Despite the hundreds of pilot studies using mobile
health—also known as 'mHealth'', which describe medical and public health
practice supported by mobile devices— there is insufficient evidence to inform
the widespread implementation and scale-up of this technology, according to
international researchers writing in this week's PLOS Medicine.
There are over 6 billion mobile phone subscribers and 75% of
the world has access to a mobile phone leading health care providers,
researchers, and national governments to be optimistic about the opportunities
mobile health has to offer. However, the authors led by Mark Tomlinson from
Stellenbosch University in South Africa, question the evidence supporting the
scale up of mHealth.
The authors say: "In some ways, mobile technology has a
magical appeal for those interested in global public health over and above the
advantages that have been proven with good evidence."
They continue: "Part of this magical promise is that
mobile technologies may solve one of the most difficult problems facing global
health efforts—that of structural barriers to access."
However, according to the authors while enthusiasm for
effective mHealth interventions in sub-Saharan Africa is high, little is known
about their efficacy or effectiveness.
They say: "The current wave of mHealth interventions
are the equivalent of black boxes. Each small entrepreneur or researcher
includes whatever bells and whistles that their funding allows in an attempt to
The authors argue that potential innovative research designs
such as multi-factorial strategies, randomised controlled trials, and data
farming may provide this evidence base and make several recommendations for the
The authors also argue that major donors could invest in
creating a robust set of standards and a platform that can inform and support
local adaptation of mHealth applications. The standardised features of the
platform could then be available to all local technicians committed to
improving the health of their local communities.
The authors conclude: "We also believe a global
strategy for programmatic examination of the optimal features of the mobile
platforms is needed."