Hesperian Health Guides Releases Open Copyright Apps

​Julie M. SmythHesperian Health Guides released the Android version of their Safe Pregnancy and Childbirth app Friday, completing the new suite of free digital tools Hesperian made available in late February. These new digital tools, which were developed by Hesperian in partnership with The UnaMesa Association, are designed to provide community health workers worldwide with quick medical references and source content for training. The new digital tools suite consists of the Pregnancy and Safe Childbirth Application, a searchable HealthWiki, and an online image library.

The strength of Hesperian’s digital tools lies in their accessibility and comprehensibility. The digital tools are accessible even in areas with limited internet connection since the Pregnancy App and other Hesperian materials need only be downloaded once. After the initial download, materials can be accessed without an internet connection. Hesperian’s digital tools are also carefully organized for easy use even for health workers with little computer literacy.

Hesperian, a small non-profit organization that runs primarily off its book sales, has been providing comprehensive health materials in print for health providers in rural, low economic areas for roughly 35 years. Now Hesperian is broadening their range of distribution through the internet and mobile devices.

Hesperian has pioneered an open copyright policy that allows for the redistribution and adaptation of its materials by health workers. According to Executive Director Sarah Shannon, Hesperian’s policy resembles a shared attribution, Creative Commons type license.

The Tools

Hesperian’s Safe Pregnancy and Childbirth mobile application includes simple, straightforward language and easy-to-understand illustrations explaining pregnancy-related concepts. The app includes topics such as: prenatal care, danger signs surrounding childbirth, how to treat a pregnant woman suffering from malaria, and dealing with anemia after childbirth. The content is essentially an adaptation of information contained in Hesperian’s widely-referenced book Where There Is No Doctor.

Navigation of the app is designed to be easy to follow. Hesperian, which has long used crowdsourcing feedback to refine products, ran field tests with health workers in rural areas who were unfamiliar with mobile apps.

Hesperian’s Pregnancy App is now available for the iPhone and the Android. The iPhone app has already reached nearly 3,300 downloads in 76 countries in the three months since its February release.

Hesperian’s new HealthWiki provides chapters of Hesperian’s book, Where There Is No Doctor, which are now easily accessible in a digital format even to those with limited internet connectivity. Only six out of forty-six chapters are currently available on the HealthWiki; the rest are scheduled to be released once updates on the material are finished.

The HealthWiki is searchable in ten languages. Different languages are cross-linked for use in mixed language communities.

“The cross-language linking is similar to what you’d find on Wikipedia, however, it’s a finer level of granularity that makes it quite unique,” Hesperian Executive Director Sarah Shannon told Open Health News.

Hesperian’s searchable online image library boasts nearly 10,000 medical and health-related images. Hesperian has long been known for including easy-to-understand illustrations in their print materials. Now these images can be access online and used by community health workers to create customized materials which suit the needs of their unique situations and patient populations. The images are searchable by topic, gender, ethnicity and keywords. By combining text materials from the HealthWiki with these images, health workers can create flexible materials for reference and teaching.

The Goal

Because cell phone usage is increasing quickly even in rural, low economic areas, healthcare apps designed for smartphones are quickly becoming a valuable method of communicating vital health information.

Shannon believes that the pregnancy app will help save lives by equipping both trained medical personnel and community health workers who are not medical professionals with the tools they need to provide emergency care, prevent needless deaths by educating their patients, and train more community health workers. World Health Organization (WHO) statistics estimate that approximately 360,000 women die each year during pregnancy and childbirth.

“Most [of these women] die from conditions that are not predictable but are totally preventable,” Shannon told Open Health News. Shannon hopes that Hesperian’s app will be an effective tool for preventing many of these deaths.

The Development

The iPhone application was developed by Hesperian and UnaMesa in HTML for the Health Wiki. This way the content itself is available in a similar format to Wikipedia. The HTML format is then modified to an iPhone format. Then Phone Gap was used to create the actual app for iOS.

A similar approach is being used to develop the Android version of the Pregnancy App. However, UnaMesa President Greg Wolff told Open Health News that because Android has a more open market and variety of mobile devices it has been more difficult to develop a code to support all the devices. The app development team has been working to create an app with a common language and process to make it accessible for developers.

The Future

To Hesperian and UnaMesa, the development of the Pregnancy App is just the tip of the iceberg. According to Shannon, Hesperian is looking for more partners and funding for future health-related apps.

Although the app content is designed primarily to assist community health workers, mHealth developers are another demographic Hesperian is targeting. Hesperian and UnaMesa both hope that innovators will find methods of adapting the Pregnancy App to other types of mobile phones.

One of the chapters from Where There Is No Doctor that is already available on the HealthWiki is Chapter 26: Pregnancy and Childbirth. This chapter has been recently bundled into Hesperian’s Pregnancy App. As more chapters are added to the HealthWiki, additional iPhone and Android apps can be created from their content.

“The app itself is a small portion, a demonstration of what’s possible for the types of material Hesperian creates,” Woolf said. “We think and hope once those materials are created, Hesperian and UnaMesa or others…can bundle them into apps at a very low cost.”