mHealth is slow to take off and riddled with failures despite a continent such as Africa having over 500 million handsets and dire health problems, says an expert.

Africa is the fastest growing mobile market in the world and could have 738 million handsets by the end of 2012, according to a survey by mobile industry body GSMA.

The continent, though, also has big health problems with East and Southern Africa being the area most heavily affected by the HIV epidemic, according to UNAIDS. Out of the total number of people living with HIV worldwide in 2009, 34% resided in 10 countries of Southern Africa, says UNAIDS.

mHealth offerings, therefore, could help millions of Africans with handsets get access to services such as HIV education, antenatal care and even Malaria-prevention help through the means of text messages and voice calls.

But Vodafone’s mHealth business development manager for Africa, Peter Breitenbach, says the mHealth industry is struggling to take off, as “probably about 95% of all mHealth projects that start fail.” He made the comments at the tmforum Africa Summit being held in Johannesburg.

“I suppose it really speaks to me why the adoption of mobile health has actually been a lot slower than people expect,” says Breitenbach.

“It’s all well and good for me and my colleagues or competitors to stand up, which we do at various conferences, and tell you what a wonderful thing it is.

“But it’s been enormously slow in terms of its uptake,” he adds.

Breitenbach says reasons for the slow uptake include a lack of harmony between regulation and policy in emerging markets.

He explains that in Kenya, for example, telco Safaricom has introduced a call centre with doctors that are capable of taking subscribers calls and giving them health advice. But this is not possible in a country such as SA because the Health Professions Council of South Africa (HPCSA) does not allow this to happen.

Breitenbach blames a lack of funding for also holding back mHealth projects.

Dr. Sam Surka, a clinical manager at the division of telemedicine and mHealth at the Medical Research Council of South Africa, says he agrees with Breitenbach’s comments that mobile health has been slow to take off.

“I don’t disagree with Peter’s comment; I think he is right,” says Dr. Surka.

“From a research point of view, mHealth is a relatively new space, but given that it is a new space, there isn’t really that much hard evidence linking mHealth services and tools with actual clinical outcomes, or improved clinical outcomes. That kind of research is in progress,” he says.

Dr. Surka adds that while there are projects that appear to have a lot of potential regarding their ability to assist health systems, there is “a dearth of hard evidence linking it to good outcomes.”

Yet Dr. Surka notes that there are mHealth projects that have been running in a country such as SA for a number of years, helping thousands of people.

A report on ITWeb as far back as 2009 said that, upon its launch, at least half a million calls went through to the HIV/Aids call centre Project Masiluleke, of which the likes of MTN was involved in setting up. The pilot project has disseminated a HIV/Aids awareness campaign using the unused space in “please call me” messages.

Regarding Breitenbach’s claims that there are regulations preventing countries such as SA rolling out certain mHealth solutions, Dr. Surka also agrees that there is a lot of red tape in the country, even though government is keen on the health sector using technology.

But Dr. Surka adds that it is better to have regulations in place, so as to ensure that if and when tech is adopted, it is implemented correctly and pervasively.

“You don’t just want to unleash technology if it has any potential risks to the end-user, to patients or consumers,” says Dr. Surka.

“You want to have standards in places so that everyone is talking the same language, and whatever people are developing is interoperable with other systems - that’s kind of lessons from countries that have come out ahead of us.

“If you have six or seven vendors creating products, and no-one’s talking to each other, you have a very messy situation,” Dr. Surka adds.

One of the biggest obstacles in the way of getting mHealth solutions to those particularly in Africa is the high use of feature phones. Developers across the globe have made smartphone mHealth apps that require the internet-connect handset devices to work.

But even this could change over the years as more smartphones enter the African market. Samsung Electronics, for example, has said it plans to double its share of the sub-Saharan smartphone market to 20% by next year by boosting its imports of the devices into the continent.

This alone could improve prospects for the mHealth industry.

“The majority of our population still use basic and feature phones right now, and it’ll probably change in the next couple of years,” says Dr. Surka.

“Right now the biggest mHealth interventions that are having the most impact are some of your basic platforms, you know, like USSD and MXit, and SMS based services.”