Template Development for a Potential Web-Based App Targeted to Low Income Populations

As of 2008, 1.3 billion people worldwide did not have access to healthcare. Low and middle income countries (LMICs) bear 93% of the world's disease burden; at least 5.8 million annual childhood deaths could be prevented in LMICs if affected communities had accurate health information to manage the most prevalent and pervasive infectious diseases. In Ethiopia, only 27% of caregivers sought medical attention for children with severe upper respiratory infections; only one in five mothers recognized rapid breathing as a sign of respiratory distress in their children. Mothers exposed to educational strategies in LMICs were twice as likely to seek help for their sick children as mothers who were not. Unfortunately, we will never have adequate health care or education for all who need it if we rely on subsidized resources and direct human intervention. A health education app could potentially reach individuals and communities other resources may not. This project consists of template development for potential integration into a smartphone or internet application (app) targeted to students, health extension workers and community volunteers in LMICs. The aim of the app is to provide accessible and understandable health information directly to families in an effort to improve morbidity and mortality in children. The project layout consists of five main objectives. First, the development of an initial user profile template with questions assessing basic demographics, general health, well-being and access to care. Second, the development of simple algorithms leading to evidenced based or culturally recognized interventions to manage diarrhea, dehydration, fever and upper respiratory symptoms. Third, templates for prospective in-app pop-up survey questions assessing overall health and well-being and potential feedback on use of the app. Fourth, outlines and resources for six newsletter topics designed for monthly dissemination through the app. Fifth, dissemination at Yale's Unite for Sight Global Health and Innovation Conference in an effort to seek counsel or advise from other humanitarian experts and to potentially raise funds or other donated resources that might contribute to the future development of the app. The initial focus of this project is catered specifically around resources available in the Oromia region of Ethiopia as a pilot area. The review of literature demonstrates an ever growing acceptance and integration of internet and smartphone use, which is climbing steadily in LMICs, including an increase in mobile app use by health extension workers as an assessment tool in LMICs. Broadband access is doubling each year in Africa. As of 2015, there were 1.36 billion social media users worldwide; if these populations have access to social media, they have access to health education. A development team consisting of Ethiopian resource experts, a seasoned entrepreneur and humanitarian expert, and tech support evaluated and approved the designed templates for potential development into an app. Health literacy and cultural considerations were evaluated and approved by the Ethiopian experts and will eventually be approved by a legal team before potential integration.This project is a long term endeavor, with many future implications. A tentative grant of $500,000 for development or implementation has been discussed. Approval is dependent on several factors including political climate and governmental support (or opposition) in the area of implementation. If initial acceptance and use is evaluated to be successful in Ethiopia, it is anticipated that efforts will be made to expand the marketing and usability of the app to other low and middle income countries. Marketing is anticipated to be integrated heavily through social media apps as social media appears to successfully transcend cultures and borders.