Tag Archives: Tanzania

Health Management Systems Rolled Out in Tanzania

North-Star-Alliance-Kahama-COMETS-Training

In preparation for my health sector presentation next week, I decided to examine how ICTs can be used to improve health in a developing country. But since I have already done a blog post on the Cariopad in Cameroon, a front office technology, I will focus on the back office application of ICTs to improve health system management in Tanzania. “Back office applications,” says Richard Heeks, “help better planning, decision-making, and management” (Heeks ICT Manifesto 2005). After writing my national ICT policy analysis, I learned that healthcare affordability for the patient alone doesn’t improve the overall level of health of a country. The affordability and efficiency of health systems for doctors and hospitals to treat more people at higher quality improves the overall development of the health sector in the long term. For this reason, I will focus on health management information systems in Tanzania.

There have been many ICT health-focused initiatives in Tanzania since the Ministry of Health and Social Welfare (MoHSW) proposed a strengthening of the country’s health information systems (HMIS) in 2000. Two such initiatives, Telemedicine, and eRCH4BC, are examples of how technology can be used to increase communication between doctors and community health workers to treat patients with severe cases who reside in places far from specialists or high quality health care.

Telemedicine in Tanzania enables doctors in remote areas to consult specialized doctors with healthcare expertise and resources in the cities for better diagnoses. “People who can afford it come to cities for their health care in huge numbers and at enormous cost. Telemedicine is beneficial for patients, because they can get specialist consultations and treatment in their own hospital.” Doctors are able to exchange medical data, still images, x-rays, live video and audio over the Internet to a panel of expert doctors in cities. Within a short period of time, they come up with the results and tell the rural doctors what to do. Dr. John Materu of Kibosho Hospital says, “Referral is easier when you can tell the patient the advice that you have got from a specialist-doctor on the right treatment” (IICD video). In terms of efficiency and cost-effectiveness, Telemedicine has the power to transform health development by cutting costs for patients and extending the knowledge of specialists. It seems to be financially sustainable since the Internet-based software is free and training manuals are easily adopted online or through visits from Telemed training institutions. My concerns about the project are the privacy and safety of patients’ information since it is discussed online by a panel of doctors. Also, if the Internet is down for an extended period while someone is in critical condition, there should be a back-up method of communication that doesn’t rely on Internet. Since the project has been able to push funding past their two-year pilot into Phase 2, hospitals are asked to provide funding from their own resources, which also could be a hindrance. Overall though, I am optimistic that Telemedicine is the key to improving HMIS and patient health care in remote areas.

Since I provided a comprehensive review of Telemedicine, I will go into less detail with the second health-focused ICT initiative. “eRCH for better care” was a joint pilot project between Spider and ITIDO from 2011 from 2012 with the objective of improving reproductive and child healthcare systems through ICT intervention in the Rufiji district of Tanzania. Amongst other RCH challenges, e-RCH4B aimed to solve the lack of antenatal check ups and lack of support for community health care workers (CHWs) in rural areas. To solve the former, an electronic record keeping system with both mother and child’s health data made check-ups easier and enabled data transfer data between facilities upon referrals. For the latter, eRCH4BC provided CHWs in with “Tele-maternal,” like to telemedicine but only for mothers, to identify danger signs of women and children “so CHWs can advise them to go to nearby health facilities for more professional care.” It is  significant that civil society recognized the lack of formal education that CHWs have to provide new and expecting mothers accurate diagnoses. I hope the Tanzanian government will catch on too. Although Spider has not yet released the project’s evaluation, I am glad to see initiatives addressing fatalities that could be prevented with ICTs.


Sometimes ICT Projects Fail

It is hard to admit when something doesn’t quite go as planned, especially when money and time are invested. ICT projects, for example, only succeed about 30 percent of the time. However, it is important to learn from mistakes and help the rest of the ICT4D community avoid the same errors. This is why it is important to say that you failed and discuss what went wrong. In December of 2012, Ben Taylor from Daraja gave a talk about lessons learned from an ICT project that had failed.

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In 2010, Ben and his colleagues set up a program in Tanzania that rallied citizens to put pressure on local authorities to fix broken water pumps by using mobile phones.  Local communities were asked to use SMS messages to report the state of the water supply to the authorities. They also informed local radio stations to observe any action that the water authorities were going to take in response to the text messages. This program received a lot of national attention before it was launched; however, after the launch only 53 text messages were received. This disappointed Ben and his colleagues, who were assuming that more than 3,000 text messages would be received.  When they looked into the reasons for the program’s failure they came up with 3 major problems. The first was for political reasons; since the relationship between the local communities and authorities was sensitive, the citizens did not feel comfortable reporting on their government. The second reason was gender-specific, as women and children were often the ones who were collecting the water and they did not have access to mobile phones. The third reason was that there was limited mobile network coverage and electricity in the villages. Ben and his colleagues shared the reasons for failure on the web and in leaflets in order to prevent others from making the same mistakes.

The reasons for failure in Ben’s project correlated well with the documentary that we watched in class.  For example, I do not think that sufficient research was done on the area where the project was going to be launched. The reasons for failure -politics, gender, and access- would have been noticed if time was spent researching the area. In development projects, it is common for people from the developed world to go into a country and decide what the country needs and how to do it without consulting anyone from the area. This is why many development projects fail. Without truly understanding a community, it is impossible to know what is best for them. I believe that the only way to implement a sustainable development project is to live on the ground and make yourself a part of the community. That way, you will be able to see and hear what would actually make a difference in their lives.


Kenya Launches National Cyber Security Strategy and Master Plan

The arrival of extensive undersea fibre optic cables in mid-2009 have spurred a major ICT revolution in East Africa with Kenya in the lead and Tanzania following close behind. The transition to broadband has spurred rapid growth in the number of Internet users and increased access for many to cheap Smartphones. Kenya has also been able to achieve faster broadband connection than their counterpart in South Africa. IBM even chose Nairobi for its first African Research Lab.

So, what does all this rapid progress mean for exposure to cyber attacks? More is at stake.

Cyber attacks could be devastating to a developing country on the path to a better future like Kenya. With the ever-increasing reliance upon and use of ICTs to enable more development, comes greater risk. Security problems like the defacement of government websites offering important services as well as attacks on the Banking sector, plus many others can be devastating in developing countries. “The use of ICT in many industries means that national infrastructure such as water companies, power infrastructure, banking and payments are exposed to ICT threats.” (Dennis Mbuvi, CIO/East Africa)  For these reasons, Kenya just recently launched a National Cyber Security Strategy and Master Plan in February of this year:

  • In a nutshell, the Strategy will enable the government, private sector and Chief Security Officer to “[come] up with a national cyber security assets inventory and [establish] approved cyber security vendors.” (Mbuvi)
  • A data protection bill is also in the draft
  • a consultant behind the plan, Tyrus Kamau, says “that its implementation will see better cyber security in the country, which will in turn lead to confidence in electronic transactions, resulting to economic growth. The move will also ensure confidence as the government rolls out various eGovernment services.” (Mbuvi)

Since I wrote my paper on the role of eGovernment in Tanzania, especially with regards to its role in establishing trust among citizens, I see huge potential in the implementation of a policy like this, especially in the rapidly developing ICT sectors in East Africa. I also think it’s interesting how what Kamau said is clearly where the benefits of employing an early plan for cyber security can be seen in developing versus developed countries.  In countries like Kenya and Tanzania there is the need to establish  trust and confidence from consumers who have been living for so long without these services, whereas in more developed countries like the U.S., the biggest threats are less of a concern to the public who is generally unaware so far of their [cyber attacks’] potential consequences. In my opinion it speaks volumes on the need for both developed and developing countries to establish comprehensive plans because regardless of their development levels, cyber threats/attacks can be detrimental to both of their economies, peoples’ livelihoods and overall safety.


Health Education through Entertaining Radio Programs

In this week’s reading, “Why Radio Matters,” Dr. Mary Myers highlights a list of reasons and examples why radio is “the most widespread mass-medium for the developing world.” One of these reasons was that radio has the potential to educate and entertain its listeners. Myers then went on to fuse these two functions into one example- that of the Tanzanian radio soap opera titled “Pilika Pilika,” which educates its listeners on myriad health issues through entertaining plot lines. Earlier today, when writing our assigned analysis and discussion questions based on the readings, I posed the question, “Do you believe that this is actually effective in educating people on important health measures?” I then went on to do a little research of my own, which is how I discovered “Shuga-Love, Sex, Money”–a 12-episode radio drama that tells the stories of a group of four young fictional characters aged 15-24, their choices, dreams, friendships, challenges, and triumphs in a world where HIV and AIDS are an ever-present threat.

Launched in June of 2012, Shuga is a joint initiative of MTV, UNICEF, and the HIV Free Generation (HFG) Partnership. Not only is the series produced in French, English, and Swahili, but it is also distributed at no cost to a wide range of broadcasters. Some of the themes and topics covered through the plot of the series are: HIV counseling and testing, condom use in stable relationships, positive prevention, gender inequality and sexual violence, transactional sex, alcohol abuse, and the role of multiple concurrent partnerships in driving the HIV epidemic. Another unique aspect of the Shuga series that has undoubtedly lent it more success is that it was written and produced by 30 young people from Cameroon, DR Congo, Kenya, Tanzania, Lesotho and South Africa. These young Africans from diverse backgrounds all came together for training in a special workshop hosted by Question Media Group with support from MTV and UNICEF in order to create the drama that informs people just like them.

Now to my question as to whether or not this means of delivering vital health advice through entertainment radio is actually successful in improving health outcomes. According to research conducted by Johns Hopkins University/Centre for Communications Programs in Kenya following the airing of Shuga, the data reported increased intentions for HIV testing coupled with decreased intentions for multiple sex partners; improved attitudes towards people living with HIV and AIDS, and increased usage of accessible health and social services among youth who had watched the series. Being a radio DJ myself at the campus station, WTUL, I know what it is like to read obligatory Public Service Announcements each week. The information is terribly mundane, and most of the time, I am certain my listeners tune out during these mandated announcements. Now having learned about these examples of innovative use of airtime to educate the public, I will question these PSAs even more.  Unfortunately, I do not think this coupling of education and entertainment, particularly through radio, would be very successful in the U.S. But programs like “Pilika Pilika” and “Shuga- Love, Sex, Money” show promise for the future of education and empowerment through radio in the developing world.


Tertiary Education for Development

When discussing the use of ICTs in education development, it seems like the majority of efforts are centered around youth education. However, as brought up in this weeks lecture, what happens to those who are left out of the ‘youth’ bubble? Although starting a movement to target children’s education early on is crucial to ensure development, how far can a country develop if they lack the ability to provide higher education? It seems that this issue was not only a concern for my classmates, but also for New York Times columnist Thomas Friedman. In early January, Friedman wrote on the need for higher education, and found a solution with the program of free massive open online courses (MOOC).

MOOCs are programs established by notable colleges such as Stanford, Harvard, Princeton, and MIT, which provide free online education for anyone. Although this education does not give you college credit or an established degree, it does provide many with the skills and capacity building programs needed to lift them out of poverty.

Coursera, a market leader amongst the MOOC programs recently partnered with the World Bank’s New Economy Skills for Africa Program (NESAP) and the Tanzanian STHEP Project to pilot the Youth Employment Accelerator Program Initiative (YEAPI). This project aims to help fill the highly demanded IT jobs in Tanzania through the skills learned by the MOOC programs. The skills acquired by these MOOC programs can prove to be incredibly beneficiary to the development of Tanzania, especially in terms of reducing youth unemployment rates and encouraging higher education.

However, after reading many cases where educational development has failed, especially the project of One Laptop Per Child, I feel that this program is struggling to address some of the key issues at hand. While these online courses can be incredibly helpful for the continuance of education in rural communities, they fail to acknowledge certain infrastructural problems that these populations might face. This program assumes that individuals will have access to computers and that these computers will have adequate access to the internet. Furthermore, this program assumes that individuals will want to partake in such education, even though it lacks initial incentives. While I completely understand and support this program’s initiatives, I feel like the pilot program will show that there are much greater problems at hand.


United Republic of Tanzania National ICT Resources

1. National ICT Policy/Plan/Strategy:

NATIONAL INFORMATION AND COMMUNICATIONS TECHNOLOGIES POLICY

Created: March 2003 (part of “The Tanzania Development Vision 2025”)

Created By: The Ministry of Communications and Transport

Language: English

The Tanzania Development Vision 2025: This government website explains Tanzania’s overall vision for development in general, but it also states specifics about the ICT sector.

Tanzania ICT Sector Performance Review 2009/2010: This is a more recent, non-government document that reviews how Tanzania is doing in terms of their ICT sector for 2009/2010.

Authors: Mary Materu-Behitsa and Bitrina D. Diyamett

4. Helpful Notes:

The above documents hold very valuable information for your papers. The National information and communications technologies policy is the most important document, as it will provide you with all of the information you are responsible for in your first paper. It is long but very thorough. You will be able to sufficiently write the paper by using this document, but you must read the document in its entirety.


ICT Savvy Universities in East Africa

Within the education sector, ICTs are used to access information from many different mediums. This can be accessed from computers, laptops, mobile phones, e-readers, radio, etcetera. In East Africa, a recent list of universities has been announced, ranking the best “ICT Savvy” institutions in the region. Five Kenyan universities were among those top 100 establishments. Universities in Burundi, Uganda, Rwanda, and Tanzania were highly ranked as well.

The Top Universities:

Makerere University of Uganda

Strathmore

Busitema University of Uganda

School of Finance and Banking of Rwanda

African Virtual University of Kenya

Makerere University

University of Nairobi

Mount Kenya University

Kenyatta University

The various universities were measured based on “how universities have complied with ICT in terms of embracing technology for both students and lecturers.” Between April and October 2012, a survey was created in determining which higher education institutions made the cut regarding ICT use in teaching and enhancing education. Face-to-face questionnaires were conducted in determining these factors. The universities that best met the practices of management, development, and sustenance of university education worldwide made the list.

What is interesting to note is that these universities in East Africa are keeping up with international universities in embracing ICT facilities. Kenya, in particular, has heavily invested in ICT compared to other African universities. Hopefully this spreads to include many more universities in time to come. This is exciting news within the education sector for ICTs.