Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa

Mark J. Siedner, Alexander Lankowski, Derrick Musinga, Jonathon Jackson, Conrad Muzoora, Peter W. Hunt, Jeffrey N. Martin, David Bangsberg, Jessica E. Haberer

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Mobile health (mHealth) technologies hold incredible promise to improve healthcare delivery in resource-limited settings. Network reliability across large catchment areas can be a major challenge. We performed an analysis of network failure frequency as part of a study of real-time adherence monitoring in rural Uganda. We hypothesized that the addition of short messaging service (SMS+GPRS) to the standard cellular network modality (GPRS) would reduce network disruptions and improve transmission of data. Methods: Participants were enrolled in a study of real-time adherence monitoring in southwest Uganda. In June 2011, we began using Wisepill devices that transmit data each time the pill bottle is opened. We defined network failures as medication interruptions of >48 hours duration that were transmitted when network connectivity was re-established. During the course of the study, we upgraded devices from GPRS to GPRS+SMS compatibility. We compared network failure rates between GPRS and GPRS+SMS periods and created geospatial maps to graphically demonstrate patterns of connectivity. Results: One hundred fifty-seven participants met inclusion criteria of seven days of SMS and seven days of SMS+GPRS observation time. Seventy-three percent were female, median age was 40 years (IQR 33-46), 39% reported >1-hour travel time to clinic and 17% had home electricity. One hundred one had GPS coordinates recorded and were included in the geospatial maps. The median number of network failures per person-month for the GPRS and GPRS+SMS modalities were 1.5 (IQR 1.0-2.2) and 0.3 (IQR 0-0.9) respectively, (mean difference 1.2, 95%CI 1.0-1.3, p-value<0.0001). Improvements in network connectivity were notable throughout the region. Study costs increased by approximately $1USD per person-month. Conclusions: Addition of SMS to standard GPRS cellular network connectivity can significantly reduce network connection failures for mobile health applications in remote areas. Projects depending on mobile health data in resource-limited settings should consider this upgrade to optimize mHealth applications.

Original languageEnglish (US)
Article numbere45643
JournalPLoS One
Volume7
Issue number9
DOIs
StatePublished - Sep 28 2012
Externally publishedYes

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Biomedical Technology
Telemedicine
Africa South of the Sahara
Sub-Saharan Africa
Uganda
Mobile Applications
monitoring
electricity
bottles
travel
health services
drug therapy
duration
Monitoring
Bottles
Travel time
Equipment and Supplies
Electricity
Catchments
Global positioning system

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Siedner, M. J., Lankowski, A., Musinga, D., Jackson, J., Muzoora, C., Hunt, P. W., ... Haberer, J. E. (2012). Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa. PLoS One, 7(9), [e45643]. https://doi.org/10.1371/journal.pone.0045643

Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa. / Siedner, Mark J.; Lankowski, Alexander; Musinga, Derrick; Jackson, Jonathon; Muzoora, Conrad; Hunt, Peter W.; Martin, Jeffrey N.; Bangsberg, David; Haberer, Jessica E.

In: PLoS One, Vol. 7, No. 9, e45643, 28.09.2012.

Research output: Contribution to journalArticle

Siedner, MJ, Lankowski, A, Musinga, D, Jackson, J, Muzoora, C, Hunt, PW, Martin, JN, Bangsberg, D & Haberer, JE 2012, 'Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa', PLoS One, vol. 7, no. 9, e45643. https://doi.org/10.1371/journal.pone.0045643
Siedner MJ, Lankowski A, Musinga D, Jackson J, Muzoora C, Hunt PW et al. Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa. PLoS One. 2012 Sep 28;7(9). e45643. https://doi.org/10.1371/journal.pone.0045643
Siedner, Mark J. ; Lankowski, Alexander ; Musinga, Derrick ; Jackson, Jonathon ; Muzoora, Conrad ; Hunt, Peter W. ; Martin, Jeffrey N. ; Bangsberg, David ; Haberer, Jessica E. / Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa. In: PLoS One. 2012 ; Vol. 7, No. 9.
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