Tag Archives: healthcare

Critical Thinking About ICT4D: A Case Study

As mentioned in our lovely textbook, the Intermediate Technology Development Group, now known as Practical Action, is one of the few programs using ICTs to provide the information needs of the poor people, not the donors.  The reason most projects do not focus on the demand side is because “people cannot ask for things of which they are not aware or have not yet experienced.” (Unwin, 57).  The important point to take from this blog post is that there are similarities in the needs of the poor in different countries, but there are also significant local differences in need and ability to gain access.

Therefore, with no further ado, let me introduce you to this organization by asking you to watch this hilarious two minute video on what they do in Peru, then we will move on to a case study in Zimbabwe (my country for this class)!

If you don’t want to watch the video, here is a short description of the organization: it is an NGO that uses ICT to challenge poverty in developing nations.  Enable poor communities to build their knowledge and produce sustainable solutions for things like energy access to climate change to enabling producers to create inclusive markets.

In a rural community in Zimbabwe, residents now have electricity, unheard of in most rural areas of the country. This is due to the implementation of a micro-hydro generator constructed by Practical Action Southern Africa, funded by the European Union.  It has provided life-changing scenarios in basic education, sanitation, and healthcare, not to mention the ease of television to receive the local news.   Before, one farmer had to travel 64 kilometers (39 miles) to find out the current market prices.  What is so very neat about this case study is that it is very sustainable (as well as renewable and good for the environment), meaning that this community can fix the system themselves and enjoy significant improvements in their lifestyles and prosper from their electricity supply.

Empowering poor individuals and marginalized communities is what one main goal of ICT4D should be, and this organization is a good example of an “appropriate balance between supply and demand, between the aspirations of those seeking to implement the initiative and the needs of those who will be using and implementing them.” (Unwin, 70).


The World Wide Battle for Health Care

health-care-resuscitation-1

This week in class we have been reviewing the role of ICTs within the health and wellness sector, as well as within the governance and government sector. The quickly changing political, technological, and medicinal landscapes not only within the developing world but within the highly developed world has meant progress in many arenas in terms of facilitating and reforming public health. It has come to my attention that since a large portion of aid and inter-sectoral projects to these LDCs has been within the purview of public health, it seems necessary to evaluate those very states that serve as the ‘examples’ of the very systems that hundreds of governments, agencies, businesses, non-profits, and NGOs are anxious to ‘replicate’. Obviously, no one state or system could possibly hold the key to the best method of administering/ overseeing the production of universal health to its citizens… or does one? This is the very question that I wish to explore and fuel with ample evidence and testimony from the field.

I also feel it would a be a disservice to this particular post, as this weeks’ posts are designed to reflect the appropriate subject area, if we do not mention the current and lively debate that is occurring within our own United States of America as the Obama administration carries out its implementation of healtcare.gov and the Affordable Care Act (aka- Obamacare).

My aim this week is to provide as many sources, documentaries, videos, op-eds, and expert testimonies as possible to provide a synthesis of data for our class to have either an in person or digital debate/conversation as to what kind of health system we feel will eventually be most effective in these very nations, tribes, communities, cities, mega-cities, and families that we all study so intently and care so much about.

I invite everyone to post and share their own reflective opinion after reading and watching what is available here to develop a well-informed, lively, and engaged discussion for this blog. Enjoy!

Op-Eds:

Ross Douthat, The New York Times, “But What if ObamaCare Works?” 10/26/2013

C.H., The Economist, “Why the Hysterics over Obamacare’s Software Glitch?” 10/23/2013

The Financial Times, Special Report: Global Health Policy, 8/01/2012 (link to a pdf)

Michael D. Tanner, The Cato Institute, “The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World“, 3/18/2008

T.R. Reid, The Washington Post, “5 Myths about Health Care Around the World“, 8/23/2009

T.R. Reid, PBS: Frontline, The Four Basic Healthcare Models

John McDermott, The Financial Times, “What healthcare.gov could learn from Britain“, 10/22/2013

Interviews:

Professor Uwe Reinhardt, Health Economist, Princeton University, 11/10/2007

Ahmed Badat, M.D., General Practitioner, Shepherds Bush Medical Center London

Prof. Karl Lauterbach, Health Economist and Member of the German Parliament, 10/25/2007

Prof. Naoki Ikegami, Health Economist, Keio University School of Medicine

Pascal Couchepin, President of Switzerland, 10/30/2007

Nigel Hawkes, Health Editer, The Times of London, 11/1/2007

David Patterson, M.D., Consultant Physician and Cardiologist, Whittington Hospital, London

Reports:

l’Organisation mondiale pour la Santé, Research for Universal Health Coverage, World Health Report 2013, August 2013 (PDF english) (PDF français) (PDF español)

Michael Tanner, The Cato Institute, Policy Analysis, “The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World“, March 18, 2008 (PDF english)

World Economic Forum + McKinsey & Company, Sustainable Health Systems, January 2013 (PDF english)

OECD, Health at a Glance 2011, OECD Indicators, November 23, 2011 (organization has reports on specific regions and countries as well)

Videos + Documentaries:

PBS: Frontline, Sick Around the World, April 15, 2008

One.org compiled list of 52 youtube videos about Global Public Health

Even More Resources:

PBS: Frontline resources for their special addressing international and domestic issues here


The Importance of ICT Accessibility

When I first approached the subject of ICT4D I was somewhat skeptical of the immediate need of information and communications technology in developing countries. I figured that programs focusing in on healthcare, education, and gender equality are more important to the developing world. However, through this week’s lecture and a recent article on RYOT.com, I realized that it is through the use of ICTs that these three ideals are able to be promoted and sustained.

During this week, we discussed that one of the main problems with the spread of ICTs is the difficulties of accessibility. Without proper devices or nearby locations to access such technologies, there is little hope for ICTs to spread and help develop these countries. In order to fight this obstacle, Earth Institute Director Jeffery Sachs has pledged to train 1 million health workers in sub-Saharan Africa. This new campaign provides workers ‘mobile phone and broadband access to sophisticated medical resources’ in order to deliver health care to the rural poor.

Jeffery Sachs, along with Rwandan President Paul Kagame and Novartis CEO Joseph Jimenez announced the campaign earlier this week, and have hopes to ‘equipping and deploying one million health care workers by the end of 2015’ across sub-Saharan Africa. This pledge of ICTs to rural Africa will have huge impacts on these countries which are plagued with disease and have high maternal and child mortality rates. Through the accessibility of such simple technologies, the largely incompetent health care services in sub-Saharan Africa have the potential to develop and modernize.


FrontlineSMS: The Impact of Open Source Tools for Development

Through Mission 4636, 80,000 earthquake victims throughout Haiti were able to solicit help via text message. What’s most astonishing about the project is not the large number of people it was able to help, but the speed at which it was set into motion. From conception to launch, the Mission 4636 came together in a mere 48 hours. People from 10 organizations from around the world dropped everything to build the best platform possible. Among these organizations was one that caught my eye, Frontline SMS:medic, whose director was responsible for obtaining the short code “4636” for the project.

Frontline SMS:medic is one of many programs that utilizes the FrontlineSMS free software program. Through FrontlineSMS, users can text large groups of people anywhere there is a mobile signal. FrontlineSMS enables instantaneous, two-way communication on a large scale by utilizing computers and mobile phones—two technologies that are available to most NGOs. This means a laptop plugged into a cell phone can become a low-cost communication hub. Frontline SMS makes use of open-source software to support development services across the globe and provides easily implemented solutions to many communication barriers in developing countries.

FrontlineSMS:medic is one of the most successful initiatives of the 5 FrontlineSMS programs (others are credit, learn, legal, and radio).  It utilizes FrontlineSMS to improve and extend healthcare delivery systems by helping health workers communicate, coordinate patient care, and provide diagnostics using appropriate cost-effective technologies. The pilot program was launched in 2009 to great results: in six months, hospital workers saved 1200 hours of follow up time and an accompanying $3000 in motorbike fuel. In less than one year, FrontlineSMS:Medic grew to 1,500 end users who were serviced by clinics seeing approximately 3.5 million other patients. Growing from the first pilot at a single hospital in Malawi, programs were subsequently established in 40% of Malawi’s district hospitals and the software was introduced in nine other countries, including Honduras, Haiti, Uganda, Mali, Kenya, South Africa, Cameroon, India and Bangladesh.

FrontlineSMS demonstrates the importance of building upon and implementing open source tools to serve end users and achieve impact in the field of development. For complete information on FrontlineSMS click here. For complete information on FrontlineSMS:Medic click here.


Text4Health: More effective in the states than in Developing countries?

One of the articles we read this week, Found Here, “Text4Health: A Qualitative Evaluation of Parental Readiness for Text Message Immunization Reminders”, by Olshen Kharbanda and colleagues, takes note of some of the challenges of and successes of Text4Health initiatives. This trial in particular, took care to; send text messages in both spanish and english to reach a wider audience, as well as including a wide demographic of ethnicities and educational attainment levels. Yet, most of the people they drew statistics from were based in an urban area, and it does not address the cost and difficulty of using cell phones for older parents who aren’t as well acquainted with similar technologies, and extremely low income families who do not have access to multiple cell phones or even one cell phone.

The article also noted that reminders about vaccines should be simple, short, and personalized- this would definitely be more effective, yet is not practical for a huge mass vaccination campaign. Another thing to consider is that if the texts sent are simple and short, simply getting across that one or more family member is due for a vaccination, doesn’t underscore to a family that does not have a lot of access to healthcare services or healthcare information, the important of getting a vaccine in a child’s life, and what the consequences could be if the kid did not get vaccinated in time. It also doesnt take into consideration issues that would be at the forefront in developing countries- whether there is enough infrastructure for the family to reach a healthcare provider, whether the specific vaccine requires multiple visits, which may not be possible, and whether in order to get their child to the clinic, if the parent will miss a day of work (meaning a day of productivity, and a lost paycheck). Large  international organizations like WHO have started utilizing door to door vaccination campaigns, taking out the middle man and making sure that each and every person is vaccinated. This would be effective on a small scale, but on a larger scale, a text4health initiative might be able to reach a broader audience- if that audience can access the right technologies and can access the vaccines themselves.


Midwives with Mobiles: A Qualitative Study

While researching Indonesia’s National ICT policy, I came across several articles discussing individual programs and case-studies in Indonesia. One excellent article, that I think serves as a great case study, is Midwives with Mobiles: A dialectical perspective on gender arising from technology introduction in rural Indonesia. The paper is clear, concise, and provides both useful background on ICT penetration and gender in LDCs as well as specific information on the use of mobile phones is post-2004 tsunami Indonesia to increase access to and between community healthcare workers, specifically among females. Although the paper identifies itself primarily as being concerned with ICT4H(health), as students of Development we share the same concerns, obstacles, and goals as the authors.

The World Vision pilot sought to rebuild and improve the healthcare within the rural Indonesian province of Aceh. The region’s already inadequate healthcare system was severely debilitated by the 2004 tsunami, which wiped out most of the front-line healthcare relied on by Aceh’s impoverished rural communities. Mobiles were given to midwives, who were then able to connect to patients, doctors, and each other to improve quality of care by increasing access and decreasing the wait period for transmission of time-sensitive information. The linked paper is a qualitative study based on patient, midwife and doctor interviews that seeks to recognize and remedy the inefficiencies and failures of the program, which suffered from limited mobile use and acceptance due to cultural, socioeconomic, and gender constraints between patients, midwives and doctors not accounted for in project deployment.

The paper’s bibliography is an excellent jumping off point for further study, as it directs readers to a number of scholastic sources both general and specific. I would recommend this paper to anyone with a particular interest in the intersection of gender and public health, especially as relates to ICT.


Equal Opportunity Healthcare Emerging from ICTs

Gone are the days of going to a doctor’s office– today we live in a world where it is possible, and feasible, to access professional health care services through the comfort of your own home. The field of telemedicine, which is a specialized branch of the broader telehealth category, seeks to improve patient health by opening a two-way communication channel between patient, and provider, no matter the distance.
What used to be seen as an expensive, futuristic way of delivering services has now grown to a common, more cost-effective manner than traditional face-to-face physical examinations. Supplementary technology services, especially video conferencing, that build upon existing radio/mobile telephony ICTs have been key to the growth of telemedicine. Telemedicine uses a unique combination of the following three sects to provide real- time consultations, testings, monitoring and medical procedures over geographical barriers: 1. Remote Patient Monitoring (RPM) 2. Patient Data Storage and 3. Interactive telemedicine.
In recent years, RPM has grown rapidly, allowing for substantial decreases in health care costs. More sophisticated devices allow patients who suffer from chronic diseases to transmit information, like blood pressure or sugar levels, to a central monitoring station from which a doctor can review it and stay up to date with his patient’s progress from virtually anywhere, any time. This data taken from RPM is kept stored in a network of numerous pieces of equipment, each with a unique storage feature. Data stores combine to form a patient’s complete medical history which is able to be backed up, secured, and forwarded to necessary personnel. Telemedicine then employs the use of interactive features, like video conferencing, to allow for a real time patient to provider or provider to provider communication.
Telemedicine has shown promise, especially in places like Kenya, where often times patients die not from their ailments, but rather from misdiagnoses and subsequent mistreatment. Providers can connect with their colleagues in order to ensure a proper diagnosis and correct course of treatment. This is especially helpful when looking at the skill and training gaps between doctors in developing nations and doctors in more developed ones. In this sense, good health care becomes available to those who previously suffered unnecessarily at the hands of poorly trained physicians.
Of course, there are still issues of accessibility in accordance with a nation’s networked readiness, but the future of telemedicine looks bright as we continue to shift our everyday lives more and more towards technological reliance.