Abstract
ABSTRACTThis article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical ‘conditions’ – type 2 diabetes and depression – we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient ‘self-management’ may not be as readily translated to a country like India as proponents of mHealth might assume.
Highlights
The term mHealth refers to the delivery of health-related services via mobile communications technology
We identify some of the difficulties which will need considering by mHealth advocates and planners in a country known for the complexity of and gaps in its health system
In rural settings access to health care is recognized to be an even greater concern than in urban settings, while the chronic nature of diabetes and typically depression was seen to pose particular health care difficulties
Summary
The term mHealth refers to the delivery of health-related services via mobile communications technology. Our analysis draws on data collected in rural South India (Andhra Pradesh) It stems from the initial phase of an applied multi-disciplinary project whose primary purpose was to design and test a mobile phone application to assist those with chronic health problems.. Hypothetical benefits in terms of remote clinical support by district-level clinicians, or as an aid to patient ‘adherence’ in the case of chronic conditions such as HIV or diabetes, have been identified by the authors above, along with some indications of anticipated acceptability to patients of using mobile phones for support with their own health care (Bali and Singh 2007) One limitation of this literature is that it makes assumptions about treatment pathways which may bear little relation to actual practice by patients or their families. The Discussion pulls together the main implications of our analysis, in relation to communication between clinic and patient, and the potentially vexed issue of ‘self-management’
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
