mHealth and the management of chronic conditions in rural areas: a note of caution from southern India

This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area cu...

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Bibliographic Details
Published in:Anthropology & medicine 2017-04, Vol.24 (1), p.1-16
Main Authors: Nahar, Papreen, Kannuri, Nanda Kishore, Mikkilineni, Sitamma, Murthy, G.V.S., Phillimore, Peter
Format: Article
Language:English
Subjects:
Activities of daily living
Adolescent
Adult
Caregivers
Cell Phone
Cellular telephones
Chronic Disease - therapy
Chronic illnesses
depression
Depressive Disorder - therapy
Diabetes
Diabetes Mellitus - therapy
Disease Management
Everyday life
Female
Fieldwork
Health Personnel
Health promotion
Health services
Health Services Accessibility
Humans
India
informal providers
Interviews as Topic
Male
Management
Medical conditions
Medical personnel
medical pluralism
Medical treatment
Medicine
mHealth
Middle Aged
Mobile phones
Older people
Original
Patients
RMP
Rural areas
Rural communities
Rural Health Services
Rural Population
Selfmanagement
South India
Telemedicine
Telemedicine - methods
Telephone communications
Type 2 diabetes mellitus
Uptake
Young Adult
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Summary:This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient 'self-management' may not be as readily translated to a country like India as proponents of mHealth might assume.
ISSN:1364-8470
1469-2910
DOI:10.1080/13648470.2016.1263824