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Related Experiment Videos

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

Emily R Mangone1,2, Smisha Agarwal1,2, Kelly L'Engle1,3

  • 1FHI 360, Durham, North Carolina, United States of America.

Plos One
|January 30, 2016
PubMed
Summary

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Financial sustainability for mobile health (mHealth) programs is achievable through user pay-for-service models and reduced SMS costs. However, this may limit access for low-income populations, impacting program reach and effectiveness.

Area of Science:

  • Public Health
  • Health Informatics
  • Health Economics

Background:

  • Mobile health (mHealth) interventions show promise for improving health behaviors, especially in low-resource settings.
  • Many mHealth programs in developing countries struggle to achieve scalability due to financial sustainability challenges.
  • This study examines cost-recovery models for mHealth programs using data from Tanzania's Mobile for Reproductive Health (m4RH) service.

Purpose of the Study:

  • To explore strategies for achieving financial sustainability in mHealth programs.
  • To develop and evaluate cost-recovery models for mHealth program implementers.
  • To analyze the financial viability of the m4RH text-message (SMS) based health communication service in Tanzania.

Main Methods:

  • Delineated 2014 operational costs of the m4RH program.

Related Experiment Videos

  • Developed four cost-recovery scenarios based on user pay-for-service, SMS cost reduction, and strategic partnerships.
  • Conducted break-even and uncertainty analyses using 2014 user volume and potential break-even volumes.

    • Main Results:

    • Three of four scenarios showed deficits, but with significant cost reductions (54-83%) from the baseline $203,475.
    • Scenario four, with a negotiated $0.01 per SMS rate and full user cost transfer, achieved a $5,660 profit at 2014 user volume.
    • Uncertainty analysis indicated user volume, not cost variations, primarily determined break-even points.

    Conclusions:

    • Program break-even is most probable when users bear all SMS costs and low per-SMS rates are negotiated.
    • While financially sustainable for implementers, this model raises concerns about equitable access for impoverished populations.
    • Balancing sustainability, scale, and impact requires careful consideration of proposed strategies for mHealth funding and investment.