Notes from the Beginning: Target Markets

Envision Arabia Summit 2012
October 16, 2012
Our Team is Amazing
April 3, 2013

One of the initial concerns we on the Dunia team grappled with involved identifying appropriate target markets for SMS-based vaccine management. “Appropriate technology” is a vague phrase that gets tossed around frequently in the field of global health, but its vagueness is a necessity: the environmental constraints it implies will be different for each technology.

The fundamental problem our vaccine tracking system tackles is a knowledge gap (patients don’t know when vaccines are available) precipitated because of general instability (irregular delivery, the reason for which differs by area). Though the idea formed from observations at refugee camps in Gaza, this problem certainly isn’t limited to Palestinian refugee camps; however, many areas too isolated to have adequate vaccination supplies have limited mobile phone access, and vice versa.

Our utility depends on identifying regions with high mobile penetration and limited vaccination – and gathering that information is more complicated than you might think! In addition to Gaza camps, other markets we’re considering include:

  1. Egypt experienced a nationwide stock-out of MMR vaccines after someone realized all backup stores in the national warehouses were expired – and it’s unclear how many expired vaccines were administered before that discovery! Subsequent mumps and measles outbreaks indicate that the shortages had a substantial effect on patients who could not afford private hospitals, and unfortunately these incidents occur with enough regularity that a notification service implemented in even 2014 could prove useful. In any case, mobile phones are as good as universal, and it’s a shame that network isn’t being utilized in this context.
  2. India still contributes to a full half of the world’s deaths from measles. While mobile penetration is finally escaping city hubs, clinical access lags in this regard. While detailed rural data has been difficult to come by, anecdotal evidence suggests that vaccine shortages are spotty and often seasonal (monsoon season impedes delivery?) – meaning that our SMS alerts might be useful.
  3. Morocco, where a classmate of ours is attempting to put us in contact with some rural clinicians, presents a different conundrum. All measures we can find suggest that vaccination rates are admirably high – in fact, the national measure listed by WHO places Morocco above the US! But are scattered Berber populations adequately sampled? Does the data include Western Sahara? It’s unclear.

Data sets from the World Health Organization, while useful, tend to prompt more questions than they provide answers. Somali refugees in Kenyan camps, for example, have finally started buying mobile phones at rates that would presumably make our system useful by next year, and these camps are large enough that going door-to-door – rather, tent-to-tent – is a burdensome task. The population is still transitory enough to exacerbate the problem of infectious disease, but does that transitory nature of the population undermine the usefulness of our product? Is there a way we could re-vamp our design so that patients are not tied to a particular clinic?

With luck, answers to these questions will emerge over time as we connect to more individuals who can help provide our team – anchored in the states –  with a clearer perspective of constraints at each potential location we examine. For now, I’m hoping to use this blog to explore issues that arise as our team works through the early stages of prototype development and implementation, in hopes of saving some of the lessons we might learn the hard way for other fledgling social ventures. 2013 is already shaping up to be an eventful year for Dunia Health, and we’ll continue to provide updates here as things progress.

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