One of the many paradoxes of 21st century medicine is the growing inequality of health care outcome. While recently published data by the International Comparison Program (ICP) has suggested that the global economic inequality has fallen sharply over the past few years, and economic growth has helped emerging economies to ‘catch up’ with the developed world, there is striking evidence (whatever the resolution of arguments about particular numbers of Thomas Piketty’s ‘Capital in the 21st Century’), that inequalitywithin countries has risen. Technology has been seen by many as key to understand, and to resolve, the problem of inequality, particularly in developing countries. It seems that health care inequities are no exception here.
This poses a number of questions for mHealth initiatives and mobile learning interventions for community health workers in low income countries. For example:
- What implicit notion of ‘development’ underlies and drives goals and aims of mHealth projects?
- Given that most of the inequalities within countries are politically motivated, how can we locally improve health care through mobile phone technology without reproducing inequalities – and possibly even enhancing them – through technology?
- How can we overcome and transcend the institutional obstacles through technology that prevent the poor from getting the health care they need?
- How can mobile phones become tools to promote and facilitate health treatments and health care as a human right for everyone?