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Africa's Health System Development and Mobile/Wireless eHealth
 

Africa's Health System Development and Mobile/Wireless eHealth

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    Africa's Health System Development and Mobile/Wireless eHealth Africa's Health System Development and Mobile/Wireless eHealth Presentation Transcript

    • Mobile/Wireless eHealth for Health System/Workers development in Africa: Opportunities for eMobility ETP @ eMobility Mobile Communications &Technology Platform Staying ahead! 2 nd Workshop on Shaping the Future of Mobile and Wireless Communications Rome, Italy. September 25 2007 Adesina Iluyemi [email_address]
    • Content
      • Exploring eHealth concept
      • Health Systems in Developing Countries (Africa): issues and problems
      • Global/Africa/ EU eHealth policies
      • Mobile/Wireless Technologies in Developing Countries (Africa)
      • Mobile /Wireless eHealth Case Studies from Africa
      • Opportunities for eMobility ETP
      • Research agenda
    • 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.
      • An opportunity for the development of public health.
      • strengthening of health systems through eHealth may contribute to the enjoyment of fundamental human rights by improving equity, solidarity, quality of life and quality of care. WHA 58.28, WHO 2005
      • The combination of mobile/wireless technologies with eHealth is known as mHealth
    • Health Problems in Developing Countries (Africa)
      • 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
        • Human resources impact
      • mHealth offers a potential low-cost alternative for managing these diseases.
    • Millennium Development Goals
      • MDGs are 8 Goals set by United Nations in 1999/2000 to achieve for specific 18 targets by 2015
      • MDGs, a strategic & operational drivers for Health System development in developing countries
      • 3 MDGs are health related
        • To reduce child mortality from childhood diseases
        • To improve maternal health
        • To combat HIV/AIDS, Tuberculosis (TB) malaria.
      • Target #18 of MDGs calls for using ICTs to achieve MDGs.
      • European Commission has also adopted these goals as benchmark for developing countries
    • Why eHealth in developing countries?
      • 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
      • Issues: Cost, existing health problems etc
    • Global Policy for eHealth 1
      • 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)
      • A document is available for eHealth readiness of its global member states
      • WHO eHealth objectives are:
        • health system performance
        • health human resource capacity
        • access to health knowledge
        • decision and policy making process
        • better health outcomes for patients.
    • Global Policy for eHealth 2
      • WHO(2004) calls for the use of eHealth for PHC delivery especially in developing countries
      • WHO is currently developing an mHealth strategy with specific focus on developing countries
      • 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 focus on mobile/wireless technologies especially in developing countries
    • African Regional Policy for eHealth
      • Africa Union through New Partnership for Africa’s Development (NEPAD) calls for using ICTs :
        • to improve patient care
        • for sharing health knowledge
        • To build human resource capacity
        • for health system development
      • e-Africa commission is already a point of collaboration with EU on ICT for development .
        • A major priority is the building of ICT connectivity and access infrastructure
      • NEPAD/EU: eHealth initiatives
        • The recent European Space Agency (ESA) satellite eHealth proposal for Africa is an example of this intercontinental collaboration-
        • The Africa Health Infoway (AHI) is also another initiative with WHO
    • EU/EC Policy on eHealth for developing countries 1
      • EU in 2004 (STOA 122EN) developed a policy on eHealth for health system development in developing count ries
        • Highlights the importance of ICT infrastructure for eHealth adoption & diffusion
        • Encourages the exploration wireless technologies for eHealth connectivity especially WiFi
      • Health workforce development in developing countries is an EU priority and eHealth as one of the solutions (COM(2006) 870 final)
        • eHealth linked with EU strategy for Africa
    • EU/EC Policy on eHealth for developing countries 2
        • EU strategy for Africa [SEC92005)1255]
          • Recommends the use of sustainable low-cost ICTs
        • To help in strengthening Africa’s Health System
        • Establishing an EU-Africa Partnership on continental-wide ICT Infrastructure development through terrestrial and satellite means (‘interconnectivity in Africa’)
    • Existing eHealth applications in Developing Countries: A framework
      • Using 5Cs Acronym (Peter Drury 2005)
        • Content: EHR, referral system, HMIS, CME/e-Learning & Telemedicine platforms etc
        • Community: Online Communities of Practice, Knowledge networks
        • Communication: Web services; voice and data tools
      • What is needed? ACCESS, through what?
        • Connectivity: wireless/mobile ICTs- Opportunities for eMobility WG
      • What is lacking? understanding
        • Context: Cultural, end-users, social, organisational economics issues etc.
    • EU/EC eHealth for developing countries: Mobile/Wireless Technologies
      • MOCCA: The Mobile Cooperation and Coordination Action (MOCCA) an initiative by EU in translating wireless and mobile technologies to developing countries under the IST FP6 in a report
        • This is a previous EU-IST FP6 programme
        • ………… ..that appropriate wireless/mobile technologies can be employed for providing connectivity in developing countries
        • The success of EHAS eHealth project as an illustration of this
      • European strength in wireless networks can be employed like Alcatel Broadband Initiative, Ericsson & Nokia initiatives
    • Wireless/Mobile tools in Developing Countries (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.
    • Rationale for mHealth
      • 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 (EU strategy)
      • Case studies below supports this proposition
    • mHealth impacts in Africa: Case Study 1
      • UHIN (Uganda)
        • Started in 2003 and has continued to expand within & beyond the Country (Mozambique).
        • Uses existing GSM/GPRS/ WiFi links with PDAs to support (community) health workers (HWs) creating a regional eHealth network
        • Uses solar panels for power
        • For Primary Health Care service provision
        • Provides learning materials, health information and e-mail (upcoming) to HWs
        • Enables timely response to health system needs, diseases outbreaks and enhances organisational health planning and resource allocation.
        • BACK
    • mHealth impacts in Africa: Case Study 2
      • Cell-Life (South Africa)
        • Started in 2003 by 2 universities in SA
        • A multiplatform system for the therapeutic and logistic management of HIV/AIDS population
        • Mobile devices (Cellphones & PDAs) with 3G/GPRS/SMS networks
        • Enable community health volunteers to assist their fellows HIV + management.
        • Enables organisational planning for drug supply and emergency situations
    • mHealth impacts in Africa: Case Study 3
      • MindSet Health (South Africa)
        • Started about 2002
        • Uses DVB wireless satellite technology to provide
          • Health education (eLearning) to rural health workers in clinics and hospital (datacasting) through PCs/Laptops
          • Health promotion to patients and citizens through large screens and TVs (broadcasting) in clinics and community settings in form of documentaries, drama etc.
          • Delivers information all aspects of health (TB, HIV, Malaria etc).
        • Improves health workers’ capacity and empowers citizens’ to keep healthy
    • mHealth impacts in Africa: Case Study 4
      • EHAS (Peru)
        • Started in Peru is early 2000 with joint collaboration between a Spanish and two Peruvian universities & MoH and an international NGO
        • Initially with HF/VHF but now with long distance WiFi wireless links connected with Laptops creating a regional eHealth network
        • Uses solar panels for power
        • For Primary Health Care service provision
        • Provides learning materials, e-mail and voice communication and teleconsultation to HWs , organisational health information & data exchange
        • Enables timely response to health system needs, diseases outbreaks and enhances organisational health planning and resource allocation .
        • BACK
    • Wireless Networks: Opportunities for eMobility ETP 1
      • Transmission
        • Wireless Internet Protocols (IP) for eHealth web services and applications
      • Development of optimal/low-cost mobile devices 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 (SEC92005)1255)
        • This is line with the recommendation of EU strategy on eHealth technologies in developing countries (STOA 122 EN)
    • Wireless Networks: Opportunities for eMobility ETP 2
      • The case studies presented above demonstrates the feasibility of mHealth in Africa Health System development portbale and mobile devices like the OLPC
      • Need for developing and providing low-cost & optimal
      • But what is missing is how these wireless networks can be made to interoperate to provide a seamless network
      • An opportunity for eMobility ETP to assist in achieving this EU/Africa strategic objective
      • And to help in the achievement of Africa Health Infoway (AHI) goal.
    • The suggested way forward
      • There is a need to institute pilot projects on ambient wireless networks for eHealth connectivity and access in Africa.
      • This should be deployed within a district health system for ambient wireless eHealth network
      • Need to implement pilot within the local environment in Africa as this is an innovation (STOA 122 EN)
      • However, detailed knowledge on designing, developing and implementing mHealth system in Africa is lacking at present (STOA 122 EN)
    • Ambient Wireless eHealth Network: A Vision Continental National Regional District Hospital Facility: Health Posts, Health Centres Community
    • A District eHealth Network
    • A Cluster of District Wireless eHealth Network = Regional eHealth Network
    • A Cluster of Regional eHealth Network = National/Continental Network
    • Ongoing Research Work @ CHMI
      • 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
    • Ongoing Research Work @ CHMI
      • Specific focus will be on Health workers & Health System impact of implementation & use
      • Will aim to:
        • develop a mHealth readiness framework for Africa
        • improve existing projects
        • Provide valuable good practice for new projects
        • save cost from preventing project failure
        • improve health systems
        • empower health workers
        • eventually to ensure sustainability of projects.
    • Conclusion
      • eHealth is strategic to health system development in Africa/developing countries as in EUAfrica strategic policies
      • Mobile/wireless ICTs have potentials of providing the much lacking is access and connectivity
      • The achievement of ambient wireless network provides the best opportunity for developing Africa’s health system interconnectivity
      • This is an opportunity for eMobility ETP in implementing pilot projects
      • Understanding contextual organisational issues is paramount
      • Funding sources for field studies urgently required!
    • Thank you for listening! Questions and Comments