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Computer science applications to  improve health  delivery in  low-income  countries. Neal Lesh
 
My Story ,[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factor ,[object Object],% survived Poverty as a
Global Health
Simple Story $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $ Infant  mortality:  5 per 1,000 births  Maternal  mortality: 8 per 100K births Life expectancy:  78 years Infant  mortality:  95 per 1,000 births  Maternal  mortality: 500-1000 per 100K  Life expectancy:  45 years 300-540 57 69
Simple Story $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $
Simple Story $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$ $$$$$$$$$$$$$ $$$$ Infant  mortality:  95 per 1,000 births  Maternal  mortality: 500-1000 per 100,000 b Life expectancy:  45 years
Simple Story “ We are the first generation that can end poverty. ” - Eveline Herfkens, UN Millennium Campaign
Complexity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Information as Care ,[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],AIDS Treatment in Rural Rwanda
[object Object],Improving Health Systems
[object Object],Connecting to the Internet
Electronic Medical Record (EMR) Patient Monitoring Reports Clinicians & Patients Managers EMR Staff Paper forms Program  Monitoring Reports Funder &  government reports $ Re-allocate  resources
Patient Monitoring
Missed-Visit List
ICT task: satisfy reporting requests
OpenMRS ,[object Object],[object Object]
Data Quality ,[object Object],[object Object],[object Object],Potential solution: point-of-care systems
Challenges & Opportunities ,[object Object],[object Object],[object Object],[object Object],[object Object]
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rural Dispensary in Tanzania
Standardized Care (IMCI)
Standardized Care (IMCI)
Standardized Care (IMCI)
Tanzania: underfive mortality was 13% lower in the two IMCI districts Source: Schellenberg J et al Full IMCI in HF End of study 13% difference 95% CI: -7%, 30% Significant  impact on  stunting
Deploying IMCI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why Automate IMCI?
Why Automate IMCI? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Field Work Results to be published in CHI’08
How Automate IMCI?
Exploratory Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Viral Training
Key Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adherence Results Investigation Current practice adherence e-IMCI adherence p-value Vomiting 66.7% (n=24) 85.7% (n=28) - Chest indrawing 75% (n=20) 94.4% (n=18) - Blood in stool 71.4% (n=7) 100% (n=3) - Measles in the last 3 months 55.6% (n=9) 95.2% (n=21) < 0.05 Tender ear 0% (n=1) 100% (n=5) - All 61% (n=299) 84.7% (n=359) < 0.01
Triaging patients on treatment for AIDS (Study ongoing in South Africa)
e-CTC for HIV screening Counselors ask a series of questions leading to a patient assessment.
CommCare Start House Hold Visit Plan Day Explore Data Exit
House Hold Visit  (Task Queue) 0 0 0:04:56 Register Birth Investigate Diarrhea of Sick Child Review malaria bed nets Topic of month: nutrition during pregnancy END VISIT
Day Planning MKWERA : TB Referral (2 wks) MKEA: Severe diarrhea (3 days)  CHUMA: late HH visit (3 months) KAIGILE: routine HH visit MGANDA: routine HH visit EXIT
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]

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