From Policy to ImplementationWorld Bank
Washington, D.C.
Rodrigo Saucedo-MartínezPrincipal Investigator
Wireless Communication for Health
Non-for-profit organization created by the Carlos Slim
Foundation in Mexico to contribute in the generation of
sustained health initiatives that have a profound impact.
Empowering individuals
Health Professionals
Health services
Individual online micro-database(confidential and anonymous)
Mobile phone
Fixed phone
Internet
Interactive Voice Response (IVR)
•Lab tests•Medical
appointments•Notification and
follow-up
Wireless Communication for Health
Our solutionsWireless Communication for Health
Changes in lifestyle
Diabetes
HIV/AIDS
Wireless Communication for Health
Cardiovascular risk assessment
Classification of results by risk level
Educational messages: General well-being and exercising Nutritional plan Hypertension Prevention and caring of diabetes Tips to quit smoking
Reassessment of cardiovascular risk
Assessment of cardiovascular risk of non-diabetics
Educational messages
Personal profile and family history
Reminders on Medications Appointments Lab tests
Registry and online monitoring of personal health indicators
Daily and monthly adherence survey
Wireless Communication for Health
LowRisk
MediumRisk
HighRisk
Wireless Communication for Health
Educational messages
Family history
Reminders Medications Appointments Lab tests
Registry and onlinemonitoring of personal healthindicators
Monthly adherence survey
Networking among family members and friends
SWOT AnalysisWireless Communication for Health
Strengths
Use of a standardized methodology
Flexibility
Weaknesses
How to scale?
Scarce technological knowledge
Opportunities
Governments are open to initiatives
ICT’s are incorporated in people’s daily lives
Threats
Governments are risk averse
Technology = expensive interventions
From planning to scale-upUse of a standardized methodology
1. Strategic planning2. Operation
3. Progressive scale-up
Problem identification
Design of the intervention
Q&A
Social marketing
Focus groups
Fine tuning
Partner selection
Training
Evaluation
Adjustments
SWOT AnalysisWireless Communication for Health
Strengths
Use of a standardized methodology
Flexibility
Weaknesses
How to scale?
Scarce technological knowledge
Opportunities
Governments are open to initiatives
ICT’s incorporated in people’s daily lives
Threats
Governments are risk averse
Technology = expensive interventions
Finding the right partnerFlexibility
Public
Private
Third sector
SWOT AnalysisWireless Communication for Health
Strengths
Use of a standardized methodology
Flexibility
Weaknesses
How to scale?
Scarce technological knowledge
Opportunities
Governments are open to initiatives
ICT’s are incorporated in people’s daily lives
Threats
Governments are risk averse
Technology = expensive interventions
• Risk averse:Technology = luxury
• They need results in the short term
• The need for evidence:
mHealth vs a traditional intervention
Governments’ approach to mHealth
Causes of obesityThe impact of lifestyle
Food production Food
consumption
Physiologic factors
Psico-social factors
Individual psychology
EnvironmentPhysical activity
Source: Tackling Obesities: Future Choices. Project Report. Government Office for Science. UK: 2003.
Prevalence of chronic diseases in people 60+Chronic diseases in Mexico
Hypertension High cholesterol Diabetes(3.4 million)
40 +35 – 39.9
30 – 34.925 – 29.920 – 24.9
(1.4 million)
25 +20 – 24.9
13 – 19.910 – 12.95 – 9.9
(1.8 million)
25 +20 – 24.9
15 – 19.913 – 14.910 – 12.9
Source: Mexican National Survey of Health and Nutrition 2006.
SWOT AnalysisWireless Communication for Health
Strengths
Use of a standardized methodology
Flexibility
Weaknesses
How to scale?
Scarce technological knowledge
Opportunities
Governments are open to initiatives
ICT’s are incorporated in people’s daily lives
Threats
Governments are risk averse
Technology = expensive interventions
Jan-99 Nov-99 Sep-00 Jul-01 May-02Mar-03 Jan-04 Nov-04 Sep-05 Jul-06 May-07Mar-08 Jan-09
Fixed lines Mobile phone users
Mobile phone users and fixed lines in MexicoTechnology is incorporated in people’s daily lives
* Data estimated considering the economically active populationSource: Mexican Federal Commission on Telecommunications
3.5
9.9
20.5
78.0
1.07 mobile phones per inhabitant*
Internet users in MexicoTechnology is incorporated in people’s daily lives
9.1
2000 2001 2002 2003 2004 2005 2006 2007 2008
Con PC, internet en el hogar Con PC, sin internet en el hogar Sin PC
14.1
2.52.5
23.2 million
Source: Mexican Federal Commission on Telecommunications
Foresee the future:• Training• Social Marketing• Integration into national health systems
Public-Private-Third sector partnerships:• Interdisciplinary teams• Integration of ideologies and positions• Co-funding and co-development
Conclusions
The need for evidence:• Peer-reviewed articles• Standardized framework• Benchmarking• Networking• Best practices
The future of Mobile Health:• Coverage increase• Incorporation of new technologies• The role of the third sector
Conclusions
Adding efforts to
multiply solutions
www.salud.carso.org