06 December 2012

Embed Women and Girls into mHealth, says Dr Sadik

Washington DC - A marginal part of the recent mHealth Summit, global health took center stage on the final day with keynote addresses and discussions from global health leaders. Dr Nafis Sadik, UN Foundation Board Member and former head of United Nation's Population Fund used her time in the spotlight to issue a challenge for embedding women and girls into mHealth.

Dr Sadik spoke directly to the mHealth Alliance, a convening group for coordinating mHealth that involves multiple stakeholders from the public, private and NGO sectors. She commended the work done by the Alliance to bring people to the table in order to improve health outcomes through mobile technologies.

The promise of rapid technological growth makes Dr Sadik feel optimistic, but she was careful to point out that there are still significant gaps in the technologies and health solutions reaching women. "Whole groups are left out of the hi-tech revolution, notably the poor, and especially poor women," she said. "Women in general are less likely than men to have access to mobile technology – in South Asia, nearly 40% less likely."

Allison Stone of MoTeCh illustrated this very problem at last year's mHealth Summit and the NYC FailFaire. A project in Ghana that used mobile phones to support pre-natal and ante-natal care for women. Both the mothers and the community health workers were meant to use phones in order to enter information and receive SMS reminders. An initial survey found that women had high access to phones.

However, the implementation of the project revealed that access was loosely defined. Some women relied on neighbors to charge a phone or would borrow the phone with the permission of the husband. That meant that messages were not reaching women at the right time or at all. The truth was that cell phone use was much lower than what the survey revealed.

At a summit where major telecoms companies like Verizon presented new technologies for mHealth, Dr Sadik made the argument that access is central to ensuring that women around the world have access to health services. "For the mHealth Alliance to be fully successful, it must reach the women most in need, the less privileged and more excluded: precisely the women least likely to have access to mobile technology," she advised.

Reaching women also includes finding ways to bring men on board and in some cases change their attitudes. When I asked Dr Sadik after her remarks what she wanted to see done about including men in women's health she uncomfortably laughed saying that she had no idea how to do it. Then she switched to a serious tone as she reiterated that men can be a barrier to women's health and must be included in the effort.

To be successful, the mHealth Alliance must not only directly engage with women and girls, but address their needs and tackle the obstacles to better health, Dr Sadik argued. "Whatever opportunity exists we should be giving the maximum opportunity for that person," she said. 

Dr Sadik. stressed that it goes well beyond access to technologies. Women need to be able to access comprehensive services, rather than fractured or specific health interventions. "In the real world, women don’t have separate boxes for family planning and HIV prevention. They don’t know why the HIV clinic supplies condoms but not contraceptive pills, she explained. "They don’t know why they have to go to different places on different days for family planning, pregnancy testing, ante-natal care, cervical cancer screening, and all the other services they need."

Empowerment is at the base of Dr Sadik's argument. "It is not about me taking your power," she said to me. "It is about equal value. I believe everyone has equal value." The end goal is to ensure that women have the ability to make their own decisions in their lives.

At the conclusion of her prepared remarks, Dr Sadik challenged the mHealth alliance to do three things: 1) Involve women directly; 2) support gender equity and women's empowerment; 3) remove the obstacles to participation. "This is both a matter of basic human rights and a contribution to peace, justice and prosperity. Women are half the world. With our help, women will change the world," she concluded.