Mobile services: Its impact on health and development sectors in Bangladesh

Dr. Salehuddin Ahmed, Managing Editor, The Daily Star
To reach to the grass root level, mobile technology is an efficient medium. In Bangladesh, we have seen that within a decade alone it has become a vibrant communication medium. However, to access the full optimum of mobile services we need smartphones which are yet to be affordable to the majority in Bangladesh.

I think affordability is an important issue here. Another important issue is training -- to access certain mobile services, there is a need to train our people in mobile technology.

Mubin Khan, Managing Director, EATL
In Bangladesh, 97% of the households have mobile devices, 65% people use mobile phone according to BTRC. It means that mobile devices have reached to 10 crore people here. In that perspective in order to provide public with important messages on different issues like vaccine, HIV/AIDS, Health Services, tax payment, and the election, we can successfully use mobile devices.

According to a research, within 2014, financial value of mobile applications will be more than 30 billion in the global market.

I will talk about five options of mobile services. One is "voice call." In the reality of our rural areas, many people cannot read English, even Bengali. "Voice call" is like a normal mobile call, one has to just receive the call and hear pre-recorded messages. This is very simple but effective. It is also more cost effective than SMS.

Another option is "mobile app store" that was first introduced in Bangladesh by us. We have Bengali sites in our app store, where one can find solutions to problems in our every day life through their mobiles.

The next option is "call & services." One can get primary services from a remote area through dialing a specific number of a call centre. With the location-tracking service we can track down on whether our root level workers are attending their jobs sincerely.

Lastly, through mobile technology we can really fulfill the vision of "digital Bangladesh." We can provide important government services using mobile technology to the grass root people.

Dr. Nizam Ahmed, CEO, EATL
In the world ranking, Bangladesh stands 11th in mobile usages. Now 6 billion people use mobile phone that will exceed to 7 billion by 2015, and there will be more mobile phones than the people living in the world.

The number of mobile subscribers in Bangladesh is approximately 9.8 crore (July, 2012). 65% people have mobile, 97% households have at least one mobile set but only 7% people have access to computers and 5% people have access to internet.

The Bangladesh government has just launched 3G. Therefore, more people will have internet access in their mobile over the next few years. The main thing here is the government's commitment towards "Digital Bangladesh" -- for example, Jessore is declared the first digital district, there are policy support programmes and operations.

Now, we should take it to the next level. It is interesting to know that 80% Bangladeshi farmers are using mobile phones to gather information on markets and contact buyers; 50% farmers manage to sell their goods directly; communicating via mobile phone.

Usage of mobile has increased in health, education, disaster and other sectors. Most subscribers only use their handsets to call others; the use of SMS is very low. We have English keypad and our messages are 'Banglish,' which is not understandable.

Our SMS system should be Bengali. Bangladesh is the first Asian countries to launch mobile service in 1989.We have been experiencing ever-fastest growth of mobile communication and its revenue in Asia since 1993. Now, we need to create and expand the opportunities and options with mobile phone for health, development and business sectors.

Our available options are voice, text, location tracking, applications, data transfer service and other sorts of communication. These all can be available within a mobile. If the government supports this policy, operators will decrease the cost and development agencies will use this technology and we will certainly achieve our MDGs by 2015.

Advocate Shahara Khatun MP, Minister, Ministry of Posts & Telecommunications
EATL and The Daily Star are really doing a recommendable job for taking forward the idea of 'digital Bangladesh'.

Our prime minister has a vision of a digital Bangladesh and we have progressed a long way to digitalise this country. The "Voice Call" system will be launched by a recorded voice of our prime minister that will provide messages on community health services.

In our government's term, we have turned the telecommunication sector to a thrust sector in order to attract international investment. We have taken several epoch-making steps to reach to the doorsteps of the grass root people. Most recommendable are the 3G service, net-book connection, WiMax, Doel laptop, Bangabandhu Satellite, International Gate Way license delivery and so on.

The government has taken steps to establish optical fibre lines to the Union Parishad level. Within four years, we have increased the tele-density from 30% to 64%, internet density from 3% to 27%.

Today, 95% area and 100% people are under tele-network. We have increased the band with from 7 gbps to 200 gbps, and reduced the charge from 27,000 taka to 8,000 taka. To ensure e-service at the Union Parishad level, we have established Information Service Centres in 4501 unions.

We have also launched mobile banking, electronic money order, tele-medicine system, multimedia classroom, income tax return payment, online admission system, e-ticketing and so on.

Mostofa Faruk Mohammad MP, Minister, Ministry of Information and Communication Technology
First, I want to give thanks to EATL and The Daily Star for this well-timed initiative.

Our present government has been doing a lot to fulfill its commitment towards "Digital Bangladesh." In Jessore, the first digitalised district, we have introduced e-attendance registrar to increase accountability of government officers. We are seriously working towards an effective e-governance.

It is essential to utilise ICT in the development and business sectors; particularly mobile options and its uses. Mobile use in health and education sector is also very important, and the government is working hard to facilitate these usages.

Sunil Kanti Bose, Chairman, BTRC
Firstly, without reliable and robust infrastructure we cannot expect optimum use of mobile phones. The government plays an important role in building infrastructure; it cannot happen in any isolated or controlled condition. Issues regarding macro environmental facts are also involved in the process where our major obstacle for developing infrastructure is finance. We are allowing Grameenphone to bring equipments for 3G.

Bandwidth speed is very important. And here the question of affordability creeps in. We have reduced the cost to 8,000 take from 27,000 and the present government is committed to reducing it further to 3,000 taka. Reduction of tax on the equipments will increase the affordability as well, but the government needs revenue for the overall maintenance. And we must also note that the rural people are not able to afford digital education.

The government has, however, created social obligation fund within BTRC for this purpose. 1% of total revenue goes to this fund regularly.

The development of appropriate content is also vital. Content developer is one of the groups who do not get their proper share. We have also made a committee to look after this and we are encouraging the use of mobile options and its services in all sectors for its benefits without having any negative impact. Collaboration of public and private sectors will enhance the use of mobile services for its high impact and effectiveness in development.

Dr. Makduma Nargis, Additional Secretary, Ministry of Health and Family Welfare
In our "Revitalisation of Community Health Care Initiative in Bangladesh" project, we have been successfully using mobile technology. In every community clinic, we place mobile numbers of service providers on the walls, so that people can take a 24-hour health service through their mobile phones.

We are using mobile in our referencing system as well. If any patient needs treatment at a higher level then we immediately contact the next tier, send the patient and inform the doctor about the patient's status. In case of complications, our community health providers take advice from senior colleagues and experts through mobile phones.

We have installed software in six community clinics on a pilot basis, to collect information about the patient's data, so that we can better understand their needs and provide feedbacks. We are also using mobile tracking services to ensure that our health providers do perform their duties sincerely.

Soon we will be transmitting mobile voice calls by the honourable prime minister for community clinic services for mothers and children.

Md. Abdul Karim , Former Principal Secretary to the Prime Minister's office
To popularise mobile applications, we have to make some regulatory changes in our ICT Act-2010 and ICT Policy 2009-10.

We have to increase the reach of optical fiber line to make internet and mobile applications effective. There is a network coordination committee, who look after this issue. Power Greed Company Bangladesh (PGCB) offered a vacant fiber line to BTCL. This opportunity should be taken as early as possible and Band with price should be reduced further.

We need an institutional mechanism to coordinate effective internet use in our different sectors.

Print media and electronic media can play a vital role to popularise mobile applications.

Iqbal Khan Chowdhury, Additional Secretary, Ministry of Education
We really appreciate this effort in using mobile phones within health and development activities for higher impact. We have severe weakness in our field administration. We often get complains that people cannot find field level service providers in their office. Therefore, if we use mobile location trackers, we can ensure their presence and streamline our field administration.

The government provides stipend to more than 4.8 million students. If we use mobile technology to identify students and ensure their reception, then existing malaises in stipend will wither away.

Nilufar Ahmed, DG, Prime Minister's Office
The most important point is developing infrastructure for ICT services. We have a domestic network co-ordination committee where I will raise your suggestions.

I do not think our operators already have capacity to launch 4G services because Teletalk has suffered problems in their launches, even, 3G services. Therefore, phase by phase approach will be useful for Bangladesh.

Prof A.K. Azad, ADG, Directorare General of Health Services
In 2010 and 2011 our Prime Minister Shekh Hasina received two prizes from UN named "MDG -4," for the success of decreasing rate of infant mortality in our country, and "Digital Health for Digital Development" as a recognition of the impressive development in the health sector.

Globally any kind of communication through wireless technology is defined as m-health. Recently in Switzerland at a seminar upon m-health, they submitted a report where they compared the development of Bangladesh in this sector with a bullet train. One example is that, we established a signboard with a mobile number at the 800 government hospitals; encouraging mass people to send their complaints as text messages about the hospital. We call back to the sender's number and deal with those complaints officially.

Besides, we are registering the name of pregnant women and giving them a reminder for regular health check-ups. There are many limitations of our government. We need to combine our non-governmental efforts to overcome these.

SM Altaf Mahmud, banglanews24.com
We do not get adequate internet speed in the rural areas. If there is no internet then there is no scope of using mobile apps, however, mobile voice call and other services can greatly assist in building awareness, transmitting messages and communication. Therefore, we should emphasise on use of mobile effectively.

Dr. Md. Abdul Waheed, Line Director, NASP, Directorate General of Health Services
We can use mobile technology at each of the five levels: promotion, prevention, cure, rehabilitation and follow up in health sector. EATL has launched a mobile application in Bengali on HIV so that people, anywhere of the world, can get information on HIV.

We are also going to set up a call centre for HIV positive people to provide them regular messages in a confidential way. This is a great example of mobile utilisation and its impact.

Ishtiaq Hussain Chowdhury, Director, Corporate Affairs, Grameen Phone
Mobile operators have already laid optical fiber in almost all across the country. Therefore, we do not need new network. We have to find out ways on how we can use the existing network effectively.

We have different efforts and initiatives in digitalising health sector, but we lack coordination. We need a roadmap so that we can streamline our contributions.

Taimur Rahman, Director , Corporate Affairs, Grameenphone
In our existing frequency, we can even provide 4G services, and then there will be no problem in getting faster internet. This should be decided from the government level.

Dr. Amjad Ali, Executive Director, HASAB
We have incorporated mobile technologies in sexual reproductive health and TB programmes. The government also launched an effective mobile-based programme named "Pregnancy Care and Service."

Md. Majibur Rahman, MD, Teletalk Bangladesh Ltd
In 3G, we will get good speed in both voice and data, but in 4G voice will not be so good. Therefore, I would request to BTRC to verify frequency before finalizing 3G and 4G licenses for operators.

We are working closely with Disaster Management Bureau. Now, we can cover our whole coastal area.

Dr. Md. Khalilur Rahman, Assistant Professor, Brac University
Differentiation of information based on demand is very important. For example, rural people need information regarding maternal health care more than the urban people.

Registration of mobile number will be helpful to identify these differences.

Our young population is involved in the outsourcing sector. We should allow PayPal in Bangladesh to prevent our revenue loss. This sector has even greater potential than our garment sector. We should improvise the computer training given at our village level with training on graphic designing, mobile application development and outsourcing.

Finally, financial support from the government and nongovernmental sources is needed for various research projects on ICT.

Dr. S.M. Mustafizur Rahman, Programme Manager, NNS, DGHS, (MOH&FW)
We are working with our MDG targets in the nutrition sector and we need to communicate with our people about health factors in order to change our existing attitude. We are only concerned about "under nutrition." However, "over nutrition" is also a type of malnutrition, which also increases the rate of mortality. We should spread this information through mobile technology to improve the nutritional status in Bangladesh.

Rajesh Palit, Assistant Professor, North South University
We have to put emphasise on the ultimate gain rather than immediate profit. For example, there is an increase of foreign remittance because of the increased internet connectivity between the family members inside the country and those living abroad. This is the result of decrease rate of overseas calls. Another important issue is that if we select 10 Bengali fonts we will find three or four types of internal mapping. That means we do not have any standard to follow. We expect that our ICT ministry will set a standard and develop regulation for uniform technology.