Mobile Technologies for Managing Non-Communicable Diseases in Developing Countries

1. Introduction

Non-communicable diseases (NCDs) are becoming the world’s largest burden due to their chronic nature— which requires a long duration of care for their effective management. NCDs are causing 40 million annual deaths globally, equivalent to 70% of all deaths (see WHO (2017b)). The main types of NCDs are cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. Physical inactivity, unhealthy diets, and harmful use of tobacco smoke and alcohol are the major risk factors for NCDs. According to World Health Organization (WHO), excessive use of tobacco accounts for 7.2 million deaths every year; harmful use of alcohol caused over the half of 3.3 million annual deaths; excess intake of salt is attributed to 4.1 million annual deaths, and physical inactivity blamed for 1.6 million annual deaths. Similarly, rapid unplanned urbanization, globalization of unhealthy lifestyle and aging of the population are also causing the rise in NCDs. People of all age groups (i.e., children, adults and the elderly) from all the regions and countries are vulnerable to NCDs. Evidence shows that 15 million of premature deaths of people between the ages of 30 and 69 years are caused by NCDs, and 80% of these deaths occur in low and middle-income countries with an expected increase of 41.8 million by 2030 (Piot et al., 2016). In 2015, the burden of NCDs when compared with the statistics of 2000, it shows a remarkable increase in the burden of NCDs (as illustrated in Figure 1).

The epidemic of NCDs is a real threat to developing countries as it poses devastating challenges to their healthcare systems. Diabetes, cancer, hypertension, and cardiovascular disease (CVD) are the major cause of disability and deaths in low and middle-income areas (Slama et al., 2016). In 2015, WHO reported that 70% of death were caused by NCDs and among all those, diabetes mellitus considered as a major threat to life because it caused complications to many other diseases such as blindness, kidney failure, heart disease, diabetic foot (gangrene) (Pangaribuan & Junifer, 2014). In developing countries, the healthcare systems are already grappling with a large number of challenges. Lack of trained medical staff, unavailability of healthcare services and facilities, and poor health awareness among the population are the major problems in developing countries. Poverty is another cause for the prevalence of NCDs in these countries because poor people are at the high risk to being exposed to the harmful products like tobacco, unhealthy diet practices due to low health awareness. Further, political instability in developing countries badly affects the formulation and implementation of policy for healthcare sectors. In these situations, management of NCDs is very problematic because of their long duration and high-cost of treatment. As a result, each year around 150 million people face the financial crisis, about 100 million people are living under the poverty line due to healthcare expenses, and unfortunately, above 90% of these people live in low-income countries (WHO, 2010b). According to United Nations Project, world population in 2030 will reach 8.5 billion and projected deaths due to NCDs will be 52 million which was 38 million in 2012 (WHO, 2014b). At the same time, the rapid increase in the older population is also accelerating the growth of NCDs. According to World Bank statistics, the total number of elderly people (65+) is 8% of total population in 2016 and this number is increasing drastically which is causing great economic cost (World, 2016).

Figure 1.

Percentage of total disease burden accounted for NCDs (total disability-adjusted life year (DALYs))

Source: Reproduced from GHDx, 2015.