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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| MHealth | 3/6 | https://en.wikipedia.org/wiki/MHealth | reference | science, encyclopedia | 2026-05-05T07:30:51.903089+00:00 | kb-cron |
== Criticism and concerns == The extensive practice of mhealth research has sparked criticism, for example on the proliferation of fragmented pilot studies in low- and middle-income countries, which is also referred to as "pilotitis." The extent of un-coordinated pilot studies prompted for instance the Ugandan Director General Health Services Dr Jane Ruth Aceng in 2012 to issue a notice that, "in order to jointly ensure that all eHealth efforts are harmonized and coordinated, I am directing that ALL eHealth projects/Initiatives be put to halt." The assumptions that justify mhealth initiatives have also been challenged in recent sociological research. For example, mobile phones have been argued to be less widely accessible and usable than is often portrayed in mhealth-related publications; people integrate mobile phones into their health behavior without external intervention; and the spread of mobile phones in low- and middle-income countries itself can create new forms of digital and healthcare exclusion, which mhealth interventions (using mobile phones as a platform) cannot overcome and potentially accentuate. Mhealth has also been argued to alter the practice of healthcare and patient-physician relationships as well as how bodies and health are being represented. Another widespread concern relates to privacy and data protection, for example in the context of electronic health records. Of practical concern for mHealth studies is the high drop-out rate amongst participants, reaching up to 98% in extreme cases, while careful co-design can help minimize this effect. Studies looking into the perceptions and experiences of primary healthcare professionals using mheath have found that most health care professionals appreciated being connected to their colleagues, however some prefer face to face communication. Some healthcare workers also felt that while reporting was improved and team members who require help or training could be more easily identified, some healthcare professionals did not feel comfortable being monitored continuously. A proportion of healthcare professionals prefer paper reporting. The use of mobile apps may sometimes lead to healthcare professionals spending more time performing additional tasks such as filling out electronic forms and may generate more workload in some cases. Some healthcare professionals also do not feel comfortable with work-related contact from patients/clients outside of business hours (however some professionals did find this useful for emergencies). Communicating with clients/patients while using a mobile device may need to be considered. A decrease in eye contact and the potential to miss non-verbal cues due to concentrating on a screen while speaking with patients is a potential consideration.
== Society and culture ==
=== Healthcare in low- and middle-income countries ===
Middle income and especially low-income countries face a plethora of constraints in their healthcare systems. These countries face a severe lack of human and physical resources, as well as some of the largest burdens of disease, extreme poverty, and large population growth rates. Additionally, healthcare access to all reaches of society is generally low in these countries. According to a World Health Organization (WHO) report from June 2011, higher-income countries show more mHealth activity than do lower-income countries (as consistent with eHealth trends in general). Countries in the European Region are currently the most active and those in the African Region the least active. The WHO report findings also included that mHealth is most easily incorporated into processes and services that historically use voice communication through conventional telephone networks. The report was the result of a mHealth survey module designed by researchers at the Earth Institute's Center for Global Health and Economic Development, Columbia University. The WHO notes an extreme deficit within the global healthcare workforce. The WHO notes critical healthcare workforce shortages in 57 countries—most of which are characterized as developing countries—and a global deficit of 2.4 million doctors, nurses, and midwives. The WHO, in a study of the healthcare workforce in 12 countries of Africa, finds an average density of physicians, nurses and midwives per 1000 population of 0.64. The density of the same metric is four times as high in the United States, at 2.6. The burden of disease is additionally much higher in low- and middle-income countries than high-income countries. The burden of disease, measured in disability-adjusted life year (DALY), which can be thought of as a measurement of the gap between current health status and an ideal situation where everyone lives into old age, free of disease and disability, is about five times higher in Africa than in high-income countries. In addition, low- and middle-income countries are forced to face the burdens of both extreme poverty and the growing incidence of chronic diseases, such as diabetes and heart disease, an effect of new-found (relative) affluence. Considering poor infrastructure and low human resources, the WHO notes that the healthcare workforce in sub-Saharan Africa would need to be scaled up by as much as 140% to attain international health development targets such as those in the Millennium Declaration. The WHO, in reference to the healthcare condition in sub-Saharan Africa, states:
The problem is so serious that in many instances there is simply not enough human capacity even to absorb, deploy and efficiently use the substantial additional funds that are considered necessary to improve health in these countries.
Mobile technology has made a recent and rapid appearance into low- and middle-income nations. While, in the mHealth field, mobile technology usually refers to mobile phone technology, the entrance of other technologies into these nations to facilitate healthcare are also discussed here.
==== Health and development ==== The link between health and development can be found in three of the Millennium Development Goals (MDGs), as set forth by the United Nations Millennium Declaration in 2000. The MDGs that specifically address health include reducing child mortality; improving maternal health; combating HIV and AIDS, malaria, and other diseases; and increasing access to safe drinking water. A progress report published in 2006 indicates that childhood immunization and deliveries by skilled birth attendants are on the rise, while many regions continue to struggle to achieve reductions in the prevalence of the diseases of poverty including malaria, HIV and AIDS and tuberculosis.