Hayat writes:

Pakistan introduced mobile cellular telephony early, in 1990. Although there was no clear spectrum management policy or roadmap available prior to 2004, the issuance of four mobile cellular licenses and the assignment of spectrum to those licensees were remarkably well thought out.

…In 2003, when action was taken to issue two more mobile cellular licenses, the need for a proper spectrum allocation mechanism and roadmap arose. At that time only 2×5 MHz of the 900 GSM band was unassigned and it was expected that the clear preference of the new entrants would be GSM

…The auction design for two mobile cellular licenses was not ideal but a number of steps were taken to find the winner as quickly as possible instead of focusing on maximising the initial fee…as a result of the regulatory principles, predictability, transparency and clarity of the Mobile Cellular Policy 2004, Pakistan managed to attract foreign investors to participate in the auction.

In contrast, in India, Malik reports that until 2003, all the licences awarded (including the bundled spectrum) had some crude form of market-based price discovery through auctions. However, with growing wireless subscribers increasing the demand for spectrum, it was decided to adopt subscriber-based spectrum allocation criteria as an interim measure, disregarding market-based pricing of spectrum.

Government issued orders on these lines on January 17, 2008, totally disregarding market-based pricing of spectrum. As a consequence and by Trai’s own admission “…several incumbent operators received spectrum beyond the contracted limits free of cost and benefited from the same over several years”.

…However, the most indefensible action of the government in this regard, documented in the press and debated in the Parliament, was not to auction licences in 2008. By allocating 2G spectrum to the licensees in January 2008 at an arbitrarily decided price of Rs 1,659 crore (the price paid by the fourth cellular operator way back in 2001). All principles of efficient allocation of this scarce resource were violated.

…However, there is one window of possibility of cleaning this pricing conundrum. Very soon, many licences will be coming up for renewal. Trai has been reiterating that the contracted spectrum is 6.2 MHz with respect to GSM and 5 MHz with respect to CDMA. The licensee applying for renewal should then be assigned spectrum up to the committed amount as per the current licence. Any additional spectrum that these licensees require to carry out their operations should be priced through a transparent auction.

Read the full articles here (Pakistan)and here (India).

Introduction to research

The project is taking place in Kurunagala and Tamil Nadu. In 24 health sub centres and 4 public Helath Centres in Tamil Nadu and in Sri Lanka in 12 Hostpitals

Disease infomation

• The system architecture
• Determinants of Morbidity in India
• Determinants of notifiable diseases in Sri Lanka

RTBP Communication Technology

• mHealthSurvey mobile application
• T-Cube Web Interface
• Sahana Messaging/Alerting Module

mhealthSurvey Shortcomings

• Certification exercises
• Signal to Noise Ratio
• Real-Time vs Off-time
• Semantics and syntax
• Cost benefits

Objective of the Research

The basic objective was to see if we can collect data and detect and report the outbreaks.

Specific Objectives:

• Evaluating the effectiveness of the m-Health RTBP for detecting and reporting outbreaks
• Evaluating the benefits and efficiencies of communicating disease information
• Contribution of community organization and gender participation
• Develop a Toolkit for assessing m-Health RTBPs

The Data collection is done by Health workers and goes through the mHealthSurvey mobile phone software to the Epidemiologist for spatial and temporal analysis done using T-Cube Web Interface before going to the Sahana Alerting Module Interface and then agian to the health workers.

A sequence analysis of the functions that is happening and their was no purpose but a formal process. By using technology we can use the information is transfers more efficiently. In India the delay is minimised to minutes from 7-30 days. In Sri Lanka from 15-30 days into minutes.

RS: Amount of data has to be reduced with this?

NW: The answer is NO

SL: In Sri Lanka process the technology is jumping several steps?

NW: Because of the number of people visiting the doctors and the doctors do not get the chance to diagnose . And with this process most of the unnecessar repetitive procedures are omited. Hence we can jump (Please see the slides attached)

Regarding the mHealthSurvey software design. It’s built on Java 2 Micro edition and works  with CDC 1.1 and above (JSR). It works with MIDP 2.0 or above and use GPRS to transfer data. The software is tested on Nokia3110c, Motorola SLVR L7, Gionee v6900. Amoi A636, Sony Ericsson s302c.

The application also helps the health worker to enter the records accurately, said Chamindu when demonstrating the software.

Data collection process is done when the patient comes and meets the nurse, nurse gives a diagnosis chit which will be filled by the nurse and the doctor will fill the chit with diagnosis and treatment, then the data entry officer will digitized the data and submit. In Sri Lanka it’s real time but in India after working hours.

RS: Can they read the hand writting?

CS: Yes most of the are pharmacist , so they can read the doctors hand writing.

T-Cube Web Interface [Auton Lab] give the following features

• AD Tree data structure
• Trained Bayesian Networks
• Fast response to queries
• Statistical estimations techniques
• Data visualization over temporal and spatial dimensions
• Automated alerts

The software also generate the Epidemiological  report instantly, when regular database take days to generate.

Messaging/Alerting CAP/EDXL Broker [Sahana] – The feature

• Single input multiple output engine; channeled through multiple technologies
• Manage publisher /subscribers and SOP
• Adopt PHIN Communication and Alerting Guidelines for EDXL/CAP
• Relating the template editor with the SMS/Email Messaging module
• Do direct and cascading alert from a regional jurisdictional prospective
• Designing short, long, and voice text messages
• Addressing in multi languages

People are actually using this to send alerts. The detect the disease and the doctors who are responsible will have to send the alert to respective individuals. Currently it have short and long Common Alerting Protocol (CAP) messages. In future it will adopt voice CAP messages to send messages.

SL: What is someone hacked and send wrong information?

CS: We also do comprehensive message. The health workers are trained on how to act on suspicious messages.

NW: Sender name, Source will make the receiver to verify the alert.

RS: This is something to mention as this shows that we are not behaving like a normal project based organization but we are connecting and building on the project. Also what is the level of the person who can issue alerts?

NW: Medical officer of Health, Regional Epidemiologist, and Public Health Inspector

Evaluation metric verticals and horizontals

• Three verticals – data collection, event detection and reporting
• Four layers – social, content, application, Transport
• Arrows showing the Interoperability between layers and verticals
• Objectively assess by calculating various indicators: costs, efficiencies, error rates, etc
• Subjectively assess through interviews and simulations

SL: Perhaps the social level should be changed?

RS: Should be user level

NW: Social looks at more institutional problem

RS: then make it institutional

A small certification exercise was done. It was benchmarked against a standard that was derived, with Sri Lanka and India regarding the use of the software. And accordingly they were certified on their ability to use the mhealthsurvey. Sri Lanka was better and most in India they failed. However now they should be quite efficient as it’s being a year.

Signal and noise ration: In India the noise is very low and data was clean.  and during holiday there were no data. In Sri Lanka there was a friction.  However we managed to get the approval and the data came in. And with lot of pushing the data came in but lot of noise in the data. agian in the holidays no data came in.

Off-time vs Real-time: Real time is when people will be sending the data at least within the day. In India most of them do send the on the same day but most of the occasion they send it the next day. In Sri Lanka the Health workers did not want to disturbed when at work. Hence they did it in the afternoon.

There were problems in terms of entering the data. As they make mistakes and enter other symbols. Also local language (they use different terms) , UK/USA spellings,  different adjectives are few problems regarding entering the data.

mHealth dala collection lessons as a  summery

For India

• Nurses sending data
• Near zero noise because impacts their work
• No time to enter data patient care  and routine work comes first
• Under reporting to avoid extra work
• Improvise mHealthSurvey for collection and reporting of other
• Older slow to learn
• No prior experience beyond voice
• Resolve technical problems on their own
• Replaced handsets on their own

For Sri Lanka

• Outsourced data entry clerks
• No incentive because 1) lack of knowledge 2) not direct impact
• Data entry is their only job
• No strings attached with reporting quantity
• Nothing like that
• Young were quick to learn
• Knew all capabilities of mobile
• Resolve technical problems on their own
• Replaced handsets on their own

Cost benefits are as follows

• Both India and Sri Lanka spend on data collection now
• For half the cost RTBP can introduce collection of a richer data set along with detection and alerting components too
• Operational expenses are the bulk of the costs
• RTBP can shrink the capitol expenses in India
• Its the filing cupboards and none ICT based delivery that eat up most of the cost

SL: I would highlight the fact that the OPEX and CAPEX is not the same for RTBP Sivaganga.

mHealth can fix the imbalance:

• Ideally health facilities should be powered for data collection, health departments for detection and alerting, with health workers fully on response
• Both in India and Sri Lanka its all data collection and  almost zero resources on detection and mitigation.
• Sri Lanka – health departments consume bulk of the resources

RS: Now we are getting to the e-gov and it’s better if you talk to Helani and Chanuka on this.

Conclusions

• mhealthSurvey is a worthy candidate for patient disease/syndrome digitization
• However, must be improved to minimize the noise and delays
• Need a better GUI if Medical Officers are to enter high volume real-time data opposed to a data entry clerk
• Need a compete and comprehensive standardized disease syndrome ontology
• Need to investigate other digitization techniques

Click for the full paper

However, there is one window of possibility of cleaning this pricing conundrum. Very soon, many licences will be coming up for renewal. Trai has been reiterating that the contracted spectrum is 6.2 MHz with respect to GSM and 5 MHz with respect to CDMA. The licensee applying for renewal should then be assigned spectrum up to the committed amount as per the current licence. Any additional spectrum that these licensees require to carry out their operations should be priced through a transparent auction.

Rohan Samarajiva, CEO of Lirne-Asia, has been a long opponent of USO funds and has often stated that they are a waste of money which distort the market, and that USO-type projects should be funded from central budgeting process instead.

However, Samarajiva makes an exception for Pakistan which has succeeded in pushing out USO funds. Other countries are good at collecting money, but not spending. $4 billion (130 billion baht) is locked up in USO funds in Brazil and an equal amount again in India. Seventy five percent of the USO money is stuck in governments, unspent.

The Pakistani model is different as it has private participation in its governance model. Iftikhar said that 50 percent of his board is from private operators and the charter is such that the board is not complete if even one of the private sector members is absent.

The USO is also registered as a company rather than part of the regulator, which makes the decision-making process much faster.

The Grand Trunk Road, which covers a distance of 2,500 km today, says Wikipedia, is one of South Asia’s oldest and longest major roads. For several centuries, it has linked the eastern and western regions of the Indian subcontinent, running from Bengal, across north India, into Peshawar in Pakistan. The road also passes through the only road boarder between the two most powerful South Asian nations, Wagah.

Wagah border point, often called the “Berlin wall of Asia”, is a ceremonial border where each evening there is a retreat ceremony called ‘lowering of the flags’. At that time there is an energetic parade by the Border Security Force (BSF) of India and the Pakistan Rangers soldiers. Troops of each country put on a show in their uniforms with their colorful turbans. Border officials from the two countries sometimes walk over to the offices on the other side for day to day affairs. The happenings at this border post have been a barometer of the India-Pakistan relations over the years.

Rohan Samarajiva, a recent visitor to Wagah, having inspired by a strange signal from above, proposes a better link to make the two nations closer, in Financial Express, India.

Interestingly, while in India, a telecom operator has to contribute 5 per cent of its annual revenue to the USO Funds, Pakistan charges much less at 1.5 per cent. In India, the funds go to the national budget and the Department of Telecommunications has to make projects to source them, in Pakistan a separate company has been created to utilise the funds.

The journalist also points to a new twist whereby renewable energy has been made mandatory for all base stations supported by the Fund.

In a bold move, the Pakistan Telecom Authority, the telecom Regulator has made it mandatory that all bases stations being set up with support from the USF should be ‘Green Sites’ or renewable energy powered, especially solar and wind as the case may be. The reason being that there is currently, a huge shortage of electricity in rural Pakistan.

One hopes India will take what is good from the experience of others, even Pakistan.

Rohan Samarajiva is in Pakistan. Near the border, once marked by Mountbatten’s sharp knife, his cell phone links him to India. Airlines do not understand this proximity. Indian participants, to Expert Forum Meeting jointly organized by LIRNEasia and Pakistan Regulator, first travel led west (3 hours to Dubai) and then east (another 3 hours) to cover 678 km between Islamabad and Delhi – a one hour flight if existed.

In the backdrop of Thimpu SAARC summit Rohan asks the same question he has been asking for sometime. (But this time in Bangladesh media): Can’t telecom bring these South Asian cities closer? Should they remain artificially distanced?   

Read the article here.

Far more people in India have access to a mobile phone than to a toilet, according to a UN study on how to improve sanitation levels globally.

India’s mobile subscribers totalled 563.73 million at the last count, enough to serve nearly half of the country’s 1.2 billion population. But just 366 million people — around a third of the population — had access to proper sanitation in 2008, said the study published by the United Nations University, a UN think-tank.

“It is a tragic irony to think in India, a country now wealthy enough that roughly half of the people own phones,” so many people “cannot afford the basic necessity and dignity of a toilet,” said UN University director Zafar Adeel.

Full story.

A full webcast of the event can be viewed here.

View the full presentation here.

Starting in around 2013, points Rohan Samarajiva, Bangladesh will enter the best period for realising the demographic dividend, with the lowest levels of combined child and adult dependency in its history. It will be the closest to the ‘pot’ shape. This golden period will last until around 2033 when the more burdensome adult dependency (ratio of adults over 65 years of age to the working population aged 15-65 years) reaches significant proportions.

What does this mean to Bangladesh? How can that be exploited?

It is here that information and communication technologies can make a difference. In the past, only agricultural and manufacturing goods could be exported. Now, thanks to telecom, even services can be exported. Bangladesh is currently said to have 30,000 persons working in the Business Process Outsourcing (BPO) industry.

In 2005-06, it was estimated that India created 1.3 million direct jobs in the IT and IT enabled services sector, with another 3 million jobs created indirectly, to serve the industry. The proportionate numbers for Bangladesh, which has one-seventh the Indian population will be 182,000 direct jobs and 421,000 indirect jobs.

Read the full article in The Daily Star.

Other notable speakers at the event include Dr. Jonathon Donner of Microsoft Research, India, and Prof. Tim Unwin of the University of London.

“This is one of the highly effective tools for achieving financial inclusion. But the system is suffering because of the lack of interest among government agencies. There needs to be a policy change to take the model further and make the system financially viable,” says IIM-A Professor and LIRNEasia‘s Senior Research Fellow, Subhash Bhatnagar, PhD.

The research is a part of a larger study conducted by LIRNEasia on the use of mobiles for more-than-voice.

Read the full article here.

The trick for Bharti, which pioneered low-cost telecoms in India, will be to bring down Zain’s high cost base and win subscribers, say analysts — and to get subscribers to talk more using lower tariffs.

Bharti is famous for its so-called “minutes factory” business plan — the low-cost, high-volume model that has made it India’s leading mobile company.

Mittal said Bharti expects to be able to “substantially increase usage” and sign up more callers that would boost call traffic and improve margins.

Bharti’s strength is “bringing down costs of operations and prices”, said Romal Shetty, head of Indian telecom at global consultancy KPMG.

In case licenses are not de-linked, there will be rollout obligations. Some analysts suggest penalties to be enforced, like taking away extra/unused bandwith for spectrum that is not used optimally. According to Kunal Bajaj, MD, BDA Connect, “Open auction will remove all these problems. Adequate spectrum will be allocated to the best player. However, there should be local benchmarks like existing players should get the first right of refusal.” According to Malik, “There should be no restriction on services as this inhibits competition. In fact, licenses should be given free, as they are meaningless without spectrum. After trading or auctions, those players who have enough spectrum should be allowed to use it the way they want.”

In this scenario, Tata Teleservices has suggested the formation of a spectrum pool, wherein players can pool their extra spectrum and trade it in a free and fair market. Furthermore, it is argued that currently a large chunk of the spectrum is being wasted as each operator requires start-up frequencies as well as guard frequencies to ensure that there is no interference between networks. “The concept of introducing a single radio frequency (RF) network based on the maximum available spectrum and controlled by an independent body will address this problem of scarce spectrum. It will provision the RF network in such a way that the complete spectrum is available to operators a on-required basis. This will resolve all the contentious issues related with spectrum, and provide an efficient RF network to all the existing as well as future service providers. This concept will drastically reduce the capital expenditure and operating expenditure of individual operators, and result in the most efficient use of the available spectrum,” it said on its official website.

Malik explains, “I am in favor of re-sale of spectrum. However, it depends on the micro market structure of pool for resale.” However, according to Satyen Gupta, “Whatever spectrum you can afford to put in a pool should be de-linked from license, as this procedure cannot work while being linked to a license.”