Quality of Care

Access to care

Cost of Care

Who takes the risk

Picture Source: Michiel Slootweg / Torooti Mwirigi 2014

Kenyan Health Sector Status

• 42.5 M citizens to 105,000 Medical Personnel

• 32 M Have no medical cover (77%)

• 8 M cannot afford medical services

• 5.9% GOK expenditure on health

• T.H.E: 46% out of pocket;40% GOK; 14% Donors

Source: WHO; IPSOS; MOH; Safaricom

Kenyan Technology Status

• 31 M Mobile phone subscriptions

• 6.2 B SMS’s sent October to December 2013

• 13 M Mobile Internet subscriptions

Source: CCK, Safaricom

Kenyan Technology Status: MPESA

• 11.5M Active MPESA users

• 75 B KSH sent per month over MPESA (2013)

• 15% MPESA amounts sent related to Health

• 1.8B KSH saved in Mshwari Accounts

Source: CCK, Safaricom

Mobile Phone the Solution for Healthcare?

Quick Poll• From the statistics, who sees problems?

– Which one?– How do we resolve them?

• Who sees opportunities?– Which ones?– How do we tap these opportunities?

• Do you think the mobile phone is the solution?

What is Mhealth? Mhealth is the use of mobile phone networks in health care

• Education & Awareness

• Monitoring & Complicance

• Disease/Epideminctracking

• Data Analysis

• Health Data Access

• Health financing

Applications Mhealth

Source GSMA, 2014

46Kenya

Kenyan National E Health Strategy

Kenya National E Health Strategy 2011-2017

Why is mHealth promising?

• Donors love it: A solution for developing countries• “Everyone” has one• Portability• Low cost of maintenance by users• Remote area connectivity• Your bank in your hand

The Reality

• “Pilotitis”: No scale yet. No “MPESA”• Lack of Collaboration, “Silo” MentalityInsufficient evidence on: • Impact on clinical and behavioral outcomes• Cost effectiveness and cost benefits• Influence on healthcare system at scale• Conditions for successful scale-up

Source: GSMA (2012) Mhealth Summit 2012

The way forward

• More research in mhealth with help get break-throughs• Partnership between medics and Donors

Source: GSMA (2012) Mhealth Summit 2012

The way forward

• Improved Collaboration: e.g AAR/PAF/SAFECARE; Safaricom/Britam/Changamka/Donors; Safaricom/GOK/Vodafone foundation

• GOK• Researchers• Medics

• Private Sector

• Donors

Quality of Care

Access to care

Cost of Care

Who takes

the risk

Picture Source: Torooti Mwirigi 2014

Summary

• We have many problems & opportunities• Innovation comes from looking for answers • Technology itself is not innovation• Mobile phones can be great tools for healthcare• We need more research in mhealth• We need more collaboration

THANK YOU

Dr Torooti Mwirigi0722857210tmwirigi@aar.co.ket.mwirigi@pharmaccess.org