1. Will mHealth Be Accepted in India?
Results of a Pan-India Survey
Dr. Arun Rai
Regents’ Professor & Harkins Chair
Center for Process Innovation & CIS
Department
Robinson College of Business
Georgia State University, Atlanta, U.S.A.
arunrai@gsu.edu Web site: arunrai.us
4th International Conference on Transforming Healthcare with IT 6th – 7th Sep. 2013 Hyderabad, India
Dr. K. Ganapathy
President, Apollo Telemedicine
Networking Foundation
Chennai, India
drganapathy@apollohospitals.com
Web site: www.kganapathy.com
Liwei Chen & Jessica Pye
Doctoral Students
Center for Process Innovation
Robinson College of Business
Georgia State University, Atlanta, U.S.A.
liwei.chen@eci.gsu.edu & jessica.pye@eci.gsu.edu

2. Study Motivation
Amritya Sen
Nobel Laureate, Economics, 1998
Bharat Ratna, 1999
Quality of life is linked to citizens’ capability
to use resources to function effectively
Realizing the
transformative
potential of
mHealth in India
hinges on
acceptance & use
“Basic” (mobile) internet access
needs to be a human right given
its pivotal role to effective living
Marc Zuckerberg
CEO, Facebook

3. Study Objectives
1.
Willingness?
2.
Awareness?
4.
Disparities?
3.
Use?
5. IMPLICATIONS?
 Designing Solutions
 Building Awareness
 Promoting Use

4. Procedures
 Questionnaire developed by ATNF and GSU
 Pilot testing and refinement
 Trained volunteers from Apollo Nursing Colleges for
multilingual field survey administration
 Stratified sampling across demographics & location
 Pan-India Survey (Oct 2012 - April 2013)
 1886 valid responses

5. Sample Characteristics (I)
Age
18-22 31%
23-30 30%
31-40 18%
41-50 11%
51-60 6%
over 61 4%
Gender
Female 52%
Male 48%
Income/month
≤ RS 5,000 20%
> RS 5,001 & ≤ RS 15,000 26%
> RS 15,001 & ≤ RS 30,000 17%
> RS 30,001 14%
Education
Below secondary school 10%
Secondary School (6-12 std) 28%
College Graduate 31%
Master’s degree and higher 31%
Location
Urban 69%
Rural 31%

6. Sample Characteristics (II)
• Health perceptions
 Healthy: 65%
 Moderate/Unhealthy: 35%
• Healthcare checkup
 No health checkup in last year: 54%
 No health checkup in last 5 years: 30%
Share mobile: 57%
BASIC SMART
URBAN 54% 46%
RURAL 78% 22%

7. Behavioral Intention to Use mHealth:
Equal Enthusiasm Among Urbanites and Ruralites
0%
10%
20%
30%
40%
50%
60%
Urban Rural
14%
18%
27% 25%
55% 55%LOW
LOW
NEUTRAL
NEUTRAL
N=1271 N=573

8. 0%
10%
20%
30%
40%
50%
60%
Urban Rural
28%
51%
44%
31%
28%
17%
mHealth Awareness & Use:
The Urban-Rural Divide
N=1271 N=573
USERS
USERS
UNAWARE
UNAWARE
AWARE
AWARE

9. #2.CONVERSION
#3. AWARENESS
5%
22%7%
24%
94% 94%
84%
52%
0%
20%
40%
60%
80%
100%
Urban Rural Urban Rural
Phone calls Text messagesMissing Data Not Aware Aware Non-User User
Awareness and Use:
The (Three) SMS Urban-Rural Divides
#1. USE

10. #2. AWARENESS
#4.AWARENESS
24%
53%
21%
53%
28%
25%
21%
24%
42%
17%
51%
19%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Urban Rural Urban Rural
Emails Internet
Missing Data Not Aware Aware Non-User User
Awareness and Use:
The (Four) Urban-Rural “Internet Mobility” Divides
#3. USE#1. USE

11. Leading Disparities of URBAN Relative to RURAL
Education (>= College) 2 : 1
Individual income (> 15 K) 3 : 1
SMS use 1.6 : 1
Smart device ownership 2.1 : 1
Mobile internet use 2.7 : 1
Health checkup at least in last 5 years 1.07 : 1
Proximity to primary care (<3km) 1.02 : 1
Proximity to specialized care (<10km) 1.13 : 1
Socio-
economic
Mobile
Access &
Utilization
Healthcare
Access
& Utilization

12. Leading Disparities of AWARE Relative to UNAWARE
Education (>=College) 1.5 : 1
Individual income (>15K) 1.85 : 1
SMS Use 1.45 : 1
Smart device ownership 1.98 : 1
Mobile internet use 1.41 : 1
Health checkup in last one year 1.07 : 1
Proximity – primary care (<3km) 1.1 : 1
Proximity-specialized care (<10 km) 1.19 : 1
Socio-
economic
Mobile
Access &
Utilization
Healthcare
Access
& Utilization

13. Leading Disparities of USERS Relative to AWARE
Education (>= College) 1.25 : 1
Individual income 1:13 : 1
SMS use 1.04 : 1
Smart device ownership 1.25 : 1
Mobile internet use 1.52 : 1
Health checkup in last one year 1.14 : 1
Proximity – primary care (< 3km)* 0.95 : 1
Proximity-specialized care (<10 km)* 0.93 : 1
Socio-
economic
Mobile
Access &
Utilization
Healthcare
Access
& Utilization

14. IMPLICATIONS?
 Designing Solutions
 Building Awareness
 Promoting Use

15. Designing Solutions & Building Awareness:
Key Segmentation Criteria
3.
Preventive
Disposition
to Health?
2.
1.
Advantaged
OR
Disadvantaged?

16. Promoting mHealth Use:
Key Levers Across Segments
1.
SELF-EFFICACY
2.
ELECTRONIC
MEDIUM FOR
HEALTHCARE
SERVICES
IN3.

17. Willingness:
 Uniformly high across
urbanites & ruralites
Build Awareness:
Tailor strategies to
segments—advantaged vs.
disadvantaged; male vs.
female; prevention
Disparities:
 Socio-economic
 Basic/Internet Mobility
 Healthcare
access/utilization
Develop Use:
Promote Trust,
Self-efficacy &
Empowerment

18. 4th International Conference on Transforming Healthcare with IT 6th – 7th Sept. 2013 Hyderabad, India
Acknowledgements
• Apollo Hospitals Educational & Research Foundation, India
• Principal, Apollo Institute of Nursing, Gandhi Nagar, Gujarat, India
• Principal, Apollo College of Nursing, Hyderabad, Andhra Pradesh, India
• Principal, Apollo College of Nursing, Chennai, Tamil Nadu, India
• Principal, Apollo College of Nursing, Aragonda, Andhra Pradesh, India
• Principal, Apollo College of Nursing, Bilaspur, Chattisgarh, India
• Principal, Madurai Apollo College of Nursing, Madurai, Tamil Nadu, India
• Principal, Apollo School of Nursing, New Delhi, India
• Principal, Apollo Gleneagles Nursing College, Kolkata, West Bengal, India
• Ms. Geethanjali, Project Coordinator, ATNF, Chennai, Tamil Nadu, India
• Staff of Apollo Telemedicine Networking Foundation, Chennai, India

19. 4th International Conference on Transforming Healthcare with IT 6th – 7th Sept. 2013 Hyderabad, India
Dr. Arun Rai
arunrai@gsu.edu
Web site: arunrai.us
Dr. K. Ganapathy
drganapathy@apollohospitals.com
Web site: kganapathy.com
Comments
and
reactions
welcome!
Will m-Health Be Accepted in India?
Results of a Pan-India Health Survey