Evaluating scope of mobile technology for bridging health care gaps in impoverished population in LMICs

BACKGROUND: mHealth has potential to improve health care delivery but little is known about its effectiveness on health amongst marginalized communities. This study was carried out to determine the scope and usefulness of mHealth implementation in underprivileged slum population. MATERIAL AND METHODS: A cross-sectional study was carried out in an urban slum of Northern India where the government primary health care facility was digitized and mHealth component was integrated into the system to improve the health care service delivery. The survey was conducted using a pre-tested questionnaire among 921 persons who were sent SMSs within the last 2 months prior to survey to assess the reach and acceptability of mHealth in the underprivileged slum populations, and the role it can play to improve the healthcare services provided through primary health care facility. RESULTS: In the surveyed population majority (59.8%) were young (18–30 years), females (79.3%), Hindu (94%) belonged to Scheduled caste (77.8%) and a significant percentage of them were illiterates (30%). Mobile phones were available with 87% of the surveyed population and more than 50% had smartphones. Though, only 59.5% of individuals confirmed the receipt of SMS, a very high proportion of survey population (98.3%) were willing to receive health-related SMS. About 72% individuals received SMSs and remembered the content of the message. Adherence to health advise sent through SMS was significantly higher among females (OR = 2.4 (95% CI: 1.2,5.1), P = 0.01), those who read messages themselves (OR = 1.9 (95% CI: 1.0, 3.3), P = 0.03), and who received SMS more than once in a month (OR = 2.2 (95% CI: 1.2, 4.2), P = 0.01). Majority of those who received SMS (83%) expressed that the health-related SMS were beneficial to them. CONCLUSION: mHealth has high potential to improve reach and increase accessibility of health care services for marginalized communities.