Health promotion through eHealth: The case of mDiabetes in Senegal

diabetes-blood-sugarRecently a post on the WHO website caught my eye. The title is self explanatory. “Mobile phones help people with diabetes to manage fasting and feasting during Ramadan”. We at Heartfile are heavily engaged in the use of mobile phones, with Heartfile Health Financing (HHF) which is an mHealth enabled social protection system protecting poor patients against medical impoverishment.  We believe mobile phones are the most powerful lever to lift people out of poverty. The WHO post is critical, with millions of Muslims around the world observing the holy month of Ramadan.

The month of Ramadan is highlighted by complete fasting, no food/drink intake from dawn to dusk. This practice is meant as an exercise for patience, perseverance and symbolic of empathy with the less privileged in the world. However, “Ramadan is a period of high sugar intake” which along with the effect of urbanization and changing lifestyles can contribute to excess body weight and physical inactivity which are risk factors for type 2 diabetes. For example, during Ramadan the health authorities in Senegal witness a peak in the urgent hospitalization of people with uncontrolled diabetes. Also, there is a perception amongst diabetics that their glucose levels are within limits during fasting. However, the contrary happens and the liver is releasing more glucose within the bloodstream to compensate for no food intake throughout the day. This makes the need for diabetes management while fasting ever so critical.

mDiabetes is a project established under “Be He@lthy Be mobile” a joint initiative by WHO and the International Telecommunication Union (ITU). The initiative which was launched in 2013, supports countries to set up large scale mWellness programmers that make use of text messaging and apps, to control, prevent and manage non communicable diseases.

The first phase of mDiabetes involves health messages like the ones below being sent out in order to “increase awareness and to help people with diabetes to avoid complications triggered by fasting and feasting”. The project also includes a training module for health workers and will allow for remote consultations and monitoring of patients in rural areas.

Messages include:

  • “Drink one litre of water every morning before you begin fasting.”
  • “Take care not to overeat and watch out for foods high in sugar such as dates.”
  • “Ask your doctor to adapt the dose and timing of your diabetes medication before you fast.”

eHealth initiatives like this are made possible by the rapid explosion of mobile technology in the developing world. In Senegal 83% of the population has a mobile telephone of which 40% are smart phones. This provides an opportunity to reach millions and the project is a key part of the national plan to fight non communicable disease. Similarly in HHF, mobile phones are used to ensure coordination in providing high-cost treatment, used for tracking medical supplies and as a means for follow up with the patients leveraging on a low cost technology in a resource constrained setting.

Diabetes is one of the major causes of morbidity and mortality worldwide with WHO estimates of 347 million people living with diabetes, 90% if whom have type 2, which is avoidable. In Pakistan this is more relevant than ever. Changing lifestyles have had an impact on disease patterns, especially NCDs like diabetes. This Ramadan we would like to share two of our public awareness documentaries related to diabetes prevention.

Related documentaries can be viewed here:


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