SPECIAL SECTION ON HEALTH INFORMATICS FOR THE DEVELOPING WORLD Received May 10, 2017, accepted May 23, 2017, date of publication June 1, 2017, date of current version July 17, 2017. Digital Object Identifier 10.1109/ACCESS.2017.2710800 Mobile Health in the Developing World: Review of Literature and Lessons From a Case Study SIDDIQUE LATIF 1 , RAJIB RANA 2 , JUNAID QADIR 3 , (Senior Member, IEEE), ANWAAR ALI 3 , MUHAMMAD ALI IMRAN 4 , (Senior Member, IEEE), AND MUHAMMAD SHAHZAD YOUNIS 1 1 National University of Sciences and Technology, Islamabad 44000, Pakistan 2 University of Southern Queensland, Darling Heights, QLD 4350, Australia 3 Information Technology University, Lahore 54000, Pakistan 4 School of Engineering, University of Glasgow, Glasgow G12 8QQ, U.K. Corresponding author: Siddique Latif (slatif.msee15seecs@seecs.edu.pk) ABSTRACT The mHealth trend, which uses mobile devices and associated technology for health interven- tions, offers unprecedented opportunity to transform the health services available to people across the globe. In particular, the mHealth transformation can be most disruptive in the developing countries, which is often characterized by a dysfunctional public health system. Despite this opportunity, the growth of mHealth in developing countries is rather slow and no existing studies have conducted an in-depth search to identify the reasons. We present a comprehensive report about the factors hindering the growth of mHealth in developing countries. Most importantly, we outline future strategies for making mHealth even more effective. We are also the first to conduct a case study on the public health system of Pakistan showing that mHealth can offer tremendous opportunities for a developing country with a severe scarcity of health infrastructure and resources. The findings of this paper will guide the development of policies and strategies for the sustainable adoption of mHealth not only in Pakistan but also for any developing country in general. INDEX TERMS mHealth, mobile health, developing countries, remote monitoring, clinical decision support systems, epidemic outbreaks, mHealth challenges, mHealth for Pakistan. I. INTRODUCTION Mobile phones are arguably the most prosperous and cer- tainly the most expeditiously adopted modern technol- ogy throughout the developing as well as the developed world [1], [2] with. As depicted in Figure 1, mobile phone technology is ubiquitously deployed both in the developed world as well as the developing world, with consistently ris- ing mobile penetration statistics worldwide. The proliferation of mobile phones has stimulated various innovative applica- tions of mobile Health, in short, mHealth for personalized and tailored care. a penetration rate of 49.4% in 2016 [3] The modern smartphone is an ideally suited technology for healthcare because it embeds a plethora of programmable sensors including gyroscope, ambient light sensor, camera, proximity sensor, microphone, digital compass, touch- sensitive screen, accelerometer, and Global Positioning System (GPS), which can be used to gather various behav- ioral and physiological information. Furthermore, most smartphone vendors offer a set of open software devel- opment kits (SDKs), which allows developers to develop novel mHealth applications (apps) [4], essentially transform- ing smartphones into medical kits [5]. The availability of FIGURE 1. Region wise active mobile users. Data source: ITU world telecommunication. sensors in commodity mobiles, along with mHealth appli- cations, allows the real-time accumulation of health-related data which increases the likelihood of an early detection of emergency states enabling a wide range of versatile, convenient, and efficient healthcare services, such as real- time interventions, improved abatement strategies for disease outbreaks and most importantly supporting the movement 11540 2169-3536  2017 IEEE. Translations and content mining are permitted for academic research only. Personal use is also permitted, but republication/redistribution requires IEEE permission. See http://www.ieee.org/publications_standards/publications/rights/index.html for more information. VOLUME 5, 2017