Cameroon and Uganda Fieldsites

Each fieldsite had its own specific issues when it came to mHealth.

Yaoundé, Cameroon

Researcher Patrick Awondo found many ways in which smartphones are being used in the field of health and wellbeing by the middle class of Yaoundé, the capital of Cameroon. Adult children may have a responsibility to look after their elderly parents, which means constantly keeping in touch. There is also an increasing interest in activities that help people stay fit, ranging from organised sports to new genres, such as Zumba classes. Smartphones have become essential to the organising of such activities, each of which tends to have its own WhatsApp group. People who come together to form a walking or jogging community develop their own Facebook groups.

The photo below, taken in Yaoundé, shows a group of civil servants from the same office playing basketball every Saturday on the campus of the University of Yaoundé 1.

As elsewhere, people google for health information. But Patrick found that in Yaoundé, the key platform for health information was probably YouTube. People frequently search YouTube for videos about specific health issues such as malaria, HIV/AIDS, infertility and menopause. Increasingly, they also look for videos about complementary treatments. These range from traditional remedies using local plants to Chinese herbal medicine. An example is a 63-year-old former teacher who regularly follows a YouTube channel that specialises in herbal care for women.

Patrick found that there was a range of mHealth initiatives being promoted by the government or by NGOs based in Cameroon, and some of these apps have even been recognised internationally or have won awards. However, there was little sign that most people were aware of them. As part of his research, he examined several such initiatives and tried to find out why they had failed to be adopted more widely. For more on this topic, you can read one of his recent blog posts, which is linked below.

Kampala, Uganda

For Charlotte Hawkins, working in a neighbourhood in central Kampala, Uganda, it was soon clear that there was one mobile phone and smartphone function that dominated all others when it came to matters of health: mobile money. You watched a film about this in step 1.15. Being more easily accessible than banks, mobile money has become the main way to transfer cash. Whilst there is some state support available, some health requirements are paid for ‘out-of-pocket’, which means families are responsible for paying for certain medical bills. This means that mobile money is a form of health care. Mobile phones and smartphones enable people living in the city to have direct contact with their relatives living in rural areas and, often thanks to mobile money, to be active in supporting them when they fell ill. This showed that whilst smartphones are often associated with the neglect of older people, they are used extensively to help them deal with health issues.

Given the issue of ‘pilotitis’ and a proliferation of short-term and internationally funded mHealth pilots, Charlotte felt it was important to consider the sustainability of her contribution from the outset. This included focusing on people’s existing uses of mobile phones for health purposes, and working alongside established digital health practitioners who were interested to better understand and accommodate them. This resulted in a partnership with a leading digital health organisation in Uganda called the Medical Concierge Group, who have extensive experience working alongside the national health system. At the time, they were also interested in formative research about mental health perceptions, experiences and treatment preferences. This research has informed collaborative publications and grant-seeking efforts, with funding awarded for a ‘Community Tele-psychotherapy’ pilot project to launch later in 2021.