Mobile technologies have the potential to transform health service delivery across low-income countries around the world. However, 3.7 billion people worldwide are still excluded from benefits of computing technology. To help bridge this digital divide, Arm believes that the technology sector needs to think differently when designing products for developing markets, delivering the best performance economies allow on low-cost devices. Part of this involves designing new bespoke products from the ground up. A ‘one-size-fits-all’ approach to product design based on the needs of mature markets creates products that are not always universally suitable, particularly for the developing world.
This is why, back in 2017, Arm took up the challenge from Be He@lthy, Be Mobile (BHBM)—a joint initiative between the World Health Organization (WHO) and the International Telecommunication Union (ITU)—to collaborate on the design and spec of a tablet for healthcare workers in low-resource settings. The aim of the device was to enable better healthcare services, and provide a permanent, centralized record of the provision of care, as well as reduce the physical burden on workers, who are often obliged to carry very heavy paper ledgers.
Figure 1 The use of mobile technologies has the potential to transform healthcare in developing countries. Source: WHO
Despite the direct design and manufacture of a physical device being outside Arm’s usual remit, we knew immediately that we wanted to be involved in the project to explore and highlight what is possible. Designing such a device to meet these requirements could revolutionize the level of care these last-mile health workers can offer their patients.
Fast forward to 2021 and the project is complete: we have our proof of concept and proved it is technically feasible and of commercial interest. This has been made possible by the tremendous advances in processor technology, power management, and battery technology in recent years. Thanks to these advances, it has been far easier to meet the often-complex requirements of mobile devices in developing markets. Indeed, being involved in this particular project has allowed us to learn a lot about designing for developing markets. Below are seven key lessons.
Lesson 1: Different contexts elicit different product priorities
Depending on the context, something that is deemed unacceptable for a consumer in a mature market may be considered beneficial in a resource-constrained setting. For example, many of the healthcare workers testing our prototype device had limited access to electricity, so they needed a battery that would last three or four days while they were likely to be in the field. This could be achieved through a larger battery and optimized power management software, with a resultant impact on factors such as price and weight.
In a mature market, very few people want a super-sized battery, as this means a tablet that weighs 1 kg. However, in this particular context, a 1-kg tablet would be compared to carrying 10 kg of paper records. Therefore, trading weight for battery life and ruggedness may be a winning formula, particularly when you make the device wieldable, such as through adding a carrying strap.
Lesson 2: Think ahead to future-proof
Designing for resource-constrained settings does not mean going for low-spec. In the case of our prototype tablet, considering future use cases can help extend the working life of the device—something the user and the environment will be grateful for.
Today, our tablet would be used primarily for data entry, updates and recall, which can be done comfortably on a 7-inch screen. However, we expect demand in the near future for on-screen data analytics, visualization, and even telemedicine, which will require a larger, 9- or 10-inch display. Using a larger screen will therefore extend the useful lifespan of the device.
Lesson 3: Ensure your design is fit for purpose
It goes without saying that field testing is vitally important, since there is often a significant gap between spec in the initial design brief and what actually works for the user. It is good to outline your ideal spec, but be prepared to be flexible once you see your prototype in action. For example, we decided to have a large screen and long battery life as product priorities following field testing. Healthcare workers requested the addition of a shoulder strap to keep the device safe in busy settings and help them carry it across rough terrain.
Likewise, understanding the norms and requirements of your target sector will help ensure that your product is viable for its intended audience. The majority of healthcare apps run on Android, so targeting the right operating system is essential.
Lesson 4: Building a bespoke prototype can be expensive, so you may need to compromise
The whole process of building a bespoke prototype can be costly, especially if the manufacturer needs to change from its standard components. A change in screen size and form factor may lead to re-design and incur additional fixed costs due to re-tooling and requirement of new dies and molds. The manufacturer may also need to purchase certain components in smaller quantities—if not used in its other devices—leading to high per-unit cost.
Accommodating manufacturing constraints and arriving at compromises around certain features could save time and money. The pervasiveness of the Arm mobile ecosystem allows for features and components at lower prices, which will help when building low-cost devices for developing countries. Costs can also be saved on thermal requirements as Arm-based CPUs provide high performance at lower power.
Lesson 5: Get outside knowledge and skills
Developing the prototype product was not just an engineering exercise. We had input from a wide range of people and organizations with a broad spectrum of specialist skills to help us. We drew on the field knowledge of BHBM, the development and management experience of Accenture Development Partnerships, pro-bono legal advice from international law firm Bird & Bird, and the technical expertise of Arm colleagues.
People who have the experience and expertise bringing devices to market, particularly in developing countries, know that they must achieve a certain level of compliance and certification before it is considered safe to use. This is where having this specialist knowledge and skills outside of engineering really helps.
Lesson 6: Right-size your business model
Naturally, business models that work for consumers do not necessarily work for businesses or government organisations. In the case of our prototype tablet, device and data bundling offers are ideal for direct consumers, but governments typically prefer to purchase devices and data separately to maintain flexibility and minimize network coverage constraints.
We found that reparability beyond the warranty period and a good repair network were also of vital importance. In fact, reparability is a far more significant driver in purchasing decisions in emerging markets.
Lesson 7: Plenty of opportunities for innovation
Emerging markets present new opportunities to innovate. Innovation may look different in these economies, but the growing number of collaborations by companies around the globe openly looking to share their technologies and ideas is spurring faster innovation and wider adoption.
The prototyping of our tablet for the developing world has shown that it’s possible to develop innovative devices that provide a range of benefits for emerging markets. It also helps bridge the digital divide by giving people access to new technologies.
Figure 2 The prototype tablet is in use at a rural medical facility in Tanzania. Source: Arm
Promising results so far
The initial results of the prototype device’s field tests are very promising. With Arm-based mobile devices already offering multi-day battery life to consumers, it was only a matter of refining the Arm technology within the rugged tablet form factor to maximize this in the prototype. Workers repeatedly commented about the improved healthcare service and the increased number of patients they think the device could help them serve.
While the prototype tablet was designed primarily for the healthcare sector, it has the potential to be a useful device in other sectors such as agriculture, education, field conservation, and disaster relief. We are now sharing the lessons we have learned from this project to help guide anyone that is developing products for emerging markets. We believe this can play a role in helping to bridge the global digital divide and allow more people in emerging markets to have access to key technologies that will help and support them in the future.
Rahoul Varma is director of large screen compute for Client Line of Business at Arm.