5 Questions with Medic Mobile
Equity & Justice
Posted April 2017
While working at a hospital in rural Malawi in 2008, pre-med student Josh Nesbit was struck by the inefficient access to what many consider basic healthcare. Childhood immunizations, prenatal and neonatal care, and communicable disease testing weren't the norm. When Josh noticed that his mobile phone got exceptional service from a recently installed cell tower nearby, he knew there was a solution. The mobile network and health-minded workers were already there — all they needed were the tools to connect them.
Today Medic Mobile is used by 10,200 community health workers in 23 countries from Nepal to Kenya to Guatemala. Medic Mobile is a suite of mobile and web tools that allow low-income communities to register pregnancies, track disease outbreaks, keep inventory of essential medicines, and communicate in emergencies. The technology links health workers with the information they need to serve their communities.
Emerson Collective's Kerri Pinchuk asked Josh, CEO, five questions about Medic Mobile’s work.
How do you find your health care champions in remote communities?
You can walk into almost any community on the planet and ask where the community health worker is, and someone will point you to her or his door. So this network of people exists — and they’re doing the best they can to look after their neighbors. Sometimes they’re a government community health worker; sometimes they’ve received a little bit of training from an NGO; sometimes they’re part of a church group. Other times they’re professionals who are now trained and have a full toolkit as a health worker locally.
The programs are different shapes and sizes in different places, but almost everywhere we go we find someone who is already there looking after their neighbors — typically at least 100 families at a time. It’s really amazing that that kindness and compassion exists out in the world right now.
Medic Mobile’s mission of embracing local health workers seems applicable anywhere where inequity is an issue. Where do you see other applications for your model?
I couldn’t agree more. I think that requires us to pause and basically give ourselves permission to reimagine who health workers are — who we think of as health workers, really, and how we support them and where they’re providing care. Imagine what it would look like in the States to have someone who is embedded within a social network and is from a local community, who receives enough training to provide really high-quality care and visits every family at least once every week and knows every relationship in the community.
Having that proactive ambassador for health — that’s the model of care that’s spreading across all the countries where we are working, and we think technology is going to play such a critical role in supporting them.
To what extent is technological literacy an obstacle for Medic Mobile?
Technological literacy has become less of a problem over time, and it becomes less of a problem every year. We’ve crossed [a threshold where] 50% of the general population of Sub-Saharan Africa owns a personal cell phone, and that’ll be 100% most likely within three years. So we’re on the rapid adoption curve. If the person [we’re working with] doesn’t own a personal phone, someone in their family does, so they’ve been around tech and they’re familiar with it. Because all of our tools work on even the simplest phones, we’ve been able to meet people where they are and build familiar technology. And that’s been really helpful. Smartphones are the next wave, so there will be a similar adoption curve, probably even faster, within the next five years.
But in the same vein, we’ve learned a lot about training programs using similar methods like paired learning, group learning, sharing and demonstrations, plus targeted retraining because we can monitor how people are using the tools and see who needs more help. The goal is that everybody succeeds because the tools are really critical — it’s what helps this thing to run.
How do you track your impact? Have there been any extraordinary, defining moments?
One of the things that’s really important to us is that we make good on some of the ideals that we’ve been working towards as a global health community. So when we say we want to reach every child, that means that we need to get our immunization rates up to a certain percent. We need to ensure that the health system is reaching every family in a specific way.
In India, we have a study that shows an increase in childhood vaccinations from 60% to 98%. And that increase was because every child in every community was registered, reminders were sent to the primary caregiver in every household, and alerts were sent to community health workers if kids were missing their appointments. The network of people that was committed to that goal and connected using new technologies was able to achieve that coverage rate. And for me that is what is standout exciting. It’s fulfilling that promise that we’ve always talked about at a global level, and what people are now solving at a global level.
You decided early on to make all of Medic Mobile’s back-end technology open source — meaning anyone can see and repurpose your program. What was the thought process behind that decision?
It’s a decision that we make because we have the luxury, the freedom, to serve our mission to improve health — to do good in the world. So we can make every decision align with that mission and that bottom line. And that’s really nice for [our organization] and for our developers. They want a legacy to the technology that they’re building — and part of that is living on within our organization and likely within others.
We would definitely welcome any developers who came across the code and had ideas to share. We have open-source contributors who contribute to issues that we need solved for our mission. In the future we’re definitely going to see people pick up our technology and use it for other social good.