mHealth for Maternal Health: Who Pays?

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By: Bobby Jefferson, Director, Center for Development Informatics, Futures Group International; Gretchen Domek, Global Health Fellow, Colorado School of Public Health; Marc Mitchell, Founder and President of D-TREE International and lecturer on global health at the Harvard School of Public Health

mHealth for Maternal Health is an ongoing blog series that aims to share the knowledge and experiences of academics, implementers and funders from the mHealth and maternal health communities. As part of the series, we reached out to experts to gain insight on pressing questions around financing, partnerships, challenges and innovations in mHealth for Maternal Health.

One of the key factors that determine the long-term success of mHealth interventions is financial sustainability. Without adequate means to sustain operational costs, an mHealth application, no matter how innovative or impactful, will fail to survive at scale. In general, most organizations rely on one of two models for financing mHealth – government and donor funding, or user-generated revenue.

In designing mHealth applications for maternal health, the former has been the more widely used model, largely due to the challenges associated with generating user fees while working with low-income populations, which tends to be the user base for maternal health applications. To gain additional insight, we asked experts their opinions on how mHealth for maternal health is currently being financed and what changes they foresee for financing models of the future.

According to Gretchen Domek, a Global Health Fellow at Colorado School of Public Health involved in an mHealth project in Guatemala, “Partnerships between universities in high-income countries and private foundations in low- or middle-income countries (such as, in our case, the social responsibility program of a local business) can be important funding models.”

Domek is using mHealth as the data collection and participant tracking mechanism for a prenatal and early childhood community outreach program. She adds that the mHealth component has “contributed additional funding and facilitated the overall sustainability of the larger project. Funding sources such as the NIH and Gates Foundation are increasingly interested in innovative mHealth initiatives.”

While the use of mHealth has enabled programs to garner more interest and funding from donors, as we explored in our previous post on Pilotitis in mHealth, donors have been criticized for their vertical approach of supporting innovative pilots rather than implementing a sustainable financing model that views mHealth as an integral part of existing health systems.

Marc Mitchell, Founder and President of D-TREE International, holds a similar view, stating, “Although there are currently separate funding streams for mHealth projects, we can and should expect to see mHealth being mainstreamed into maternal health programs. The assumption will be that where mobile technology is appropriate to improve maternal programs, it will be used. The only separate funding that will be earmarked for “mHealth” is for development of specific tools such as an ePartogram or electronic medical record that can be used across many projects by many organizations.”

For Bobby Jefferson, Director, Center for Development Informatics, Futures Group International, the question is more complicated. “The real question here is not how mHealth for maternal health will be financed, but how will it be financed sustainably at scale?”

Jefferson argues that mHealth is increasingly being seen as a mobile innovation component within the framework of Health System Strengthening (HSS) programs. In his opinion, “With mHealth developers creating “Apps for Advocacy” or maternal health apps like MAMA, there are possibilities for public private partnerships (PPP).”

Public-private partnerships might be the solution needed for mHealth interventions, particularly those targeted towards improving maternal health, to harness user-generated revenue by tapping into existing public sector funding for health service delivery and strengthening. What we need now is the sharing of successful funding models or examples of scaled and sustainable mHealth programs would be helpful to other practitioners in the field.

Do you have an opinion on the role mHealth can play to improve maternal health? What do you see as the biggest advantages of mHealth? The limitations? If you are interested in submitting a blog post for our ongoing guest blog series on mHealth for Maternal Health, please email MHTF Research Assistant Yogeeta Manglani at