Uploaded on

Capture of mHealth use within Africa;s Health System

Capture of mHealth use within Africa;s Health System

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
No Downloads

Views

Total Views
1,034
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
0
Comments
0
Likes
1

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Adesina Iluyemi PhD Candidate CHMI, Univ of Portsmouth, UK Member, eMobility ETP [email_address] 22.04.2008 WWRF #20 eHEALTH NETWORK FOR AFRICA: NEED FOR LOW-COST MOBILE/WIRELESS INFRASTRUCTURES RESEARCH & DEVELOPMENT PROPOSAL
  • 2. Content
    • Health Problems in Africa
    • Definition and Policy drivers for eHealth in Africa through wireless technologies
    • Introducing the concept of wireless i-DeHI in Africa
    • Barriers to wireless i-DeHI in AfricA
    • Opportunities for WWRF
    • Research and Development proposal
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 3. Health Problems in Africa
    • Africa has a population of about ONE billion people
      • Up to 70% lives in isolated rural areas
      • Half lives on half a dollar per day
      • Poor telecom & transportation infrastructure
    • Lack of Infrastructure and Capacity Healthcare delivery
    • Brain Drain: International and Local (Rural vs. Urban)
      • Africa has 10% of world population with 25% of global health burden but with only 3% of global health workforce
    • Poverty & Financial constraints
      • HIV/AIDS accounted for 2.4 million deaths alone in 2002
      • 40% survive on less than $1 per day
      • Malaria related mortality is at 1 million deaths (mostly children) yearly
    • Enormous economic cost on health systems
      • 10% of individual income
      • 50% of Africa’s population pays out of pocket
      • Human resources impact
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 4. eHealth as a developmental tool
    • eHealth is the use of information (data) and communication technologies for health processes (Health System) either locally and at a distance (WHO 2005).
    • eHealth involves telemedicine, telehealth, telecare, health management information systems, health knowledge systems etc.
    • Health System is information, data and communication intensive and requires more than SMS
      • Health Workers as “Knowledge Workers”
      • Patients as citizens (Citizen-centric eHealth)
      • Health System as Data processing organization
    • Wireless technologies plus eHealth = mHealth
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 5. Policy for eHealth in Africa
    • Africa Union/ New Partnership for Africa’s Development (NEPAD)
    • NEPAD’s Action Plan Strategy on sector development
      • Alignment between telecom and health sectors
      • Calls for a continental-wide eHealth infrastructure based on wireless telecom infrastructure
    • NEPAD’s eHealth for:
      • Communication system
      • Integration of & access to vertical HISs
      • Extending healthcare to isolated and rural communities and populations
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 6.
    • Global initiatives in favour of eHealth is being championed by The World Health Organisation (WHO) under the Global Observatory for eHealth (GOe) (WHA 58.18)
    • The European Union has plans for eHealth in Africa
      • Using wireless/mobile technologies
    • International Telecommunication Union (ITU) since 1998 has commissioned eHealth projects in developing countries using mostly wireless technologies
      • The ITU-D Q14 Working Group is focussed on eHealth strategy and policy development with interest in mobile/wireless technologies especially in developing countries
    • All support Public-Private Partnerships (PPPs) for eHealth
    Global Policy for eHealth Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 7.
    • To provide access to distributed health knowledge and information to mostly rural health workers.
    • Urgency is required to meet the MDGs targets and to reverse the poor health and developmental ratings
    • Geographical barriers to access health service provision especially in Africa (rural areas).
    • Connectivity ( wireless telecommunications) is becoming widely accessible and available even in rural communities
    • But there are issues: Cost, telecom infrastructure, existing health problems etc
    Why eHealth for Africa Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 8.
    • Mobile devices are relatively cheaper that Fixed computers
      • Consumes less power (Lack of electricity)
      • They are portable, hence more secured?
    • Wireless networks are relatively cheaper and faster to build relative to build than fixed networks. For example , the Nigerian case
    • Mobile/ Wireless technologies provide the best opportunity for Africa to achieve the “ Africa interconnectivity objective and for building eHealth Infrastructure
    Rationale for Wireless eHealth in Africa Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 9. Wireless tools use for eHealth in Africa
    • Wireless technologies use: GSM/GPRS/3G, WiFi, WiMAX, WLL (Fixed or Mobile CDMA), Broadband wireless, Satellite, VSAT (Mobility vs Universal Access)
    • Mobile devices: PDAs, Smartphone, Cellular phones, Tablet PCs, Laptops, smart cards, memory sticks, USB keys, sensors.
    Page FMFI 2007 WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 10. Health Workers using mobile devices Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 11.
      • Health Systems in Africa are operated through a District Health System (DHS)
        • Hierarchical and pyramidal territorial enterprise
        • A distributed and geographically dispersed Enterprise
        • An information and process intensive Enterprise
        • A central urban hospital linked to peripheral semi-urban/rural health centres
      • Has different cadres of Health (Knowledge) Workers with information needs for patient care & enterprise management
    • Integrated District eHealth Infrastructure (i-DeHI)
      • Built on Wireless Infrastructure
      • Including mobile/portable hardware, software & wireless networks
    A Innovative Concept Proposal Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 12. i-DeHI Innovation
    • i-DeHI as the basic unit for an Africa-wide eHealth Infrastructure
    Page i-DeHI WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 13. A District eHealth Network
    • Basic architecture for health care delivery in Africa
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 14. A Cluster of District Wireless eHealth Network = Regional eHealth Network
    • Regional or National eHealth Infrastructure will require use of different devices and wireless networks with implications for interoperability and integration
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 15. Lessons from African Cases
    • UHIN-GPRS:- still limited in bandwidth
      • Early generation PDAs-Planning for Smartphones
    • Solar Energy
    • Cell-Life- GPRS/3G- Business model
      • PDAs/Smartphones
    • FMFI/MUTI Telehealth- Long distance WiFi- WAN&LAN, VSAT- expensive, policy barriers
      • Considering 3G
      • Desktop Laptops WiFi -CellPhones
      • Solar Energy
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 16. Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 17. A District eHealth Network
    • A rural eHealth project in rural South Africa using low-cost Mesh Wi-Fi networks
    Page FMFI 2007 WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 18. Barriers to Wireless eHealth in Africa
    • Technological
    • Telecommunication Infrastructure ( policy, high investment costs , availability)
    • Power /Electrical Infrastructure
    • Economic/Financial Infrastructure - Low-income
    • Organizational/Management issues
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 19.
    • Lessons from an Africa-wide eHealth Network
    • Multilateral Initiative on Malaria Communication Network (MiMCom)
      • A continental-wide eHealth Infrastructure with 12 National nodes
    • Inter-national nodes mostly with VSATs
      • VSATs chosen over fibre-optics at inception
    • Intra-national communication with terrestrial wireless-WiFi, microwave link
    • Devices-Laptops, PDAs, PCs
    • Reveals different solutions for national nodes- depends on availability and costs of bandwidths
    Barrier 1: Telecom/Technological Infrastructures Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 20. MiMCom continent-wide eHealth Network in Africa
    • This depicts national nodes with different networks
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 21. Lessons from African Cases
    • Melanges of devices and networks: Need for Ambient Network
    Page FMFI 2007 WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 22.
    • Issues
      • Non-availability of Low-cost Broadband Access
      • High costs of broadband access especially of satellite connectivity access
    • Possible solution ?
      • Low-cost Broadband Wireless Infrastructure
      • Introducing EU funded Digital World Foundation project on Low-cost Technology initiative
      • Bring this issue into global business and developmental agendas
    Barrier 2: Financial Infrastructure Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 23.
    • European Research Framework
      • Framework Programme 7 (2007-2013) just started
      • DigitalWorld FP7-216513 is an 18 month research project
    • ICT-1-9.1 - International Cooperation (Africa and Latin America)
    • Coordination and Support Action
    • Started January 1, 2008
    • Duration: 18 Months
    Introducing DigitalWorld EU Project Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 24. User-centric mHealth conceptual model
  • 25. mHealth Users’ Context
  • 26. Users issues 1
    • Technical
      • Human Computer Interface (HCI)
      • Open Source (Hardware & Software)
    • Social
      • Adoption issues (Development & Implementation)
      • Culture
      • Local Knowledge
      • Language
  • 27. Users issues: software & interface design
    • HCI
      • Screen size and design (Adaptive)
      • Network Configuration-Thin & Thick clients, remote & located synchronisation
    • Software
      • Palm OS
      • Symbian
      • Windows Mobile
      • Google Android
  • 28. Users issues: Hardware 1
    • Open Source design?
    • Multi-wireless connectivity
    • Power- Solar? (Global Green Movement)
    • Memory (Stable and Labile)
    • Security
    • Structure- (Ruggedized)
    • Low-cost devices-
    • Simputer
      • OLPC
      • Classmate,
      • EeePC
  • 29. Users issues: Hardware 2
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    UMPCs
    • Low-cost UMPCs for Health
      • OLPC case
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    • Low-cost UMPCs for Health
      • OLPC case
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    • Low-cost UMPCs for Health
      • OLPC case
    UMPCs
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    • Low-cost UMPCs for Health
      • OLPC case
    UMPCs
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    • Low-cost UMPCs for Health
      • OLPC case
    UMPCs
    • Device Morphology/Transition
      • mobile portable nomadic
    • Ultra mobile portable devices (UMPCs)?
    • Isomerism?
    • Users’ opinion from Africa
      • Desktop Laptops WiFi -CellPhones
    • Low-cost UMPCs for Health
      • OLPC case
  • 30.  
  • 31.  
  • 32. Users: Social issues
    • Doctors in South Africa (Banderker et al 2005)
      • Job relevance
      • Usefulness
      • Perceived User resources
      • Device Characteristics
      • Supports from Public National government & hospital administrators
      • Patient influence
      • Legal issues (Decision Support Systems, Drug directories)
  • 33. Organizational issues 1
    • Technology
    • Technology is not enough!
    • Positive economic benefits
    • Users led and focus
    • Social and ethical issues
    • Health workers’ responsibility
    • Device and applications development and regulation.
    • (HealthService 24- 2006)
  • 34. Organizational issues 2
    • Environment
    • Health Policies, regulation, structure and financing
    • Evaluation in real-life contexts
    • Multiple actors and structures
    • Health IT infrastructure (organisation).
    • Users’ Trust
    • Users’ led model
    • (MOSAIC -2005)
  • 35.
    • 70% of IT investments globally are failures: Note failure here is multifaceted
    • Africa is not faring better either
    • Same problem with eHealth projects especially in Africa
    • Hence, problem is sustainability which can be :
      • Organisational /Environmental
      • Social/cultural
      • Human (Health Workers)
      • Technological
    Sustaining eHealth projects in Africa Page 80% cause of IT Failure WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 36.
    • Building a sustainable Business Model for ‘Win-Win Situation’
      • Understanding and Meeting Multiple Stakeholders
        • End-users needs for design: Pro Poor vs. Niche markets
        • Understanding Organizational Process for innovation diffusion
      • Understanding Environmental Constraints and Enablers: Policies/Regulation, Electricity (Renewable Energy), Financial/Economic/Funding
        • Instituting sustainable Global & Local Public-Private Partnerships (PPPs)
        • Supporting Local Small & Medium Enterprise (SMEs)
        • Supporting Low Access/Entry costs models
    • Technological- Low cost Broadband Infrastructure
        • Wireless Telecom such as WiMax, WiFi, Broadband Satellite
        • Low cost mobiles devices and Laptops (OLPC, Intel Classmate etc
        • Open Source vs. Proprietary Software & Hardware?
    Sustainability issues Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 37. Sustainable Solutions
    • High investment, implementation and purchasing costs of wireless telecom infrastructures as barriers (Gilhooly 2005, World Bank 2008)
    • Policy needed to stimulate:
      • Public service innovation/re-engineering (eHealth)
      • Mass and low-cost production of components
      • Appropriate Business models- “Bottom of the Pyramid” (BOP) model
      • Local and Global Public-Private Partnerships (PPPs) (NEPAD e-Schools project)
      • Social and developmental inputs in Telecom regulation & business
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 38.
    • User-centric wireless products & services in developing countries
      • Case studies demonstrate the feasibility of mHealth in Africa Health System
      • Low-cost portable and mobile devices like the OLPC are needed
      • Low-cost broadband wireless infrastructure are also required
    • Research to influence future design and development
    • To support wireless eHealth business model in developing countries
      • Being developed with Rural Living Labs Europe
      • To be instituted in four regions of Africa
      • To develop a sustainable wireless eHealth model
    Opportunities for WWRF-WG 1 Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 39. Opportunities for WWRF-WG 2
    • Transmission
      • Wireless Broadband for eHealth web services and applications
    • Development of optimal/low-cost mobile/portable/nomadic devices, infrastructures and software
    • Ambient Wireless Networks
      • Melanges of wireless networks
      • Need to explore interoperability for facility, community, district, provincial, national regional and continental access and connectivity
    Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 40.
    • Reviewing all eHealth projects in developing countries especially on mHealth
      • Focus is specifically on the factors affecting eHealth sustainability or success in Africa
      • Operational & strategic management of eHealth implementation & use in Africa
      • Developing a holistic framework to evaluate existing eHealth systems in Africa i.e. linking operational with strategic (policy) level
    • Framework will capture process and outcome impacts from design to implementation and use
    • Funding required for field trips to Africa
    Ongoing Research Work @ CHMI Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 41.
    • A call to WWRF to support research into:
    • Low-cost mobile/wireless technologies for Development in Africa
      • eHealth
      • e-Education
      • e-Agriculture
      • e-Business, e-Commerce, e-Banking
    • Scoping change management issues in using mobile/wireless technologies for eHealth in Africa / Developing countries
    • THANK YOU FOR LISTENING!
    Conclusion Page WWRF#20 · Adesina Iluyemi · adesina.iluyemi@port.ac.uk · 22.04.2008 · Wireless eHealth for Africa
  • 42. Dr Adesina Iluyemi PhD Candidate CHMI, Univ of Portsmouth, UK Member, eMobility ETP [email_address] 22.04.2008 WWRF #20 eHEALTH NETWORK FOR AFRICA: NEED FOR LOW-COST MOBILE/WIRELESS INFRASTRUCTURES RESEARCH & DEVELOPMENT PROPOSAL