The First HIFA SMART Goal: Mobile Healthcare Information For All

“By 2015, at least one telecoms provider, in at least one country, will endorse the vision of Healthcare Information For All, and will provide free access to essential healthcare knowledge in the local language, pre loaded on all new mobile phones they may sell and freely downloadable to all those who already have a mobile phone.”

mHIFA research reveals lack of mobile access to health information in low-income countries

Dr. Christine Hagar, an assistant professor at the San José State University (SJSU) School of Library and Information Science, addressed the Healthcare Information For All by 2015 (HIFA2015) mHealth goal (mHIFA) during a poster showing at the 2014 BOBCATSSS conference in Barcelona. She explained the need for mobile access to healthcare information at the point of need in low-income countries where healthcare workers may not be available. You can view the poster here.

“Thousands of lives could be saved every day if all mobile phones had basic healthcare knowledge, including and especially first aid, maternal, and child health information” (HIFA2015).

The preliminary research findings revealed that of the 1,700 mHealth programs/projects scanned, “there are very few [<1%] projects that empower people in low-income countries with the information they need, when they need it.”

The mHIFA SMART Goal was proposed and is led by the HIFA 2012-15 Challenge Working Group, which is specifically concerned with the health information needs of citizens, parents and children, in recognition of the huge (and largely unrealised) potential of mobile phones to meet basic healthcare information needs of citizens, parents and children. A concept note is available here

The mHIFA SMART Goal was ratified by the HIFA Steering Group on 24 April 2013. The mHIFA goal is loosely defined and open to interpretation. Our intention is to identify, monitor and stimulate any current and future initiatives by HIFA members and others, which may serve to meet the healthcare information needs of citizens, parents and families. The HIFA 2012-15 Challenge Working Group is not itself aiming to implement a practical initiative.

The role of the HIFA 2012-15 Challenge Working Group is to harness the power of our growing network to stimulate current and future initiatives by HIFA members and others. We are:
1. collecting information from HIFA members and others about relevant current and planned activities,
2. encouraging sharing of experience and lessons learned, and
3. agreeing indicators and monitor progress (see below).

We invite your comments and suggestions on what is currently being done already in relation to the mHIFA SMART Goal, and ideas on how we can accelerate progress. Please join the HIFA2015 forum and we shall collate your inputs.

We are grateful to Heather Kartzinel (Student) and Dr Christine Hagar (Assistant Professor) of the School of Library and Information Science, San Jose State University for their preliminary desk research (September 2013 – November 2013) presented here to identify existing relevant projects worldwide. The researchers identified only seven (less than 1%) relevant projects among an estimated total of 1500 mHealth projects in various directories and repostories – that’s only 0.4% of all mHealth projects. This indicates a serious lack of mhealth projects that empower people with the information they need to deal effectively with acute healthcare situations. By contrast, there is a plethora of projects that push health education messages to citizens (these projects are undoubtedly important, but arguably do little to empower citizens with as-needed information to guide first aid and decision-making in childhood illness).

Christine Hagar presented this work as a poster at the January 2014 BOBCATSSS International Library and Information Conference in Barcelona.

Contact: Neil Pakenham-Walsh (Acting Coordinator, mHIFA and HIFA 2012-15 Challenge Working Group): neil.pakenham-walsh AT

Developing a framework to support the identification, monitoring and evaluation of applications

(A proposal by expert adviser Geoff Royston – please send comments and suggestions to Neil Pakenham-Walsh)

Three tasks for the mHIFA initiative will be helping identify the most promising applications, supporting their implementation, and then monitoring and evaluating their success.

This note outlines, and proposes the further development of, a framework to assist in those tasks. The delivery of successful mHealth programmes in low resource settings faces particular challenges (see e.g.1,2,3). Although there is reason to believe that the types of applications being considered for mHIFA will be less vulnerable to some of the common problems, it would be prudent to identify likely enablers of and barriers to success.

The mHIFA initiative, like many mHealth programmes, can be seen as a contribution to supporting self care. For such programmes information is a piece of a complex jigsaw – see for instance the illustration shown below (from some previous work on self care support strategy in the UK). Clearly, the better the pieces of such a jigsaw fit together, the greater the chances of success.

Information is a piece of a complex jigsaw: mHIFA initiative, like many mHealth programmes, can be seen as a contribution to supporting self care.

Taking that wider picture into account will be important, but for mHIFA we will also need to focus on some more specific factors. These will include not only technological but also behavioural factors -­ it will be important to draw upon current thinking on what drives health-related behavior change, to ensure that information produces action.

The funnel diagram below suggests a series of such factors, which could be regarded as a succession of filters all of which need to be passed through for a successful impact to be achieved:

The need to focus on some more specific factors which could be regarded as a succession of filters all of which need to be passed through for a successful impact to be achieved.

It would be helpful – both for the programme and for helping convince potential sponsors of its value – if these factors were refined to produce an agreed set, and that these were then used:

  • to help shape initial work on collecting baseline information and using its findings to identify the most promising applications;
  • to assist those implementing applications to ensure that as much as possible is being done to remove or lower any barriers to turning information into action;
  • to help focus issues for monitoring and evaluation.

  • References:
    1. Tomlinson M et al, Scaling Up mHealth: where is the evidence? PLOS Medicine Feb 2013 10 (2) e1001382
    2. Chakrabarti R, Perera C, The Growth of mHealth in Low Resource Settings. Journal of Mobile Technology in Medicine (2013) 2:1:1-­-2. DOI:10.7309/jmtm.75
    3. The Netherlands Royal Tropical Institute (KIT) website at focuses on this issue.

    mHIFA Expert Advisers

    Peter Benjamin is the coordinator for Capacity Building for the mHealth Alliance, and is currently based in Cape Town. Previously he was managing director of Cell-Life (, South Africa. Professional interests: Using mobile technology to provide access to health information and services for the majority. In countries like South Africa, 90% of youth and adults have a cellphone. However, this is not well used as a channel to access healthcare. Mobile tech can become a way to get healthcare information that allows people to manage their own health (and their families). Mobile can also be the first point of contact with the health system – for health promotion & disease prevention; general health information and queries; triage services when there is a problem; linking & referral to health facilities; self-managed care for chronic conditions; maternal & child support; community monitoring of the health system.

    Geoff Royston is former Head of Strategic Analysis and Operational Research in the Department of Health for England and is currently President-Elect of the UK Operational Research Society. He has had a range of activities and responsibilities involving analysis and research to inform the design, implementation and evaluation of evidence-based policies and programmes in health and social care. These include modelling for understanding the performance of complex systems, analysis and communication of risk, and horizon scanning and futures thinking. He has also worked on information and communication technology in the health sector, notably in leading the design and national launch of NHS Direct. He has served on both scientific and medical UK Research Council panels and is a member of the editorial board for the journal Health Care Management Science, for which he was Guest Editor for the Special Issue on Global Health published in 2012. He has been a consultant for the World Health Organisation on the use of information and analysis to improve the management of healthcare and population health.