This year, World Health Day, celebrated annually on 7 April, asks ‘How safe is food? From farm to plate, make food safe,’ highlighting the health risks associated with unsafe foods. Contaminated food containing harmful bacteria, viruses, parasites or chemical substances can cause over 200 diseases from diarrhoea to cancers. Unsafe food is also intrinsically linked to the development of non-communicable diseases (NCDs): a cycle of malnutrition and unhealthy diets can lead to long-term health issues such as diabetes and cardiovascular diseases. Every year, over 38 million people die from NCDs, accounting for 68 per cent of global deaths, including 16 million premature and preventable deaths. This has a wide-reaching socio-economic impact; between 2011 and 2025, developing countries projected cumulative loss due to NCDs is US$ 7 trillion.
Information and communication technologies (ICTs) are a powerful tool to help address this global issue. Over 90 per cent of the world’s population is covered by a mobile network and there are 6.8 billion mobile phone subscriptions worldwide. As such, mobile and wireless communication devices offer a unique opportunity to provide a reliable and inexpensive way to reach people living in even the most remote areas.
Recognizing that mobile solutions are available, accessible, portable and a cost effective means to minimize illness and disability, ITU and the World Health Organization (WHO) launched the global mHealth programme Be He@lthy, Be Mobile in October 2012 to specifically target NCDs. The programme provides governments with best practice guidelines for mHealth interventions based on existing clinical evidence from trials around the world, and enables them to launch national health programmes using tools and support provided by the initiative. It also catalyses the establishment of national and global partnerships to ensure the long-term sustainability of mHealth programmes within national health systems. To date, the Be He@lthy, Be Mobile initiative has been working with Costa Rica, Zambia, Norway, Philippines, United Kingdom, Senegal, Tunisia and India to implement mHealth programmes.
Food safety extends beyond the spread of diseases through contaminated food; the ITU and WHO mHealth initiative addresses the management of preventable diseases fostered by unhealthy diets. One such project is the mDiabetes programme, successfully launched in Senegal in November 2014. It works with the Senegalese government to increase awareness about diabetes, train health professionals and community health workers, provide remote consultation services, and offer treatment and management support for people with diabetes.
Diabetes is one of the major causes of death worldwide. WHO estimates that 347 million people have diabetes worldwide; Type 2 diabetes accounts for 90 per cent of cases, and is largely caused by food consumption and physical inactivity. In Senegal, an estimated 400,000 people have diabetes, 80 per cent of which are undiagnosed. Limited access to health services can have serious consequences for someone living with diabetes, yet ICTs can be leveraged to provide a healthcare platform which is always available – a practical solution given that 83 per cent of the Senegalese population has a mobile phone.
The mDiabetes programme was initially launched during the month of Ramadan, a period of high sugar consumption and dietary irregularity where health authorities witness a peak in the urgent hospitalization of people with uncontrolled diabetes. 80,000 free SMS messages were distributed to more than 2,000 users. Typical messages included: ‘drink one litre of water every morning before you begin fasting’, ‘take care not to overheat and watch out for foods high in sugar such as dates’, and ‘ask your doctor to adapt the dose and timing of your diabetes medication before you fast’.
Following this initial Ramadan deployment, the mDiabetes programme has been scaled up to help people with the disease and healthcare providers to prevent and manage diabetes.
The Tunisian Ministry of Health approached the Be He@lthy, Be Mobile initiative to scale up mDiabetes interventions and implement best practices identified during field application in Senegal. The first national mHealth programme will be developed this year.
Mobile phones help overcome barriers to accessing healthcare such as lack of infrastructure or trained staff. Building on mHealth initiatives such as the Be He@lthy, Be Mobile programme, mobile phone technology can be harnessed to influence behaviours that can help to control the world’s biggest killers: non-communicable diseases.
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