Changing the Face of Public Health: Click Diagnostics

This winter, through the gracious support of the Social Equity Venture Fund (S.E.VEN), I will be working in Cairo, Egypt with Click Diagnostics, a mobile tele-health social enterprise venture that recently won the $100K Entrepreneurship Competition hosted yearly at MIT. As mentioned in previous posts relating to cellphones and development, mobile technology seems to be the next frontier in terms of poverty alleviation. In this case, the focus is on the delivery of high-quality, affordable healthcare to rural populations in developing countries.

Currently, the organization is in the start-up stage, and is piloting its implementation model in several areas, including Egypt. For the benefit of those who would like to learn more about Click Diagnostics’ for-profit model, a more detailed description follows:

The Need: The confluence of four critical factors has led to what Click Diagnostics believes is a global health mandate – 1) a severe scarcity of doctors in rural areas, 2) the relative abundance of medical expertise in urban areas, 3) the presence of trainable community health workers and local-level micro-entrepreneurs, and 4) the rapid penetration of relatively inexpensive mobile technology into the markets of developing countries.

The Model:
Click Diagnostics employs a mobile tele-health model to connect locally trained community health workers with a remote, web-based network of medical specialists. Through the integration of inexpensive technology, locally trained community health workers, and remote medical expertise, Click Diagnostics aims to provide a sophisticated end-to-end healthcare service delivery chain for “remote diagnosis and consultation, health risks screening, early warning systems, and health data analysis.”

The Vision: Click Diagnostics aims to “provide quality medical advice to every household in disadvantaged regions of the world at an affordable price, and develop cost-effective solutions for gathering critical data needed for planning and executing public health interventions.”

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Cellphone Company + Fertilizer Company = Cool Idea

IFFCO Kisan Sanchar (IKSL) is a unique partnership between India’s largest mobile operator, Airtel and Indian Farmers Fertiliser Cooperative (IFFCO). According to the brief on iGovernment:

IFFCO Kisan Sanchar (IKSL), would be focusing on communication requirement of rural India, besides providing agriculture related information to enable villagers take right farming decisionsIKSL will offer handsets, co-branded SIM card, and agro development voice messages in regional languages related to farmers

There is a lot of synergy between both these companies. IFFCO has significant access to farmers and farming communities, being a major player in the country’s fertilizer industry. Airtel on the other hand is focused on extending rural connectivity and bundling additional services into cellphones. Of course, cellphones themselves are touted as the next big development success story (talk about unintended consequences), as highlighted in this space before.

Cellphones and (Rural) Development, Part Two

The agricultural sector employs 2/3 of India’s population, and contributes to 1/3 of its gross domestic product (GDP) – yet, Indian farmers in rural communities are plagued by debt, falling commodity prices, changing weather patterns, fluctuating demands in the global market, and failing crops. In regions such as Vidarbha, farmer suicides are endemic, to the extent that even the recent governmental debt relief scheme has been unable to mitigate the crisis.

Moreover, most rural farmers are unable to capitalize on the true value of their crop yields, often getting as little as “25% of the value of the final price of their raw produces against 40%-50% in America and Britain.” In light of this concern in particular, technological advances, specifically with respect to mobile phones, have gained traction within South Asia through initiatives like Grameen Phone, InternetSpeech, the recent IBM initiative, etc.

As highlighted in a recent Times Online article, of particular interest is the Reuters Market Light campaign, which has the capability to provide, for example, weather reports, crop spraying information and competitive market pricing, all through the mobile phone for 175 rupees a quarter.

I know what you’re thinking – we’ve all heard of this kind of technology before, but what makes this particular initiative so unique? According to the Indian Development Blog, Market Light uses a very different, and in their opinion, “superior system for gathering and reporting local spot prices than that employed by local newspapers.” The blog goes on to explain:

Newspapers typically rely on middlemen to report the range of prices observed in the market each day for a given commodity. The problem with this method is that the maximum and minimum quality of the produce that shows up in a mandi on any given day can vary quite a bit so these figures are often difficult to interpret.

Reuters Market Light takes a different approach. Rather than report a range of prices, Reuters provides the exact spot price for a given quality level of each commodity. Doing this takes more effort – the person providing the prices must be able to precisely discern between varying levels of quality — but it is much more useful for farmers.

In terms of measurable outcomes, this initiative has reportedly generated positive results to date, concretely enabling farmers to enhance their abilities to bargain, negotiate prices, and most importantly, make choices on the basis of the most favorable financial outcomes. Sounds great in theory, but what exactly does this look like on the ground, you may ask? (this article continues after the break – click “Read More”) Continue reading

IBM and Rural India Make a Connection, Literally.

As a follow-up to previous posts relating to the role of mobile technology as an enabling factor in the development of rural India, IBM has recently launched a pilot project in south India that will allow rural communities to access information ranging from healthcare service providers to potential markets for finished goods through a toll-free number. Users will be able to access this information either through their own mobile, or through local “kiosks”:

Rural users can dial the toll-free number from a kiosk or their own handset to find out things like what precautions to take for some common diseases, where to find the nearest primary healthcare centre, which plumber or carpenter is available at what time and at what charges, what are the micro-finance options available and also learn some basic English or another language.

This project is part of the India Research Lab’s “Spoken Web” project, which includes 6 other projects in the area of voice-enabled mobile commerce. In terms of the logistics, the exact revenue model has not been disclosed, but the kiosks themselves will be established in partnership with local NGOs.

Although I am optimistic about initiatives of this nature, it is my hope that IBM, in partnership with local NGOs, work not only to enlighten rural communities on the concrete, locally relevant implications of this resource, but also provide insight into the connection between access to information/knowledge and power. If a community member does not feel empowered enough to effect profound change within their own lives through more concrete means, how can they see the tangible benefits of a voice enabled mobile service? There need to be more concrete, awareness/confidence building initiatives that accompany these technological innovations in order to bring about true behavioral change and boost self-confidence on both an individual and community level.

Cellphones and Development

Recently, the NYTimes featured an article entitled, “Can the Cellphone Help End Global Poverty?”, in which it highlighted a new wave of “human behaviour” research funded by cellphone companies such as Nokia in order to tap into less developed markets. The author of the article centers around a series of conversations/interactions with Jan Chipchase, a “user anthropologist” for Nokia, but I will highlight the larger trends presented in the article instead.

According to the article, Asia and Africa are at the cusp of a new wave of technological improvements and access that potentially stand to benefit a significant portion of the poor, underprivileged population (we have highlighted a few key trends here – InternetSpeech, SMS for Blood Donors, Quarter Million Internet Capable Phones, LifeLines Education, Cellphones as a Social Epidemic, and CureHunter). Small improvements in terms of access, suggests the article, can generate exponential returns:

Today, there are more than 3.3 billion mobile-phone subscriptions worldwide, which means that there are at least three billion people who don’t own cellphones, the bulk of them to be found in Africa and Asia. Even the smallest improvements in efficiency, amplified across those additional three billion people, could reshape the global economy in ways that we are just beginning to understand.

To get a sense of how rapidly cellphones are penetrating the global marketplace, you need only to look at the sales figures…Eighty percent of the world’s population now lives within range of a cellular network, which is double the level in 2000. And figures from the International Telecommunications Union show that by the end of 2006, 68 percent of the world’s mobile subscriptions were in developing countries.

How exactly do cellphones contribute to development, you may ask? Well, according to development specialists and business scholars Robert Jensen, cellphones have been proven to augment income:

Robert Jensen, an economics professor at Harvard University, tracked fishermen off the coast of Kerala in southern India, finding that when they invested in cellphones and started using them to call around to prospective buyers before they’d even got their catch to shore, their profits went up by an average of 8 percent while consumer prices in the local marketplace went down by 4 percent.

In fact, “a 2005 London Business School study extrapolated the effect even further, concluding that for every additional 10 mobile phones per 100 people, a country’s G.D.P. rises 0.5 percent.” Further research by the World Resources Institute, which, in collaboration with the International Finance Corporation, published a report entitled, “The Next Four Billion,” has found that poor families invest a significant amount of their savings in the information-communication technology category. Here are further details from their findings (more after the jump): Continue reading