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This book presents a range of studies into formal and informal mHealth initiatives from across the Asia region. The need for this book is clear—current mobile phone penetration in many Asian regions stands at well over 100% and in some cases has increased by up to 150-fold in the last 10 years (ITU, ).

mHealth solutions represent an exciting new frontier in the fight against myriad health challenges faced in the developing world, where the use of mobile phones has become pervasive across various socioeconomic boundaries. The principal users of these solutions are frontline healthcare workers; mostly women, often working at the lowest rung of health hierarchy. The distinctive value of this workforce lies in its ability to successfully deliver health services whilst being sensitive to the culture and context of their communities. Since these women are the client communities, they can speak them in ways outsiders cannot. Using a contextualized case study of lady health workers (LHWs) working in rural areas of Pakistan, this chapter demonstrates how the potential represented by such frontline health workers can be maximized. To this end, it draws upon in-depth longitudinal qualitative accounts of eight LHWs involved in a 2-year pilot mHealth project to improve antenatal health care. This chapter uncovers how sociocultural barriers—such as prohibitive financial concerns and gender-based discrimination—inhibit acceptance of mHealth solutions in Pakistan. The study found that these barriers adversely impact both LHWs’ initial adoption of mobile devices as well their inclination to continue using mHealth solutions. This chapter explores how macro- and micro-level communication strategies can be used to ease these barriers. It also explores how LHWs themselves can use mobile technology to better connect with their client communities. If mHealth is to be the brave new frontier in the domain of health innovations, we need to do more to understand the finer points of its contextually sensitive applications. This chapter seeks to explore how this can become a reality for rural areas of Pakistan.

mHealth offers a unique opportunity to improve access, quality, and adherence of care in last mile and low-resource settings around the world. However, the path to scale for mHealth interventions can be complex and challenging due to the barriers presented by fragmented infrastructure, policy gaps, and more. This chapter proposes a framework of nine key components that are essential for the successful scale-up of mHealth including mature infrastructure, a conducive policy environment, strong institutional partnerships, well-designed and context-appropriate technology, a skilled health workforce, financial sustainability, interoperability, and an evidence-based approach to mHealth. While not exhaustive, this framework offers implementers and policymakers a potential path to scale up mHealth interventions in order to strengthen health systems and improve health outcomes—particularly in remote communities around the world.

Previous studies have found mHealth-based smartphone applications are promising tools to help improve diabetes management and self-care. However, rural populations are often not smartphone-equipped and therefore cannot access diabetes management apps. Guided by a culture-centered approach, this chapter describes an ethnographic study of health behaviors among women in two Javanese villages. In-depth interviews were conducted with 30 female participants in Central Java, Indonesia. Grounded theory was adopted for data analysis. This study sought to unearth the existing modes of communication and it was found that—in conversation with (a male health practitioner)—the participants developed alternative modes of mHealth communication based on SMS. The sending and receiving of diabetes-related SMS became embedded in the women’s daily lives and enabled them to navigate their health routines as people living with diabetes.

The aim of this qualitative study was to test how social and cultural research methods can be used to anticipate opportunities and barriers to the use of consumer mobile devices by community health workers (CHWs) for HIV/AIDS prevention, testing and treatment. An exploratory study was conducted with CHWs (n = 19) at the regional capitals of Denpasar and Makassar in Indonesia in order to build to a clearer picture of how the participants have integrated personal mobile handsets into their daily professional and personal routine. A communicative ecologies framework was applied to the research design which included a range of qualitative methods including in-depth interviews, focus group discussions and communicative ecology mapping. Our main findings revealed that there was no bottom-up impetus for the introduction of a formal mHealth system to support client interactions. Existing client data collection systems were locked into paper-based systems to ensure compatibility with local government and/or funding body administrative systems; hence, mobile device-based data collection would require additional processes by the participants. Boundary issues were reported with regard to out of hours contact by clients. Some CHWs sent SMS medication reminders to clients but the strong preference indicated by all participating CHWs was to meet clients face-to-face in order to build and maintain trust through the in-person counselling process, rather than introduce mobile-mediated interaction.

In this chapter, we examine the interplays of the symbolic and the material in the constructions of mHealth. By attending to the key themes that play out in discourses of mHealth, we examine critically the ways in which power plays out in the structuring of mHealth solutions. The articulation of mHealth as instrumental to generating positive health outcomes in communities across Asia erases the contexts within which mobile technologies are constituted. mHealth interventions reproduce the logics of the state and the market, reproducing communities as homogeneous and monolithic sites of top-down interventions.

A phenomenological study was conducted to explore how Chinese consumers perceive fitness mobile apps in their everyday lives. Twenty in-depth interviews were used to collect data. Findings suggested that the meanings of mobile fitness apps are multidimensional, dialectical, and multilayered. On the positive side, mobile fitness apps embody control, empowerment, and networked individualism which assist Chinese consumers in achieving their fitness goals, maintaining healthy lifestyles, and enhancing the quality of their lives. On the negative side, mobile fitness apps have a constraining effect, geographically and temporally speaking. Some participants even linked fitness app use to their feelings of loneliness. Practical implications were offered to mobile fitness app companies and health organizations.

The aim of this qualitative study was to test how social and cultural research methods can be used to anticipate opportunities and barriers to the use of consumer mobile devices by community health workers (CHWs) for HIV/AIDS prevention, testing and treatment. An exploratory study was conducted with CHWs (n = 19) at the regional capitals of Denpasar and Makassar in Indonesia in order to build to a clearer picture of how the participants have integrated personal mobile handsets into their daily professional and personal routine. A communicative ecologies framework was applied to the research design which included a range of qualitative methods including in-depth interviews, focus group discussions and communicative ecology mapping. Our main findings revealed that there was no bottom-up impetus for the introduction of a formal mHealth system to support client interactions. Existing client data collection systems were locked into paper-based systems to ensure compatibility with local government and/or funding body administrative systems; hence, mobile device-based data collection would require additional processes by the participants. Boundary issues were reported with regard to out of hours contact by clients. Some CHWs sent SMS medication reminders to clients but the strong preference indicated by all participating CHWs was to meet clients face-to-face in order to build and maintain trust through the in-person counselling process, rather than introduce mobile-mediated interaction.