Category Archives: Health & Medicine

Technology contributing to VAW

All too often we view ICT4D projects as a means to empower women and minimize the gender divide, and overlook how technology can exacerbate gender issues, such as violence against women (VAW). While ICTs can decrease/stop VAW, it can also be seen as a facilitator, as technology can provide additional platforms for violent action. In order to understand how technology can exacerbate VAW, it must be understood that VAW does not simply include physical violence, but also psychological, economic, and sexual abuse. The MDG3: Take Back the Tech program, which was a project created in 2009 to strengthen women’s rights activists to use technology tools to prevent technology related VAW, categorizes technological violence into 5 broad categories including online harassment and cyberstalking, intimate partner violence, culturally justified violence against women, rape and sexual assault, and violence targeting communities. There are several ways in which violence is committed with the use of technology:

  • Mobile Text Messaging and calling
  • Intimate Photos and Blackmail
  • Mobile Phone Tracking
  • Manipulating Photographic Images
  • Use of Internet to Fake Recruit victims
  • Violation of Passwords
  • Listening and Recording Phone Conversations
  • Monitoring Web Browsing

According to a paper from the Association for Progressive Communications, men are misusing mobile phones to harass and threaten their partners, and even track their partner’s phone to know her location at all times. Technology has added another dimension to the issue of privacy, as men try to gain control of their partners by tracking and monitoring their every move. Additionally, in several developing countries husbands are using intimate/pornographic photos of their partners to blackmail them and gain control. Men have even been known to use fake advertisements to lure women into forced marriages, guess partner’s passwords, and disrespect their privacy by listening to phone conversations.

Technology related VAW is a dangerous and growing problem as technology enables violence by allowing anonymity, automation, affordability, action from a distance, and propagation. Technology does not only provide an affordable and detached way to harm women, but has also made it easier for the offender to remain anonymous, to stalk and monitor their partner, and to create damage that can follow their women around forever. While technology is a promising way to improve gender equality, I think we must not ignore the growing and serious issue of how technology can exacerbate VAW. After reading this paper, I question how we can protect women from technology related VAW.

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Gender Inequality in Côte d’Ivoire

In class today, we had a presentation on gender inequality by Keshet Bachan, a gender equality expert from Israel. Among her talking points, Bachan noted that there are many forms of violence against adolescent woman, including trafficking and prostitution, and that many women who come from poor backgrounds are vulnerable to this sort of violence.

In my country papers for this class, I researched the Francophone West African state of Côte d’Ivoire. Through this research and my interest in this nation, I have learned that it lags behind many of its neighbors in the different ICT sectors and that there is much gender inequality in the state. The government does not invest much money, if any at all, in women’s education or fertility. And along those lines and echoing Bachan’s presentation, female mutilation/cutting is a common practice. UNICEF defines female mutilation as “the partial or total removal of the female external genitalia or other injury to the female genital organs for cultural or other non-therapeutic reasons.” This is particularly a problem in Cote d’Ivoire where a national law was adopted in 1998 to criminalize the activity. It is a problem among people who do not have access to education, the Muslim population and the Voltaïques and Northern Monde ethnic groups, where over 70% of the women are mutilated. Genital mutilation is not only a problem for the obvious reasons of discriminating against and suppressing women, but it also leads to child mortality and makes it easier for adolescent women to contract HIV/AIDS, malaria and other diseases.

Genital mutilation in Côte d’Ivoire is a form of social integration and sometimes a required religious ritual of purification. Seeing that female mutilation was in direct conflict with four of the Millennium Development Goals, (MDG 3: promoting gender equality & empowering women, MDG 4: reducing child mortality, MDG 5: improving maternal health, MDG 6: combatting HIV-AIDS, malaria and other diseases) UNICEF has begun to take action to safeguard human rights in the country. Through advocacy for women’s rights, gender equality and access to education, UNICEF has been able to raise awareness about the issue and help curtail genital mutilation. They have also used nationwide technology campaigns on radio television and mobile phones to establish child protection networks and to empower adolescent and adult women. Between 2000 and 2006, national genital mutilation dropped in females from 44% to 36.4% in direct response to these radio and television campaigns. While we in the United States may scoff at the power that radio has to bring people together and raise awareness about issues, because we are so engulfed with social media and smartphones, radio is showing in Côte d’Ivoire that it is a reliable strategy to achieving gender equality in developing countries.

 


Education and Training to Ensure Sustainability for ICT Applications

In class today we discussed the various ICT applications in all sectors worldwide such as Health, Energy and Environment, Disaster and Humanitarian Aid, Agriculture and Business. It is definitely clear from the presentations that a common challenge each sector faces when implementing ICT’s is proper education and training programs for management and regulation. Education must come from both sides from the outside in, and the inside out. People who are coming into a country must understand that the “One Size Fits All” method has a high failure rate and overall does not work due to the  uniqueness of each developing country. On the other hand, the people within these countries must be properly educated about the changes and new systems created for their benefits. Without proper education about new types of technology (computers, e-Health), new systems (Green spaces, GIS, early warning systems), the sustainability of the projects are at a high risk. Specifically in health education, as discussed by fellow classmates, is one of the more important topics because of the high birth rates that are overcrowding communities and making poverty and hunger more prevalent. By simply spreading necessary health information about pregnancy and up to date information about maternal care, this can be alleviated with just the spread of vital information and filling education gaps in this sector.

In addition, training programs in these sectors help ensure initial successes and positive outcomes (both short term and long term), ensure sustainability for the future and even create jobs for technicians or experts in for a given sector. This would also help create a bottom-up approach to implementation strategies. For the Humanitarian aid especially this is vital because it comes at a high (yet necessary) cost, so efficiency is necessary.

Though money will always be an issue for many of the implementations of new programs or systems for development through ICT, without training and education the sustainability of each and every one is at a high risk. Unless long-term protocols are set in place, the successes of the short term are qualitatively less valuable.


“Smart” Undies

In class on Tuesday, March 18, we spoke about the difference between front office and back office in terms of the potential for ICTs in education. On Thursday we spoke of ICTs for health.  This article is about technologies that keep you away from the office altogether—the doctor’s that is.  Most of these technologies are mHealth technologies, defined by Meredith on her blog here.  There are eight initiatives: “smart” pill bottles, health tracking briefs, ThriveOn for customized mental health help, wearable fall protection underwear, baby monitor clipped to clothes, smart footwear, smartphone thermometer, and Scandu Scout to analyze vitals on your smartphone.  These are all new concepts that were on display at a recent South by Southwest conference.  I am going to analyze the two types of technological underwear.  Pixie Scientific is the company that created the health tracking briefs, smart diapers that contain an indicator panel that tracks UTIs and monitors hydration to prevent disease.  These diapers sound like a great idea for public health, more so than the ActiveProtective underwear with 3-D motion sensors to detect falls.

smartdiapers

However, if Pixie Scientific and ActiveProtective could combine the two?  How amazing!  They would be preventing UTIs by tracking hydration, injury with micro-airbags in the underwear, and a call for help.  The cons to these undergarments would be cost—Pixie Scientifics briefs are disposable and the infant version has been around for a while.  ActiveProtective must be brand new, because there is not any information online yet, but I can’t imagine micro airbags and whatever “call for help” technology is, is cheap.  Pixie Scientific seems to still be in its research stage.  I found a funding project for the program on indiegogo.  The company claims they will use the $21,491 raised to “fund manufacturing, a data-gathering study at UCSF Benioff Children’s Hospital, and another study meant to collect data for FDA registration”.  Mainly these diapers will screen for: urinary tract infections, prolonged dehydration, and developing kidney problems.  According to UrologyHealth, approximately 40 percent of women and 12 percent of men will experience at least one UTI in their lifetimes.  I’m a big fan of these diapers because I’m a public health major, and if they can reach their stretch goals: to search for endemic diseases and screen for early signs of type 1diabetes, that would be a huge deal in terms of promoting higher quality of life through disease prevention.


Knowledge needed where tools are given

David Kulick, ICT and Innovation Program Officer with Johns Hopkins University Center for Communication Programs, addressed a problem integral to the analysis of many development projects. That problem is assuring that when tools or resources are delivered to communities, knowledge of use needs to be delivered as well.

This made me think about our discussions on One Laptop Per Child because this was a case in which large assumptions were made of the connection between a tool and results without anything in between. It may be true that a laptop can be a road towards improving education, but there has to be more to it than just delivery of the tool.

Kulick explained one assumption concerning people’s knowledge of malaria. He noted a project that delivered bed nets to keep out mosquitos, but questioned whether people got the connection between the bed nets and prevention of disease.

One program Kulick brought up as an example of closing these knowledge gaps is The ReMiND Project. Catholic Relief Services partnered with Dimagi, a technology innovator, to provide a service for new mothers to prevent newborn deaths and improve maternal health. The goals of The ReMiND Project are “Phone-based job aids for government community health workers and midwives; Real-time data tracking and SMS reminders to health workers to conduct home visits in the first 24 hours after birth with alerts to supervisors for missed visits; and Mobile phone birth announcements and health messages for fathers to generate demand for services and encourage healthy practices.” (source) This is an example of an eHealth practice to reduce newborn deaths.

The interesting contradiction is in the material I read about The ReMiND Project  I didn’t once come across anyone addressing if the people had a way to receive SMS messages.


ICT For Health and Behavioral Change: An Overview

ICT for health initiatives are widely popular interventions for disease control and prevention in developing contexts, and have been increasingly employed on both the patient side and for medical professionals over the last decade. Approaches of ICT for health cover logistics, telemedicine, supervision, data exchange, medicine reconciliation, and emergency notifications. They are also employed through a variety of mediums, including SMS services, mobile gaming, television programs, open-source software, and even voice and audio applications. Yesterday, David Kulick from the John’s Hopkins Bloomberg School of Public Health related to our class the ins and outs of developing ICT health related initiatives. The Hopkin’s Center for Communication Programs combines forces with the Bloomberg School to formulate projects devoted to changing behavior on a community and individual level, and has been active since 1988 in more than 30 countries. ICT initiatives for behavioral change, as compared with other ICT for health approaches, work to find “new, participatory ways to reach audiences with persuasive messages” that can transform ways of thinking and interacting to make a society healthier as a whole (jhuccp.org). An example of such a CCP program is MAMA, or the Mobile Alliance for Maternal Action. This initiative, which is active in Bangladesh, India, and South Africa, uses SMS during weeks 5-42 of pregnancy and the first year of a baby’s life to inform a mother about antenatal care, nutrition, and even insecticide treated bed-nets to improve health outcomes. These techniques are used by many ICT for health projects, and are an important intervention that can provide beneficiaries with critical information in a short amount of time.

An interesting dilemma facing the ICT for health field is the stratification of beneficiary access, which is in turn reflected in the results of a given project. Mobile phones and televisions are commodities, and the poorest members of a community who made need such ICT interventions the most may not be reached due to cost limits. In addition, gender biases in many societies can restrict women’s ability to use applications; for example, many times a woman’s husband or male family member controls a phone, and a pregnant woman may not be able to view SMS messages concerning maternal health or she may be afraid that the messages will result in an invasion of her privacy. Another key problem with ICT for health applications is an issue that reverberates across development projects in general: their “one size fits all” model decreases their effectiveness in getting at the root of the problem. Mass SMS programs that intend to respond to health queries are not yet sophisticated enough to take into account demographic differences such as sex, age, or economic status, and thus may provide irrelevant and unusable advice to beneficiaries in need. ICT for health programs such as those maternal health applications developed by the CCP have made strides in decreasing maternal and infant mortality, but future health projects should look towards innovations that make applications more individualized towards the recipient. Changing behavioral norms is quite difficult, but ICT has the ability to harness changing technology to find cutting edge solutions to health issues and to apply these lessons to other sectors of development.


MAMA: An mHealth Initiative

mHealth, an abbreviation of mobile health, is a broad term generally used to describe health programs and initiatives operating primarily through mobile devices.  Mobile device use is on the rise, and it is now estimated that up to 85% of the world’s population is covered under some mobile subscription. In rural areas with limited access to physical clinics, doctors, and resources this type of program can have far-reaching benefits. Because of the nature of mobile devices, applications, etc. mHealth initiatives are able to cover a wide range of health topics including general health information, diagnosis, and disease tracking.

To me, mHealth has a huge potential for use in developing nations. While researching the topic, I came across MAMA (Mobile Alliance for Maternal Action). This program operates mainly through SMS messages and simple voice reminders.  MAMA currently operates in 69 countries and reaches nearly 141 million women. Their messages are based on WHO and UNICEF guidelines and provide information about what to expect from their babies at certain ages and reminders to get checkups or vaccines. To learn more about MAMA, check out their website below.

http://www.mobilemamaalliance.org

This is just one of many examples of mHealth initiatives focusing on developing nations. Of course maternal health has always been a focus, but what other ares do you think mHealth could have a major impact in? Do you see any challenges for these initiatives in the future? I think they are a wonderful example of just how much potential technology has in developing nations.