While developed nations search for solutions to pay for the increasing financial burden of healthcare, developing nations provide a way forward in the deployment of innovative healthcare. Mobile SMS programs are low-cost and effective in supporting health services. Having been successfully used to address lifestyle factors directly affecting maternal outcomes, such as: smoking, physical activity, nutrition, substance use and psychological stressors. Of primary importance in the development of SMS behavior change programs to support the maternal healthcare of Indigenous Australian women, is cultural appropriateness; specifically, the cultural notion of ‘women's business'. In traditional Indigenous Australian culture, it is senior women who teach young women about maternal health and it is considered offensive for anyone other than a senior woman to instruct women on such matters. This discussion will consider the challenges in developing maternal healthcare SMS messages that aim to satisfy both the culturally sensitive requirements in addition to the medical requirements.
TopIntroduction
While medical science has made some remarkable discoveries over the past two centuries, the cost of healthcare for most developed nations has been growing faster than GDP and is therefore unsustainable (World Economic Forum 2013). Over the past two decades, the economics indicate the long-term sustainability of the healthcare industry by government funding is not achievable using the current models of healthcare delivery. In most developed nations, healthcare costs are increasing faster than national income to a point where the healthcare industry is considered by some to be amongst the most wasteful sectors in the world (Harvard University, 2014; World Health Organisation [WHO], 2010; PricewaterhouseCoopers Health Research Institute, 2008). To pay for this increasing financial burden governments must deny funding to education, roads, and public safety, or eventually resort to increasing taxes.
There are also concerns for many people in developed nations being excluded from healthcare systems due to poverty, communication, ignorance and distance. Populations have increased, life expectancy has improved and the numbers of physicians and specialists have decreased (Sanabria, 2014). At the same time, the healthcare industry is reluctant to look outside its traditional approach to service delivery as such change undermines the power structures in governments, pharmaceutical companies, physician services and nursing systems (Thompson, 2012).
This is not a new problem; healthcare is not the first industry needing to improve quality and convenience while reducing costs. Neither is the health industry the first to resist change. In developing nations, where healthcare resources are low, innovative new models of healthcare are succeeding. These new models provide a way forward for developed nations in the healthcare delivery of tomorrow.
One such area needing improvement in Australia is Indigenous maternal healthcare. While much progress has been made in regards to Indigenous healthcare, it is essential that the Australia healthcare system continue to leverage existing technologies to reach people in need of care. In order to maximize the potential of mobile technology in the field of Indigenous maternal health, both cultural and medical requirements need to be integrated into the design methodology of the system. Specifically, this discussion will outline the issues surrounding a proposed low-cost SMS behavior change program, intended to inform and motivate Indigenous Australian women for positive pregnancy outcomes. This low-cost innovative healthcare model has proven effective in both developing and developed nations.