Despite the aggressive onward march of smartphone penetration in the developed world, the vast majority of people on earth are still not connected to the web at all, let alone through a sophisticated handheld device. That situation is unlikely to change any time soon.
Bridging the gap is good old-fashioned cellular technology, which is becoming more widely available in some of the more impoverished reaches of the globe. In Chikwawa, Malawi, a text message-based nutritional monitoring program was introduced in September 2012. In the intervening months, it has forwarded crucial data on children’s health to a central hospital in Malawi’s capital, Lilongwe – and undoubtedly saved lives in the process.
Once a week, the mothers of Chikwawa – some 250 of them – bring their under-fives for a check up. A health worker logs their weigh, height, arm circumference and age, before sending the information by a text beginning with GM (for growth monitoring). Within minutes, the health worker receives a reply from the capital, determining whether or not the child is malnourished and needs further medical attention.
Growth Monitoring does not, in itself, identify the root causes of malnutrition, but it does expedite treatment for the most at-risk children, allowing district hospitals to get supplements to the needy. Supplements like PlumpyNut, which was developed to treat severe acute malnutrition at home. This in turn lightens the intense burden placed on the health system by eliminating the need for hospital stays. In a country with one doctor for every 44,000, measures like this are genuinely life-saving.
According to UNICEF, two in 25 children die in Malawi before reaching their fifth birthday, with at least a third of these fatalities attributed to malnutrition. Across the country, 17% of children under five are underweight, and 47% are stunted. The effects of stunted growth cannot be underestimated; where physical growth is stunted, so too is economic growth, and the effects of stunting can be passed onto the next generation, potentially hindering the country’s development for decades to come.
Before the SMS program was introduced, paper notebooks were mailed to the capital. The process could take up to a year, by which time the most at-risk children would have seriously declined – or worse. Furthermore, a study found that more than 14% of handwritten data was illegible – not an issue when it comes to texting.
Similar SMS-based initiatives have been used to great effect in other parts of the world. Some track diseases, other hold corrupt governments to account. UNICEF and other organizations are overcoming previously insurmountable problems across the developed world – and it’s all being achieved via the power of text.