Paying for Health Care through your Cell Phone

**_“Mobile money can change the efficiency of health services.”_** – Pamela Riley, Senior mHealth Advisor of [Strengthening Health Outcomes through the Private Sector (SHOPS) Project](

This was the premise behind SHOPS’s four panelist presentation and discussion, “Follow the mMoney: How Mobile Money Can Improve Public Health”, on Friday, September 14th. The event was held at George Washington University’s [“The Mini-University (Mini-U)”](, a one day forum for global health professionals around the world to share ideas and learn from one another.

As stated by Pamela Riley at the beginning of the presentation, there are currently many inconsistent and confusing terms referring to mobile money, such as SMS payments and mobile finance. However, mobile money (mMoney) can be said to be where mobile banking (conducting banking activities such as checking your balance and transferring money through a mobile device) and mobile payments (paying for goods and services through a mobile device) collide.

It is in improving both aspects of mobile money; mobile banking _and_ mobile payments that people can be reached in new and innovative ways in health care, on both the provider and patient side. Through mobile money, health care providers can pay workers, reward patients for treatment compliance, encourage healthy behavior, provide vouchers or conditional aid, and even improve supply chain management. On the other side, patients can pay health care providers, pay their insurance premiums, receive claims, and more effectively evade informal payments (i.e. bribes) to public officials. As explained by Charley Johnson of USAID’s new mobile development program, [Mobile Solutions](, programs such as [“SMS for Life”]( and [“Changamka”]( exemplify the change mobile money can have on the health care market. SMS for Life, a Tanzanian SMS stocking program, has reduced stock-out rates of anti-malarial drugs from 95% to 6% in select areas, while Changamka has provided patients with a safe and reliable method to save and pay for health care services in Kenya.

Mobile money can even be used to pay for health care in the direst of situations as explained by Project Manager Christine Martin, of the [Mennonite Economic Development Associates (MEDA)]( After the devastating 2010 earthquake, Haiti was a country without money - runs on the bank had left the country without cash to conduct even the most basic of transactions. However, through mobile money, donors such as MEDA were able to provide cash transfers and vouchers to those that needed it, effectively re-establishing a health care market despite the fact the country had no physical cash with which to conduct transactions.

However, according to Dustin Gibson, a Research Assistant at [Johns Hopkins Bloomberg School of Public Health-International Vaccine Access Center](, mobile money is not without its difficulties. Mobile money operators are often difficult to coordinate with, and hesitant to help in the initial start-up phases of a project. Many patients also do not have access to their own phones and often use a neighbor’s, friend’s, or in the case of many women, their husband’s. This can prove to be a problem for patients, as they may run into issues when trying to save money for procedures, or when trying to conduct emergency transactions for needed health care services. There is also the fact that the fees to send and receive mobile money can prove to be expensive if the amount transferred is small. Mobile money also requires a high level of market penetration; a critical level of vendors and buyers will have to accept and us it as a form of payment before the service can truly take off as a viable method in which to conduct business transactions.

Despite these challenges, as explained by Charley Johnson, mMoney is continuing to grow rapidly; as of five years ago only 6 million Kenyans had access to basic financial services. Today, 16 million Kenyans, or 70 percent of the country’s adult population, use [Safaricom’s]( mMoney product, [M-PESA](, to manage their money, revolutionizing the way healthcare services are bought and paid for within Kenya.

As was explained in the ending Q&A, there are roughly 1 billion people in the world that own a mobile phone yet lack access to basic health care systems. This situation shows that there is huge room for growth for mobile money in health and those who have never had access to basic health care services may soon become a part of their health care system.