Design and Implementation of an Open Source 'Thin SIM' System for Collecting Data & Supporting Global Health Care

Cutting edge communication technologies such as smartphones remain far from prevalent in most of the settings with the greatest need for improved health and development programs. As a result, designers of ICT4D initiatives often weigh difficult tradeoffs between the usability of smartphone applications for structured data collection versus the battery life, durability, cost and familiarity of basic phones. However, as this paper and our deployment experiences demonstrate, such tradeoffs are not always necessary. Most mobile network operators in sub-Saharan Africa offer value added services via simple, menu-driven applications that run directly from the SIM card. While conventional SIM applications can only be accessed by mobile network operators, this paper describes the design and implementation of a 'thin SIM' approach that does not require mobile network operator involvement. We have implemented this tool with more than 3,000 health workers and describe particular deployment experiences in Kenya, Benin, Nepal and Guatemala. We then reflect on a number of important limitations of the thin SIM approach, and opportunities for further development and deployment. Ultimately, we argue that there is an important role for SIM applications as one part of a configurable data collection toolkit for supporting global health and development programs.