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

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