mHealth - Short Messaging Service (SMS) Based Disease Surveillance Systems in Integrated Disease Surveillance Project in Andhra Pradesh, India

Public health surveillance is a crucial component of public health programs. The explosive growth of mobile communications over the past decade offers a new hope for overcoming the challenges of epidemics and a shortage in the health care workforce. These challenges are more pronounced in developing countries, which bear the greatest burden of disease and where new pathogens are more likely to emerge, old ones to reemerge, and drug-resistant strains to propagate. There is mounting interest in the field of mHealth - the provision of health-related services via mobile communications - which has the potential to extend benefits to the masses. In August 2008, an SMS based surveillance system was piloted in 6 of its 23 districts in the southern Indian state of Andhra Pradesh. Health workers in 3832 hospitals and health centers used mobile phones to send reports to the Government of India's Infectious Disease Surveillance Programme. Informal review of the system showed promising results like: 1) improved reporting from the hard to reach areas, 2) automatic acknowledgements of reports 3) automatic alerts to officials, 4) reduced burden on the health system in terms of man-days saved from paper based reporting and 5) a decrease in spending on stationery and postage of manual reports. As a result of the promising results from the pilot of the system, Andhra Pradesh implemented the SMS surveillance system to about 16,000 reporting units in all 23 districts in the state. This case study documents how in Andhra Pradesh, India, Short Message Service (SMS) technology is successfully being utilized to create a disease surveillance system which is adept for timely and adequate response to disease outbreaks in a cost effective way. This study will prove useful for scaling up such strategies towards developing countries with similar operational challenges and ready access to mobile phones.