ICTworks by Inveneo

Whenever we talk about mHealth, there is always much hand-wringing around sustainability. And by that we usually mean we want to find the mHealth model that can be like mobile phones - paid by users and funded by deep-pocketed, aggressive private firms. That way, we can escape the limitations of donor funding and move past the many mHealth pilots that never seem to scale, to truly global healthcare solutions.

I would like to be a heretic and put forth an idea that's be brewing since last week's Technology Salon sustainability discussion where our comments even suggested that all ICT4D efforts are sustainability failures:

Do we expect her to pay? (Data Dyne)

mHealth isn't sustainable

International development efforts in mHealth focus on bringing resources and solutions to communities who are unable to provide their own. This can mean remotely checking on patients in rural areas miles from the nearest clinic, or delivering health PSA's to urban youth in Nairobi nightclubs, to even educating affluent women in India on their menstrual cycle.

But in all these instances and more, the recipient is either unwilling or unable to pay for the service. So why do we keep looking for ways to have them fund mHealth initiatives? Why do we think private payment is the sole sustainable model? Let's look at who has the will to pay for such services and expect them to underwrite mHealth initiatives.

mHealth is fundable

Public health is a high priority for governments. A healthy population is a happy, productive one, and therefore every government has a keen interest in providing healthcare solutions to its populace. Some of these solutions are government funded without question - in the USA we don't expect the Centers for Disease Control or Medicaid to be self-funded in a pay-for-service model. Some solutions are a public-private hybrid - general healthcare services are almost always a mix of public, business, insurance, and private funds. And other solutions can be either - HIV testing and treatment varies by country and even by client.

But in any of these scenarios, do we hear talk about sustainability? Outside arguments about the cost of these programs, no one is advocating that governments stop funding for CDC's or HIV treatments. So why then, when we talk of mHealth, do we try to force a fully private-payer model?

(Like what you read? Then subscribe to ICTworks updates via RSS, Email, or Twitter)