Like scale-up, sustainability should be on the radar from the beginning of the mHealth planning process. Given that the mHealth field is not yet mature, many programs still rely heavily on donor funding for start-up and ongoing support. Ministry of Health (MOH) and private sector financing have contributed funding to many efforts, and consortia funding models are quite common for mHealth deployments. There is less documentation of programs that are self-sustaining, though they do exist. This section of the Guide will help you think through sustainability considerations by exploring:
- How will implementation costs be tracked and used to estimate costs of scale-up and potential cost savings of the program?
- Are long-term operating costs considered when making early project decisions, such as what kind of software should be used?
- What actions, if any, will the implementation team take to build local capacity to deliver mHealth services and develop, maintain, and upgrade mHealth systems?
- What is the financing plan to support the program over time?
- Is there a potential revenue generation model to support the service? What does that look like?
- Will end users share the costs of the mHealth application? Why or why not?
- What is the program’s business model, if applicable?
- How can the project leverage the expertise and support of international technology partners or other business partners who might provide long-term support? Are there opportunities to leverage donated expertise?
THE EXPERTS SAY...
“We worked with a business consulting firm to develop a business model [for CycleTel™], and this has helped IRH articulate what we need financially to go reach scale (1 million users) and self-sustainability in India over a 5-year period. Without the business model to back-up our “ask,” it was hard to come up with accurate numbers to request funding earlier in the development process. The business case is helpful, but also note that it is based on assumptions, and if you change any of the assumptions it affects what you are able to accomplish.” – Priya Jha, Georgetown University's Institute for Reproductive Health, CycleTel, India
Lemaire J. Scaling up Mobile Health: Elements Necessary for the Successful Scale-up of mHealth in Developing Countries. Advanced Development for Africa and Actevis Consulting Group. 2011.
Sarriot E, Ricca J, Yourkavitch J, Ryan L, and the Sustained Health Outcomes (SHOUT) Group. Taking the Long View: A Practical Guide to Sustainability Planning and Measurement in Community-Oriented Health Programming. Calverton, MD: Macro International Inc. 2008.
Sustainable Financing for Mobile Health (mHealth): Options and opportunities for mHealth financial models in low and middle-income countries. mHealth Alliance and Vital Wave Consulting. 2013.