Tweeting for Health

Last week, CHMI co-hosted a “twitter chat” along with [Next Billion]( ([@NextBillion](!/NextBillion)) and [Ashoka]( ([@Ashokatweets](!/AshokaTweets)), in connection to NextBillion’s blog series “[Advancing Healthcare with the Bottom of the Pyramid](,” to which CHMI is a contributor. More than 34 people actively contributed to the conversation. Here are some of the big topics covered in our chat:

NextBillion started off the chat by asking, “What are some examples of mobile applications in managing healthcare and/or preventative care that have impressed you?” Here are some of the examples that were mentioned:
• [Medic Mobile](, an open-source program for cell-phones that connects health workers to central hubs
• [mDhil](, using cell-phones in India to push out health tips to the general public
• [mPedigree](, using cell-phones to prevent people from taking counterfeit drugs
• [SIMpill](, using pill bottles equipped with SIM cards to let health workers know if a patient has taken their drugs or not
• [Changamka](, using smart-cards to help Kenyans save money for health expenditures

**Cost Reduction**
As the conversation moved on, Next Billion asked for examples of how to drastically reduce costs while maintaining quality of care. Participants came up with a variety of methods, including:
• Cheaper surgeries (e.g. [Aravind Eye Care System](
• Overcoming transportation issues (e.g. [Living Goods]( or telemedicine)
• Increasing efficiency using open-source software
• Standardized operating procedures
• Task shifting (although, this can come with problems, such as resentment from doctors, when implemented poorly)

**Working with Governments**
The chat then transitioned to a discussion of the advantages and disadvantages of working with governments. Participants noted that it can be advantageous for NGOs to work with government because they can use government infrastructure to lower cost, government can help with financing by providing insurance coverage for the poor or by giving grants, and government can help ensure that quality of care standards are respected. In addition, NGO’s can make use of government for greater publicity and assistance in scaling-up.

On the other hand, participants also noted that restrictions and resistance to change can make it hard to expand healthcare innovation when working with governments. Corruption, slow government machinery, lack of connection to people on the ground, and half-hearted cooperation were identified as other disadvantages of working with governments. Several participants also commented that India’s government is notorious for ignoring primary health care.

**How can MNCs help?**
The conversation ended with a discussion of how multi-national corporations (MNCs) can help improve health coverage and health outcomes for the bottom of the pyramid (BoP). Some participants suggested that MNCs could:
• Find social business opportunities with the BoP
• Address socio-economic determinants of health through corporate social responsibility programs
• “Lend” key persons with experience in finance or administration to NGOs
• Facilitate social research, the study of social conditions, and the identification of needs

_Follow CHMI on Twitter: [@CHMInnovations](!/CHMInnovations)_