Free multimedia for the developing world
What developing countries need is a stable, sustainable, robust and low-cost means of delivering services and information.
Microsoft researchers have developed a route to deliver large chunks of multimedia content to mobile phones – at no cost to the user. The development is intended to make mobiles the channel for distributing information and supporting healthcare, education, training and social programmes in parts of the world where there is little other infrastructure on which to build these services.
Of course, mobile phones are transforming the delivery of services worldwide. In advanced economies, this involves persuading users to switch from another channel to using a mobile, on the grounds of greater convenience or immediacy. But in developing, low-income countries, mobiles provide an infrastructure where none existed before – no banks, no schools, no clinics and very often, no roads.
Estimates say that almost two-thirds of the four billion mobile phone users worldwide live in developing countries.
But as Richard Harper, head of the Socio-Digital Systems Group at Microsoft Research Cambridge, points out, there are many issues that need to be overcome before the full potential of mobile phones to promote development can be realised.
In developed economies, the lure of newer, faster, more sophisticated – and by implication more expensive – phones, might be the way to increase the attractions and utility of mobiles. What developing countries need, however, is a stable, sustainable, robust and low-cost means of delivering services and information.
A further complicating hurdle is that many of the poorest and most in need are illiterate. This means that applications that are light on bandwidth but heavy on text, such as short messaging services, are often inappropriate. “In fact, the situation is more nuanced,” says Harper. “Many potential users may not be able to read, but they are technology literate when it comes to using a mobile phone.”
Microsoft’s mHealth projects
The Medinet Healthcare Management System
In collaboration with the University of the West Indies, Microsoft is developing this system to give advice to diabetics and people with cardiovascular disease via the short messaging service (texts) and pre-recorded voice messages. The system is designed to relay information from patient monitoring devices to a central server over a cellular network. At the server, the data are analysed and alerts sent to healthcare staff to inform them of patients who have developed problems.
Design for living
The Socio-Digital Systems group at Microsoft Research Cambridge, United Kingdom, seeks to understand how technology can be designed so that it supports and enriches daily life. This draws on psychology, sociology, design, computer science and hardware engineering to explore how people relate to technology, to ensure the technology is appropriate, easy-to-use and enhances rather than atomises human experience.
To take a few examples: the Digital Postcard project looked at the way images and text could be delivered to displays in the home. Similarly, the Digital Shoebox looked at ways to put digitised memorabilia such as personal emails or photos stored in computer memory on display so they could be shared by family members.
Another device, Epigraph, is intended to let a family member have an immediate presence when they are away. The device, which is linked to the Internet and cellular phone network, has a space for each member of the family to send pictures and messages to its screen.
Not only can information be accessed by mobiles, but once downloaded it can be studied and shared at leisure. This is an advantage over broadcast media such as radio and television, which in any case – and despite being very mature technologies – do not have the reach of mobiles. However, the evidence from a number of projects is that while mobiles are a good way of receiving and storing data, the costs of downloading multimedia information is too high.
And Harper points to the need to have a software application resident in the handset as another factor that has to date held back the use of mobiles for information gathering in developing countries.
Flexibility is a further and critical requirement. Community members must be able to manipulate, input and update information, to ensure it is appropriate for the target community.
In summary, Harper says the aim of the project is to create a system that allows a community to create, share and access multimedia information at no cost.
The Microsoft team worked with Learn to Earn (www.learntoearn.org.za), a non-governmental organisation that runs a community training centre in Khayelitsha, a township 20 kilometres outside Cape Town, South Africa.
An interesting aspect of the project is that many factors driving the use of mobiles are the same in developing and developed countries. “People want to be able to do the same things with their phones, download music and find stuff they find interesting and share it,” says Harper.
This observation led the researchers to consider if a free-to-download “snap and grab” system, developed to induce cash-strapped teenagers in the UK to download marketing and advertising content to their mobiles, could be adapted to support community groups in developing countries.
“What we are trying to do is come up with an elegant solution to a complex thing,” says Harper. “In terms of technology there are many ways you could think of distributing information, but we wanted to come up with a system that could handle multimedia, could be used by people who are unable to read or write, and to make it free at the point of use.”
In snap and grab, the topics on which information is available are represented by a picture or icon on a notice board. In the system the Microsoft researchers tested in Khayelitsha, this notice board was a computer screen, but Harper says the display could be drawings pinned on a wall. To select a topic the user takes a snapshot using the camera on his or her cell phone and sends the photo via a free Bluetooth network to a personal computer.
The computer uses image recognition software to identify the image and then send the relevant information package, again via Bluetooth, back to the handset that took the picture. Similarly, community leaders putting new information on the system can upload it over Bluetooth.
“This is free to the user, does not require any client software to be installed on the phone and can transmit from one-to-many without individual phones needing to be registered on the system,” Harper says, adding, “The personal computer is low-end, and all it needs to transmit and receive is a Bluetooth dongle.”
Harper and his colleagues are now making moves to make the snap and grab system more widely available
Microsoft’s mHealth projects
Chinese Aged Diabetic Assistant
Microsoft is working with several universities and medical centres in China to develop a self-management and support system for elderly diabetics (www.cadaproject.com). Smart phones are used to send recommendations and guidelines on exercise, glucose and blood pressure monitoring, weight measurement and diet to patients. In turn, patients send data on glucose levels back to their doctors for monitoring and tracking.
1.South Africa: Collaborating for innovation
South Africa is a country at the early stages of its innovation journey, as Boni Mehlomakulu, Deputy Director-General at the Science and Technology Directorate, described at the Science|Business conference on the Innovation Economy, held in Brussels earlier this year.
“We have a young system and are looking at innovation in a two-part way. On one hand we are building our national capability; on the other we are positioning South Africa as a player in the global system of innovation,” said Mehlomakulu.
In basic research, South Africa has a tradition of collaborating with other countries, for example running a joint radio astronomy programme with Australia. “I think we can do the same in climate change and other areas,” said Mehlomakulu. “We can use these existing collaboration models.”
One tactic that would fit well in a global innovation system is the practice of setting up research chairs in South Africa, but also funding chairs elsewhere in the world. “We’ve decided to focus: on climate change, space science, biotechnology, biodiversity and human dynamics. Research elsewhere in the world contributes [to these fields] so we network our programmes globally,” Mehlomakulu explained.
It was also necessary to factor the nation’s brain drain into the policy. Here the strategy takes a very open approach – of working with the country’s diaspora and leveraging knowledge wherever it is located. “That is why we are building an innovation system that works at two levels; this addresses the issue of human capital,” said Mehlomakulu.
For the past 20 years the government has focused on building up the science base. But at the end of 2008 attention turned to innovation, with the passing of an Intellectual Property Rights Act and a Technology Innovation Agency Act. These aim to bridge the gap between universities and companies, as well as to promote technology transfer and commercialisation.
An innovation fund of 1 billion rands (€88 million) a year has been set up, which Mehlomakulu said is “small by other players’ standards, but is a start”.
The Innovation Act also calls for the formation of innovation hubs to connect researchers and make sure entrepreneurs can get access to the research base. The act also calls for the creation of incubators to provide accommodation and mentoring services for start-ups.
In addition, a National Intellectual Property Management Office has been established to help universities with technology transfer. This has a patent fund to subsidise university patenting activity.
The South African government is also seeking to ensure respect for intellectual property rights in indigenous knowledge systems and the country’s genetic resources. “They are often not seen as belonging to a country and needing to be protected. We are working to get them included in IP rights regimes,” said Mehlomakulu.
Nor is the innovation system being developed in isolation from South Africa’s basic research effort. In particular, the number of PhDs and graduates is being increased to strengthen R&D as a whole.
A key difficulty in designing the South African innovation system and building it from scratch was finding appropriate guidance and role models. Among the sources that were consulted were Canada’s policy from 1965, and policy from the US, Japan and some European countries was also referenced. “We then considered the South African context and came up with our model,” Mehlomakulu said. She added, “Finding best practice was hard work. There is no basic knowledge inventory.”
Whatever the difficulties, South Africa has made progress, according to an OECD review of the system carried out in 2007. “This found the country is on a path of trying to address the challenges,” concluded Mehlomakulu. Certainly, there is an open global outlook that maturer, more developed – but still internally focused – national innovation systems elsewhere lack.
2. How can the mobile phone improve healthcare?
In putting robust and easy-to-use technology into the hands of the poor and disadvantaged and bridging the digital divide, mobile phones have also opened up a route to close other gaps between rich and poor nations.
Almost two-thirds of the planet’s 4 billion mobile phone users are in developing countries. As well as basic telephony, this means services such as banking are becoming available for the first time. In health, the explosive growth of mobile communications has the potential to help fill the huge gaps in provision and bring healthcare to communities that at present have few basic medical services.
Microsoft Research is working with governments, academics and non-governmental organisations in a number of countries to understand how to deploy mobile technology in a sensitive and sustainable way.
The shorthand mHealth has developed for these applications, with health services delivered via mobile phone and wireless networks seen as a branch of electronic healthcare – eHealth, the application of all forms of computing and communications technology to healthcare.
The most comprehensive survey of the field to date, “mHealth for Development: the Opportunity of Mobile Telephony for Healthcare in the Developing World”, published in February this year, finds that mHealth is in the early stages of development, but gives some tantalising snapshots of how it is beginning to transform healthcare delivery.
Concrete examples include increased access to health information, providing the means to diagnose and track diseases, better public health information, an improved ability to update the education and training of health staff, and to provide them with information and reference material that can improve diagnoses.
The report profiles more than 50 mHealth projects in 23 countries, including several in which Microsoft is involved.
The catalogue of need that such projects seek to address is depressingly familiar and discouragingly long. In the 2008 update on progress to achieving the Millennium Development Goals, the United Nations highlighted the gulf in infant mortality: a child born in a developing country is more than 33 times as likely to die before reaching the age of five than a child born in the developed world. This statistic is all the more shocking given that the main causes of death, such as diarrhoea and measles, are preventable.
Meanwhile, in the adult population, other avoidable and treatable diseases such as malaria, HIV/AIDS and tuberculosis remain big killers. The UN Millennium Development Goals Report of 2008 said that even small advances in prosperity are fuelling a rise in the chronic diseases of affluence such as Type II diabetes and cardiovascular disease.
Many factors conspire in this terrible need, but according to the World Health Organisation in its World Health Report 2006 – Working Together for Health, a critical issue is the severe shortage of healthcare workers.
According to the mHealth report, education and training of healthcare workers is one of the most promising applications of mobile phones in healthcare.
Author: Nuala Moran