Of the 1.1 billion people in the world who do not have a formal identity, 40% are children under the age of 18 and 78% are located in underdeveloped areas of Sub-Saharan Africa and South Asia (1). A lack of identification means that these individuals are consistently overlooked or forgotten by governments and agencies and ultimately precluded from accessing essential services such as healthcare, education, and banking and ultimately trapped in a cycle of poverty. NGOs and governments are increasingly turning to biometrics as a means of solving this identification challenge, using this technology to authenticate users of healthcare systems (2) and other services that can increase living standards (3,4).
Simprints, a nonprofit technology startup, was created to develop biometric solutions tailored for the world’s most pressing health and development challenges (8). To assess how existing technology performed and to optimise their performance for these settings, Simprints collected over 125,000 fingerprints from poor rural and urban populations in four countries: Bangladesh, Zambia, Nepal, and Benin. It was found that existing biometric technologies failed in populations with high levels of manual labour, as fingerprints became thick and burned over time due to cooking with hot pans, or worn down where farmers were harvesting crops by hand. Systems that recorded <1% error rates in the West often had >10% error rates when used in rural Zambia or urban slums in Bangladesh, and the poorest were at the greatest risk of exclusion. Simprints designed their system against these technical challenges, as well as improving usability for operators with varying levels of education and exposure to technology. Leveraging research at the University of Cambridge, the system can now reliably and consistently identify users in the diverse and demanding contexts of resource-poor settings. The tap of a patient’s finger can now be used to accurately link a patient to their medical history in order to enable continuity of care. Field testing of Simprints biometric system in Bangladeshi health clinics revealed a 1.68% equal error rate (a measure of accuracy for biometric security systems) which functionally decreases to zero when multiple fingers were used.
Simprints is currently deployed across six different countries, supporting high-impact projects in education, maternal health, immunisations, and cash transfers. Simprints’ current research explores the potential of biometric identification for neonates, long considered impossible for children under the age of two. Given that more than one third of births are unregistered and 6.6 million children die of vaccine-preventable diseases each year (6), such technology could have profound implications on neonatal health. Neonate biometrics would enable more efficient delivery of vaccine and nutrition programs, aid distribution, and greater continuity of care. Simprints is also exploring how biometrics can enable real-time longitudinal data collection for monitoring & evaluation, empowering organisations with the tools and data needed to understand, measure and share their impact.
Digital technology is increasingly used to structure interventions in global health and drive impact. When consent, security, and other ethical and privacy considerations are held to the strictest standards (7), biometrics can help ensure mothers are receiving essential health antenatal care visits from community health workers, ensure life-saving vaccines are administered universally, and maintain continuity of care for everyone. With over 1 billion people now enrolled in biometric programmes in developing countries, biometric identification has and will continue to drive powerful interventions in global health and beyond.
References
1. World Bank Group. ID4D Identification for Development 2017 Annual Report. World Bank, 2017.
2. Mordini E, Ottolini C. Body identification, biometrics and medicine: ethical and social
considerations. Annali-Istituto Superiore di Sanita. 2007;43(1):51.
3. Gelb, Alan, and Caroline Decker. Cash at your fingertips: Biometric technology for transfers in developing countries. Review of Policy Research 2012; 29.1(2012): 91-117.
4. Shoewu, O., and O. A. Idowu. Development of attendance management system using biometrics. The Pacific Journal of Science and Technology. 2012; 13.1(2012): 300-307.
5. Storisteanu, Daniel ML, et al. Can biometrics beat the developing world’s challenges?. Biometric Technology Today 2016; 11(2016): 5-9.
6. UNICEF. The ‘Rights’ Start to Life: A Statistical Analysis of Birth Registration. UNICEF, 2005.
7. Hooper B. The case for better privacy standards: why development organisations should comply with the key aspects of the EU data protection regime. Simprints, 2017. Available from: https://www.simprints.com/wp-content/uploads/2017/05/The-Case-For-Better-Privacy-Standards-April-2017.pdf [Accessed 15th January 2018].
8. Storisteanu DM, Norman TL, Grigore A, Norman TL. Biometric fingerprint system to enable rapid and accurate identification of beneficiaries. Global Health: Science and Practice. 2015; 3(1):135-137. Available from: doi.org/10.9745/GHSP-D-15-00010.
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