NB Health Care

Tuesday
August 23
2011

Usha Ganesh

Bangladesh’s Mobile Tech Surge, What It Means for Development

Editor’s Note: This story originally appeared in the August 2011 edition of Searchlight South Asia, a monthly newsletter created by Intellecap for The Rockefeller Foundation to report trends in urban poverty around the South Asia region. The project started in September 2009 as way to highlight on-the-ground urban issues and initiatives in Bangladesh, India and Pakistan. Through the research and content presented on education, water and sanitation, health, energy and infrastructure, the newsletter seeks to raise awareness and inspire ideas to action. NextBillion is proud to feature one article each month from Searchlight.

Tahmima Anam, a Bangladeshi writer in India to promote her latest book, said in a recent interview that Dhaka is a city bursting at the seams but with a surprisingly tangible energy of possibility. This energy – often driven by an overwhelming necessity to act quickly in a country of extreme poverty – has ignited innovation in many areas, development included.

Bangladesh’s unique approaches to poverty reduction and inclusive growth have been exhibited most recently by the different ways in which mobile telecommunication is being harnessed by the development sector. While mobile phones have increasingly become ubiquitous in developing countries, Bangladesh has taken the technology’s capabilities a step further. Many new initiatives have leveraged the sheer number of people using mobile phones (76.4 million in Bangladesh), as well as the capabilities of mobile phones to promote inclusivity and access around education, health, and banking, among others. Neighboring countries, it turns out, have lagged behind in the effort to leverage mobile phones for development purposes: India, for example, has a significantly higher number of mobile subscribers at over 700 million and tele-density of 67 percent and would seem to be a place where new technologies could be exploited in many different ways. This, however, is not the case.

An Environment for Innovation

Bangladesh has been able to leverage mobile technology for development for several reasons, largely situational and specific to the country’s context. Given that most of Bangladesh’s population lives on less than US$2 a day, any growth would have to be inclusive. India, on the other hand, has a burgeoning middle-class with many sub-strata driving the direction of growth, and inclusivity faces many obstacles in this environment. Bangladesh has to perforce include the BoP in its growth agenda. Bangladesh also attracts international donors and think tanks due to its extreme poverty and other development challenges. The inflow of development aid has certainly helped, but the influx of international ideation and thinking has really made a difference in launching projects that successfully combat the country’s myriad challenges.

Another reason why Bangladesh was able to leapfrog to mobile-based innovations is timing. Bangladesh was still struggling to get basic infrastructure in place while, simultaneously, the mobile revolution was developing roots and branches in the last decade. As the country was focused on tapping opportunities to pull itself out of poverty, it was able to build from the ground-up a net of optimal development interventions. In contrast, India has in place some of the requisite infrastructure, albeit often inefficient, such as access to English language classes and bank branches. The existence of these systems most likely deters India’s adoption and success of innovative mobile phone-based business models.

Mobile-based Services in Bangladesh

In Bangladesh, mobile phones have become an important element of pilot and live programs across multiple urban development sectors. Primarily, the technology aids in data collection and quick information dissemination resulting in significant savings in time and investment as well as shrewder decision-making and improved data accuracy. The result of these new uses have also helped development projects plan for scaling up. Some of these mobile-phone based services include mobile money (OboPay/Grameen’s Bank-a-Billion project), healthcare (Manoshi), education (Janala) and information or helpline services (Pallitathya Help-Line).

Mobile healthcare is one example of development innovatively using mobile technology. Bangladesh’s public sector has been struggling to cover its vast urban population for healthcare. NGOs and private sector providers are stepping in to bridge this gap. Projects like BRAC’s Manoshi gained considerable traction using community health workers to aid poor women in child birth and neonatal healthcare. Without extensive public sector infrastructure to back it – as is available in India’s healthcare system – Manoshi turned to technology to improve documentation of records and prioritize emergencies in preparation for scaling up. BRAC conducted a pilot study in three slums areas of the city where community health workers were provided with mobile phones that they used to record patient data. Dr. Rashed Haider Chowdhury, who leads implementation of BRAC’s M-Health initiative, says: “Community health workers, who previously carried heavy registers around, were enthusiastic about the mobile phone because they could now send data directly to a central MIS system. This not only reduced the time lag but also ensured that critical data was not lost in the delay.” It helped that health workers found the product easy to adopt due to the Bangla interface, the simple step-by-step process with multiple choice answers and voice record. Click Diagnostics, the software firm that created this module for BRAC, has included an automated risk assessment algorithm that prioritizes emergency cases.

Bangladesh has also found significant utility with mobile education services. The English language is considered extremely important in urban Bangladesh, India and Pakistan, even by those who are extremely poor. English-medium schools in Bangladesh are typically private and expensive. Public sector education, which is what a sizable proportion of the population can afford, is delivered in the native Bangla language. Research done by BBC World Service Trust indicated that 84 percent of Bangladeshis thought it important to learn English. Speaking English is considered essential for anyone seeking to gain better employment opportunities. In response to this finding, BBC planned Janala (meaning ’window’), a DFID-funded project, that is part of English in Action, an initiative that aims to raise the language skills of 27 million people by 2017. The service provides three-minute audio lessons via mobile phone at a cost of three pence per lesson. Janala has received more than 3.5 million calls since its launch in 2009. The lessons range from Essential English for beginners to Pronunciation for intermediaries and Vocabulary in the News for users who wish to improve their English.

Replicating Bangladesh’s Success

Globally, mobile phone adoption has also been rapid, even among those who traditionally are not early adopters for most products and services. Movirtu, a UK-based technology firm in partnership with a UN-backed initiative, plans to provide three million poor people in Africa and South Asia with access to low-cost mobile phone numbers. Understanding that not everyone can own mobile phones, this initiative enables the poor to own their personal phone numbers which they can access from any mobile. This initiative is in response to evidence that access to mobile communication improves lives and expands earning potential of people.

Efforts to replicate Bangladesh’s success in leveraging mobile technology for development have been sporadic and piecemeal in India and Pakistan. Often emerging out of strategies to widen the customer base – as opposed to a development perspective – these solutions often fail to address the BoP as a unique customer segment with special characteristics. Development solutions like Janala will find it difficult to gather followers in India because they will find several other sub-optimal solutions to “learn” English. India’s public sector has the infrastructure in place, but one that has often been accused of poor quality in service delivery – be it in healthcare, education or other areas. Bangladesh’s innovative efforts strongly suggest that mobile technology, taken up through a more overarching plan of action at the government level, akin to the UID project, can help India improve on this front and deliver on its agenda of inclusive growth.

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telemedicine