In the following guest post, Lily Walkover and Robin Young describe how Hesperian Health Guides is adapting its trusted sources of health information into open source mobile applications for community health workers.

In developing countries around the world, as many as 50% of people are now using cell phones¹. Access to cell phones is certainly greater than access to reliable health care and health information! Yet in the emerging field of mHealth—the use of mobile phones to support health—the focus has veered significantly toward data collection.  At Hesperian Health Guides (publisher of Where There Is No Doctor), we’ve been part of a conversation to expand that focus and include using mobile phones to deliver health information to community health workers and the people they support. 

Health educators all over the world have told us how they have adapted our print resources to their needs. At times this has meant literally cutting up images and text with scissors in order to prepare presentations, handouts, and other materials to provide accessible health information to their communities. This hunger for resources combined with enormous user creativity has motivated us to design mobile apps that not only make health information more accessible, but also facilitate adaptation, feedback, translation, and conversion into new formats for lower-end mobile technologies.

The idea for a mobile app emerged in response to a growing need for content that is lightweight for travel, can be updated easily, and takes advantage of technologies that are increasingly used by community health workers and health educators. But how can a book like Where Women have No Doctor, a trusted source of proven health information for health workers globally for 15 years, be transformed successfully into a mobile format? The first challenge is to break the content into pieces small enough to fit on a phone screen, but large enough to provide sufficient information for an individual to be able to make an empowering health decision, not just follow instructions.  During the development process, we tested our ideas with over 40 reviewers, from experts to lay practitioners. Their feedback told us that an encouraging tone, step-by-step instructions, and a healthy ratio of images to text were all key elements in communicating complex information effectively. 

Our pilot mobile app, Safe Pregnancy and Birth, provides clear, low-literacy information on staying healthy during pregnancy, as well as danger signs during and after delivery.  This information is supported by an extensive how-to section that provides step-by-step instruction for everything from taking blood pressure to treating kidney infections.  Released for iPhone in January 2012, and for Android four months later, the app has been downloaded over 10,000 times in 126 countries and is free and open-source (find the source code here). 

We invite you to use and adapt the Safe Pregnancy and Birth app to meet the needs of the communities and health workers you support – by translating it, adapting it for other platforms and devices, or by field-testing it to find out which parts are most useful in different settings and where further development is needed.  Please contact us at mobile@hesperian.org if you are interested in working together. 

At Hesperian, we hope this mobile app, and the other new tools in the Hesperian Digital Commons, meets the technology needs of health workers by providing access to empowering, accurate, low-literacy, and multi-lingual health information. Providing health workers with appropriate resources is a crucial step towards reaching maternal and child health goals internationally, and the mobile app is one tool that we believe promotes knowledge for health action in global communities.

1. Cell phone use surging in developing countries