24 December 2015

For many countries a "Christmas mobile phone fast" would lead to hunger and malnutrition

The Archbishop of York, Dr John Sentamu, recently called for a UK “mobile phone fast” on Christmas Day so that families could reconnect and bond.  My kids are glued to their phones much of the time and I have been known to sneak a few looks at my email on the 25th, so I can definitely relate.  But many people around the world do not have the luxury of laying down their phones, because their mobiles are essential to their livelihoods and to their health.  

Consider the following: fishing communities rely on weather data from mobile phones to help them work out the best times to take their boats out; farmer clubs using text messaging to help farmers to share information about growing conditions; market traders who use apps to tell them which locations are offering the best prices for different commodities; medical staff who use cameras on mobile phones to remote diagnose and prescribe treatment; HIV positive individuals who are reminded to adhere to their antiretroviral regimes; and communities that can the world know if government services fail to reach them.  These mechanisms, if effective, are probably helpful to accelerating development and the reduction of hunger and malnutrition. 

But, with a few exceptions, there are far too few mobile services designed to focus exclusively on just that: the reduction of malnutrition. 

Why should such services exist?  Malnutrition in all its forms—children who can't realise their rights and develop to their full potential, women with not enough iron in their blood carry their children, adults who are at risk of diabetes, hypertension, strokes and heart disease due to obesity—affects 1 in 3 people world-wide.  The consequences of malnutrition are devastating.  45% of all under 3 mortality is related to malnutrition and the economic losses are enormous—trapping people, families and communities in poverty and acting as a drag on sustainable development.  

And the returns to the scaling up of high impact interventions are astonishing.  The Global Nutrition Report has shown that the median benefit-cost ratio of expanding programme coverage is 16 to 1.  In other words for every dollar, birr, rupee or peso invested in scaling up high impact nutrition interventions, 16 will flow back to individuals, communities and nations from improved schooling and labour force outcomes.

Despite these impressive returns, the scaling up of programmes is challenging.  Lack of finance and human capacity are familiar barriers.  Frontline health workers have heavy case loads and are burdened with paperwork.  Finance to develop messaging around preferred nutrition practices and to provide appropriate technology to record, aggregate and analyse nutrition measurements quickly and efficiently is hard to find from public sources. 

Can mobile operators help?  Mobile networks are re run for profit.  But they do offer a broad potential platform for the delivery of government approved nutrition messaging.   Can they be geared to reminding pregnant women about receiving antenatal care, to change the attitudes of mothers of newborns about the need to breastfeed within an hour of birth, and exclusively for 6 months thereafter? Can they be designed to help mothers wean their children onto the right semi-solid foods at 6 months of age? Can they help children understand what a balanced diet looks like?  Can they persuade and help adults to consume diets that are lower in sugar, salt and saturated fats?  We simply don’t know.
The nutrition community has been slow to experiment with (and then evaluate) mobile technology. Similarly mobile operators have been slow to recognize the potential for attracting customers to their services through offering nutrition information, free or even at a price.  Let’s be clear: mobiles are not a panacea. There are important and significant challenges to their effective use for nutrition. For example, will mothers be able to read the information sent?  Will they trust nutrition information via mobile services and will the quality be sufficiently good?  Will the information be acted on? And will mobile operators be able to find a sustainable business model? 

But the potential is great: mobiles offer a way to personalize information, to allow customers to engage with information services rather than simply be passive receivers of messages, to scale geographically and to generate knowledge spillovers for those who do not have direct access to phones.

As the 2015 Global Nutrition Report suggests, the mobile network industry offers the potential to scale up nutrition interventions that are reliant on behavior change.  These two communities – public nutrition professionals and private mobile operators-- need to begin innovating, piloting and evaluating their joint efforts to accelerate the reduction of malnutrition. 

Can we really “Dial N for Nutrition”?  Let’s at least try, and turn the conversation to the avoidance of enforced fasting of food, care and health services rather than the promotion of voluntary phone fasting.

No comments: