New rural healthcare inequalities as mobile phones replace friendships?

  • Health behaviour research in Thailand and Laos studied how poverty, mobile phones, and social relationships affect access to healthcare in rural populations
  • Researchers documented a broad spectrum of informal mobile phone use during illnesses, even in the absence of specific healthcare interventions
  • Support from family and friends as well as phone use were widespread and improved poor patients' access to public healthcare
  • Mobile phones were also generally less accessible for the poorest of the poor, which makes them prone to aggravating inequalities in rural areas of low- and middle-income countries
  • Researchers call for caution in health interventions that use mobile phones, as such interventions could drive out other ways of gaining access to healthcare
  • Leading health and development organisations such as the World Health Organization increasingly recognise the risk of "digital inequalities" – that the use of technologies like mobile phones can exclude poor and disadvantaged groups.

    A new study led by Warwick University Assistant Professor Marco J Haenssgen has now demonstrated directly how mobile phones can support access to healthcare in developing countries, but at the risk that the poorest are deprived of support. Published in the prestigious journal World Development, the researchers highlight the complexities of technological change and caution against over-enthusiastic medical interventions that aim to promote health through mobile phones.

    The researchers conducted a representative health behaviour survey among 69 villages in northern Thailand and 65 villages in southern Lao PDR. Responses from this sample of 2,141 people reflect the broader living conditions and health behaviours of more than 700,000 villagers.

    The study found that

    • People in both regions often suffered from non-monetary poverty. Despite widespread poverty, mobile phones were commonly owned – by 97% of households in Thailand and 75% of households in Laos
    • Phones increasingly integrate into people's health behaviours and fulfil similar functions as the direct support from family and friends during an illness. Social support remained more common, however: two-thirds of patients in rural areas involved other people during their illness, only one-quarter (Thailand) and one-sixth (Laos) of patients used mobile phones when they were sick. Patients who used phones were significantly less likely to be poor
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