Explore Possible Solutions & Desired Results
Deciding whether and how to use mHealth calls for in-depth understanding of the health issue or challenge that a program will tackle.
Begin with the end in mind: start by defining your goal and expected outcomes. Next, consider a range of solutions—not just those involving mobile phones. It is possible that a low-tech solution is more appropriate to solve the particular issue or that mHealth is just one piece of a larger, more complex solution. Remember that while mHealth is a cutting-edge tool for improving access to health information and services, mHealth does not replace a health system or a health care provider.
mHealth experts strongly emphasize that the health problem or challenge must determine the solution. In other words, implementers should not pre-select a technology and then search for a health issue to solve. Ken Banks in The Truth about Disruptive Innovation and Kentaro Toyama in Can Technology End Poverty? eloquently explain why technology is not an end in itself.
To fully explore the problem at hand and possible solutions, use these guiding steps and questions.
- What is the goal of your effort?
- What is the health issue or challenge to be addressed? What are the root causes or drivers of the challenge?
- What benefits, or results are you seeking to achieve?
- Identify other programs or systems with similar goals. What do these programs do well? What are the gaps?
- Considering the wide range of mHealth possibilities, what might your program benefit from? Is it client-centered, provider-centered, or health systems strengthening?
- What potential solutions might address the issue? Think about ways to improve or complement existing programs. Consider how mHealth could be applied. Create an exhaustive list of possibilities—brainstorming with others is often a valuable way to create such a list.
- Compare and analyze prospective solutions—what seem to be advantages and disadvantages, possible costs, staffing, training, and other “people needs” (this is often underestimated), and what are the challenges to making it happen?
After working through these questions, ask “Is mHealth the appropriate solution for the problem?” If yes, continue on to the next section, Logic Model.
THE EXPERTS SAY...
“Among the biggest challenges [in mHealth]: making sure that mobile technology can address the problem to be solved, rather than it just being a solution in search of a problem.” – Nina Frankel, IntraHealth
“[A common pitfall] is when you decide to digitize what is already happening, such as making paper forms electronic. A deeper approach is better. Rather than digitize what’s there, understand the goals of this health service—why does it exist—and approach use of technology with same goals. First, set a high-level goal, and then think about what it looks like to have a technology-enabled service to achieve that same goal. Is it more effective?” – Isaac Holeman, Medic Mobile
“mHealth amplifies what is there [with regards to how the health system operates]—stronger clinics did better; weaker clinics did not really improve or adopt tools.” – Merrick Schaefer, World Bank (with UNICEF at the time of the interview), Programme Mwana in Zambia