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November 12, 2020

Mobile Phones for Maternal Health in Rural Bihar

In 2016, seven billion human beings have been cellular cellphone users, for that reason propelling the cell cellphone beforehand of different facts and conversation technology (ICTs). Whether it be cell non-public health information or personal clinical records sent via textual content messaging, those gadgets are increasingly used to provide “higher” fitness services in a context of reduced health expenditure and accelerated involvement of patients. Substantial research has been carried out on eHealth—fitness on the net—in latest years, specifically concerning the character and the value of fitness statistics at the net (Adams and Berg 2004), the redefinition of the roles of lay and expert in fitness, and the subsequent transformation of the patient-caregiver dating (Henwood et al 2003). Yet, very little research has been performed on the usage of the mobile phone and wireless technology inside fitness programmes, known as mHealth or cell health, and in particular within the global South, or in improvement contexts. However, the impact of cell technologies on healthcare in such contexts increases critical questions that grow to be in particular acute inside the context of increased access to mobile phones in India.

The current multiplication of mHealth worldwide illustrates the overall fashion towards the globalization and technologisation of biomedicine. The sizable idea, that virtual technology improves the fine of care, lessen fitness disparities and optimize health systems, takes form in a numerous set of technical devices: mHealth, telemedicine, massive information, and many others.

This paper gives a glance at this new field of mHealth via the examination of a particular maternal mHealth assignment deployed in Bihar, based on fieldwork conducted in 2015 in two districts and five blocks, among nearly one hundred women, 30 community health workers (CHWs) and 20 implementers, all involved in a maternal mobile fitness undertaking. We propose to recognition extra especially on gender inequalities that those socio-technical devices are revealing and even enhancing at the ground, and the way these are entangled with socio-monetary and health inequalities. Whereas cell fitness is supplied by way of its implementers as a neutral, standard, accessible and “clever” generation to improve fitness in Bihar, we can examine the way it, in fact, reinforces inequalities at the floor.

A ‘Simply Brilliant’ Innovation

Using cell telephones to get entry to and relay fitness data in growing countries is the topic everyone in health and technology is talking approximately right now. There’s a cause for that, of course. It’s one of those “virtually incredible” innovations that seem to make the best sense. … Can a cellular phone shop a life? It’s extremely viable. (Newman 2011)

Access to mobile telephones is turning into an increasing number of common over the globe and is increasing an awful lot quicker than access to the internet (ITU 2013). MHealth figures are mainly coming from cell operators and cellular era carriers. They envisioned the worldwide marketplace in 2013 between 23,000 and 1,00,000 apps global, a rather approximate estimation that focuses simplest on apps that are on hand on the foremost United States-primarily based app stores (Pew Research Centre 2012). Only smartphones can use the ones kinds of apps. Thus, maximum of them are not yet on hand for the majority of the developing nations. Thereby, most of the initiatives deployed in useful resource-negative settings are SMS-based totally or vocal offerings, which can be used on a fundamental handset. Mobile fitness tasks and programs emerged at the start of the 2000s and were popping up inside the growing international locations for the beyond 5 years.

Aware of the growing deployments of mobile technology, worldwide health actors were trying to higher characterize this phenomenon. In 2011, the World Health Organization (WHO) defined mHealth because the exercise of drugs and public fitness assisted by way of mobile technologies, including cell phones, patient monitors, “personal digital assistants” (PDAs) and different wi-fi technologies (WHO 2011). The WHO segments mHealth in step with a typology of initiatives that include: conversation from people to health services (call centres, helplines or hotlines), communication from health services to people (appointment or remedy reminders, cognizance and mobilisation campaigns on health issues), and verbal exchange between fitness specialists (mobile telemedicine, patient tracking, aid to prognosis and choice-making).

The innovative and transformative component of mHealth constitutes an imperative argument to promote its spread. “Mobile phones and wireless net end isolation, and will, therefore, show to be the maximum transformative technology of monetary improvement of our time,” as Jeffrey Sachs had already encouraged in 2008 (World Bank 2012: 1). This name for technological trade—its destiny and guarantees—is structuring the sector of mHealth, its corporation, and actors. Actually, innovation studies diagnosed those dynamics as characteristic of revolutionary gadgets. In line with the work of Joly et al (2013) on the economy of technoscientific promises, or Flichy (2003) on imaginaries of innovation, or Rajan (2012) on the promise as a symptom of technoscientific capitalism, our corpus analysis1 brings out a clean “promising conversation” at stake in health discourses.

All those guarantees come together to promote the mobile telephone as a “truly exquisite” innovation for fitness. Some of those promises—unrelated to fitness—are fed with the aid of the overall hopes and hypes related to the mobile telephone. Its ubiquity and accessibility permit all of us to be effortlessly connected with everybody, anywhere, and at any time, making this generation omnipotent and every day at the same time. Mobile telephones are key to the financial growth of developing nations. “Studies have advised that multiplied cell ownership is linked to better financial boom. It is likewise possible to have twice as big an effect on the economic boom in developing nations as in advanced ones due to the fact the place to begin of infrastructure in poorer international locations is so much decrease in terms of landlines and broadband get right of entry to” (UNDP 2012: 10). These gadgets serve as substitutes for an entire bunch of useful tools that you could rarely discover in the poorest nations: “In growing nations cellular telephones now not best supplement other technologies however also replacement for them—for instance, as cameras, debit playing cards, or voice recorders” (World Bank 2012: 4).

In addition to these “cell promises,” guarantees connected to the health quarter are increasing the complete promising tendency of these discourses: “The use of mobile and wi-fi technologies to aid the fulfillment of fitness targets (mHealth) has the capability to transform the face of fitness service shipping throughout the globe” (WHO 2011: 9).

Craig Bowen

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