Which interventions are available to Countries and how are they selected?
A country will select its intervention by identifying its priorities from criteria such as:
- Weight of disease burden for a specific NCD or risk factor on the population
- Disease priority in the national health agenda
- Existing technology that they would like to be refined through the initiative
- Desire for a rapid implementation (SMS) or a longer project (building a tailored Smartphone app or a full mobile platform for example for screening and treatment)
After identifying its priorities, a country can then pick solutions from the WHO/ITU
mHealth programme’s “juke-box” of possible approaches. These have been selected from evidence collected from all over the world.
There are three broad areas of intervention: prevention, treatment and enforcement. These cover treating patients already suffering from an NCD such as diabetes or cancer, reducing population exposure to risk factors for later developing an NCD (e.g. poor diet and no exercise, which contribute to heart disease and cancers), and helping governments enforce national policy on NCDs. This last category can include not only helping lower national targets for NCDs, but also other areas such as reducing counterfeit cancer drugs using a mobile scanner and bar code to determine a drug packet’s authenticity.
Interventions are often interlinked, meaning certain interventions can be chosen which address more than one disease or risk factor. The following table sets out the interventions currently available under this programme, along with examples of the form these interventions will typically take.
| | DESCRIPTION | EXAMPLES |
| mWELLNESS | SMS tips and Smartphone apps for monitoring and increasing physical activity and diet. | a) Smartphone app which allows the user to scan health content of a food in a supermarket and using the traffic light system for foods find healthier replacements
b) Messages to inform, encourage and track physical exercise or diet programme. |
| mDIABETES | Use of mobile phones to track a patient's blood sugar/insulin levels, remind them to take their insulin, and give advice on dietary changes to stabilize condition.
Can also be used as a preventative measure by informing people about lifestyle choices which increase their risk of developing diabetes. | a) Diabetic has a Smartphone app which tracks their blood sugar in a graph, helping them control fluctuations and reduce damage.
b) Pre-diabetic receives tips on healthy cooking, lowering their tendency towards developing diabetes. E.g. gestational diabetes could easily be prevented or better managed reducing IMR/MMR. |
| mCESSATION | Mobile-based support for tobacco users who want to quit. Toll-free SMS and mobile quitline. Smokers receive encouragement, support and advice on coping with quitting. | The programme provides an ongoing algorithm based messages to the user to help them quit based on a target date, with added interventions for eg. Smoker is craving a cigarette at 7am. They send an SMS with a key word, "CRAVE", to a toll-free number. Seconds later they receive a reply SMS telling them what is making them crave the cigarette and how to stop it. Result: smoker is less likely to have the cigarette, helping them avoid cigarettes for the rest of the day. |
| mTRAINING | Mobile based support for health workers and teachers to include training on prevention and control. | Mobile phones and internet used to train health workers, social workers, care providers, parents, teachers and also patients (for self care) in lieu of structured training. |
| mSURVEILLANCE | 2-way SMS system for enforcing smoke-free zones. | An individual enters a smoke-free zone and receives a text informing them that the zone is smoke-free. They are also able to report people seen breaking this ban within the zone. |
| mSMOKEFREE | Using a mobile-based device to track smoke levels in bars/restaurants/public spaces and register them, so that asthmatics, families with young children, etc. can avoid areas with high smoke levels. | A device developed by CERN which attaches onto a Smartphone and measures the density of smoke particles in the air in a bar. |
| mILLICIT / mTRAC | Mobiles are used to register serial numbers for cancer and other NCD drugs (already used for HIV, TB, malaria), tracking deliveries and avoiding counterfeits. | Bar code is scanned or alphanumeric code is sent via SMS to a number which verifies the code's authenticity or looks at stock and supply. |
| mSCREENING | Online and mobile platform to screen entire populations for existing NCD conditions and to monitor their treatment. | Fully integrated technology into the primary health care system allows patients and doctors to track and manage their conditions and plug in relevant interventions including schedule appointments, consult online etc. |
| mSURVEILLANCE | Mobile house to house questionnaires/surveys to monitor NCD risk behaviours in individuals. | A surveyor keys in responses to survey questions and these are aggregated and analyzed in real time. |
The “mHealth for NCDs Tool-box” includes:
- Best Practices: such as “best apps for NCDs”, case study series, literature review, projects database, etc.
- Content: including database of validated content and Community Health Workers (CHWs) eLearning materials and professional development curricula for NCD prevention and treatment.
- Technology solutions and platforms: including available validated m-apps and service delivery platforms that are preferably Open, standardized, secured and modular that can be reused by countries for NCD prevention and treatment.
- Deployment Strategies and Business models: This can include the development of materials such as “mHealth Standard Operating Procedures (SOPs), marketing strategies and sustainable business models.
- Policies: that induce an enabling environment for scalable and sustainable mHealth services.
- Monitoring, Evaluation and Evidence: including evaluation methodologies and mHealth for NCD impact assessments.
