Last week, I posted about how mobile money programs in emerging markets in Africa have run against complex social realities involving the way people in some cultures actually think about money.
In Uganda, another mobile program designed to address a specific need is falling victim to the law of unintended consequences – namely, a service designed to spread awareness about sexually transmitted diseases that has inadvertently sparked a rise in infidelity.
A few years ago, Google and the Grameen Foundation started a service with MTN in which people could send questions on sexual health topics by SMS and receive template-based answers via Google’s search technology. According to an upcoming study (funded by Google) from non-profit organization Innovations for Poverty Action, infidelity among participants grew from 12% to 27%, reports Bloomberg:
With the program in Uganda, which began in 2009, infidelity may have risen as women became more aware of the risks of cheating and insisted on going for testing with their husbands, said study author Dean Karlan, an economics professor at Yale University in New Haven, Conn. Some men resisted, leading women to deny them sex, which the men then sought from other women, Karlan said.
The report also notes that usage of the STD service “dropped by more than half the peak level after a three-month period of heavy advertising”, which appears top be partly the result of users being “turned off by the algorithm-based program that didn’t always supply appropriate answers to their questions, especially in the local Luganda language,” according to Karlan.
On the bright side, other mobile-based health info services have yielded more encouraging results. Another program in Uganda featuring an SMS quiz on HIV and AIDS and reminders of free screening resulted in a doubling in test uptake, the report says.
As with mobile money, the message is that project and application design make the difference between success and failure. John Tippett, director of mobile health innovation at Grameen Foundation, tells Bloomberg that mobile health programs work best where the objectives of the users match those of the project organizers:
In the Uganda project, "the men didn't have the goal to have safer sex, even though the women did," he said.
Better suited to mobile technology are projects to improve maternal health, where pregnant women want to deliver a healthy baby, or with sick patients who want to be reminded to take their medication, according to Tippett.