From Policy to Implementation World Bank Washington, D.C. Rodrigo Saucedo-Martínez Principal Investigator Wireless Communication for Health

Non-for-profit organization created by the Carlos Slim Foundation in Mexico to contribute in the generation of sustained health initiatives that have a profound impact.

Empowering individuals Health Professionals Health services Individual online micro-database (confidential and anonymous) Mobile phone Fixed phone Internet Interactive Voice Response (IVR) Lab tests Medical appointments Notification and follow-up Wireless Communication for Health

Our solutions Wireless Communication for Health Changes in lifestyle Diabetes HIV/AIDS

Wireless Communication for Health Cardiovascular risk assessment Classification of results by risk level Educational messages:  General well-being and exercising  Nutritional plan  Hypertension  Prevention and caring of diabetes  Tips to quit smoking Reassessment of cardiovascular risk Assessment of cardiovascular risk of non-diabetics

Educational messages Personal profile and family history Reminders on  Medications  Appointments  Lab tests Registry and online monitoring of personal health indicators Daily and monthly adherence survey Wireless Communication for Health Low Risk Medium Risk High Risk

Wireless Communication for Health Educational messages Family history Reminders  Medications  Appointments  Lab tests Registry and online monitoring of personal health indicators Monthly adherence survey Networking among family members and friends

SWOT Analysis Wireless Communication for Health Strengths Use of a standardized methodology Flexibility Weaknesses How to scale? Scarce technological knowledge Opportunities Governments are open to initiatives ICT’s are incorporated in people’s daily lives Threats Governments are risk averse Technology = expensive interventions

From planning to scale-up Use of a standardized methodology 1. Strategic planning 2. Operation 3. Progressive scale-up Problem identification Design of the intervention Q&A Social marketing Focus groups Fine tuning Partner selection Training Evaluation Adjustments

SWOT Analysis Wireless Communication for Health Strengths Use of a standardized methodology Flexibility Weaknesses How to scale? Scarce technological knowledge Opportunities Governments are open to initiatives ICT’s incorporated in people’s daily lives Threats Governments are risk averse Technology = expensive interventions

Finding the right partner Flexibility Public Private Third sector

SWOT Analysis Wireless Communication for Health Strengths Use of a standardized methodology Flexibility Weaknesses How to scale? Scarce technological knowledge Opportunities Governments are open to initiatives ICT’s are incorporated in people’s daily lives Threats Governments are risk averse Technology = expensive interventions

Risk averse: Technology = luxury They need results in the short term The need for evidence: mHealth vs a traditional intervention Governments’ approach to mHealth

Causes of obesity The impact of lifestyle Food production Food consumption Physiologic factors Psico-social factors Individual psychology Environment Physical activity Source: Tackling Obesities: Future Choices. Project Report. Government Office for Science. UK: 2003.

Prevalence of chronic diseases in people 60+ Chronic diseases in Mexico HypertensionHigh cholesterolDiabetes (3.4 million) – – – – 24.9 (1.4 million) – – – – 9.9 (1.8 million) – – – – 12.9 Source: Mexican National Survey of Health and Nutrition 2006.

SWOT Analysis Wireless Communication for Health Strengths Use of a standardized methodology Flexibility Weaknesses How to scale? Scarce technological knowledge Opportunities Governments are open to initiatives ICT’s are incorporated in people’s daily lives Threats Governments are risk averse Technology = expensive interventions

Mobile phone users and fixed lines in Mexico Technology is incorporated in people’s daily lives * Data estimated considering the economically active population Source: Mexican Federal Commission on Telecommunications mobile phones per inhabitant *

Internet users in Mexico Technology is incorporated in people’s daily lives million Source: Mexican Federal Commission on Telecommunications

Foresee the future: Training Social Marketing Integration into national health systems Public-Private-Third sector partnerships: Interdisciplinary teams Integration of ideologies and positions Co-funding and co-development Conclusions

The need for evidence: Peer-reviewed articles Standardized framework Benchmarking Networking Best practices The future of Mobile Health: Coverage increase Incorporation of new technologies The role of the third sector Conclusions

Adding efforts to multiply solutions