Using smart phones for health research in rural areas

I recently became the owner of an unlocked HTC Dream smartphone (running Android 1.6). Smart phones are still quite a rarity in Mekelle (and I’d guess in much of the rest of Ethiopia), so despite this not being the most recent model, everyone who sees me using it asks me to have a look & play around. I have seen a few people with Nokia E71 phones, but when you look closer they’re actually Nokla E71’s (yes, that’s Nokia with an L instead of an i).

In a couple of days I will be heading out to some rural areas with a colleague doing his doctorate in public health. He’s testing different smartphones and applications for data collection whilst he’s interviewing Health Extension Workers (HEWs). I’m joining him to see what some of the issues are with using these types of phones and applications in this context, with a view to spending some time over the coming months seeing how these devices may be used to deliver training.

I’ve only really been using the phone for the past week or so and there are a couple of areas where I can already see we may run into problems.

Firstly, the battery life. With my usage, not particularly heavy, the battery usually only lasts just over a day. Given that we’ll be using these devices for data collection, then they’re likely to be having heavy use in areas with little or no mains power. We are testing out some small solar power chargers.

Secondly, the GPRS coverage. GPRS is not used widely here and coverage in extremely patchy (even in large city like Mekelle) and it’s not yet been rolled out to other more rural areas (or even large towns). Sim cards need to be specifically enabled to use GPRS – it’s not turned on by default. The applications we’re testing out (EpiSurveyor and Sana) will both allow data to stored until an area with coverage is reached, but unless the user visits Mekelle on a regular basis then the data will never get uploaded.

I’m sure that improvements in the phones and the phone network infrastructure will eventually make both of my concerns invalid – it’s just a question of when they will be addressed.

The other questions and areas I’d like to look at include:

1) How easy is inputting the data on such a small screen? Might a tablet or netbook PC be more appropriate? Perhaps they’ll work well for short, relatively simple surveys, but not for others?
2) Do any of the HEW’s already have java enabled phones? If so, this would enable them to use the EpiSurveyor application without any new phones.
3) Do any of the phones support input using ge’ez (the alphabet used for Amharic and Tigrinian)? I can’t see how to input these characters on my phone (if anyone knows how I’d be pleased to hear from you), but I can display the characters.
4) How long do the phones take to get a GPS signal? For each record input we can automatically attach the location coordinates – but I’ve noticed that sometimes the phones can take a long time getting a GPS fix. With the power issues it’s unlikely they’d want to leave the GPS on all the time.
5) Would they really be used? Getting reliable data in these areas (even just for the number of births/deaths) is extremely difficult – reporting processes are often unreliable or just not used. Using these phones could help with gathering this info – but obviously only if they are used.
5) What are the other uses for the phones? E.g. providing remote diagnostic support, clinical support, training content/activities or reference, or perhaps for fun/social activities.

Plus I’m sure many other questions and possibilities will arise over the coming days.

2 Comments

  1. […] Moodle « Using smart phones for health research in rural areas […]

  2. […] look at what could be appropriate to use in this context. Not all the concerns I mentioned in my earlier post have been […]

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