Mobile phones can worsen healthcare inequalities

The fast spread of mobile phones across low-income countries like India can make it harder for poorer people without phones to access essential health services, new research has suggested.

The study by Dr. Marco J Haenssgen at the CABDyN Complexity Centre and the Centre for Tropical Medicine and Global Health at Oxford analysed publicly available data from more than 12,000 households in rural India with sick family members in 2005 and 2012.

The study suggests that healthcare services expect more people to use a mobile phone, and that mobile phone users are more assertive when they compete for access to the few doctors and nurses in rural India. In areas where mobile phones become more common, people left behind have more difficulty accessing healthcare services.

"Because of their fast spread globally, mobile phones are often seen as a blessing for development, especially in low- and middle-income countries," said Dr. Haenssgen. "This perception is particularly true when it comes to healthcare provision for the rural poor.

"According to the GSMA—the trade body that represents the interests of mobile network operators worldwide—mobile technology can increase the quality, reduce the cost and extend the reach of healthcare to benefit millions."

The GSMA operates among others a platform to record new mobile health projects, which currently registers 1,081 such projects.

Dr. Haenssgen concludes: "This study uses only crude measures of healthcare access and mobile phone use, so this certainly is not the end of the story. But the findings add to a consistent picture of mobile phone use and healthcare access that has emerged over the past five years of research. While there is no reason to demonise mobile phones, we see again and again that their spread comes with problems as well as opportunities. We should therefore not conclude that now everyone really needs a mobile just to maintain their basic access to services – that would be tyranny."

This study concludes five years of research on mobile technologies and healthcare access in rural India and China, which Dr. Haenssgen carried out during and after his DPhil in International Development at the Oxford Department of International Development. Earlier research on a smaller scale into health-related mobile phone use in low- and middle-income countries (India and China) has shown that phone users are more likely to overuse scarce healthcare services, potentially to the detriment of non-users. The present study tested this hypothesis over the long term.

The full paper, "The struggle for digital inclusion: phones, healthcare, and marginalisation in rural India," can be read in the journal World Development.