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eHealth : the promise of ICT for improving health in Africa

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eHealth : the promise of ICT for improving health in Africa, by Prof. S. Yunkap Kwankam Executive Director International Society for Telemedicine and eHealth (ISfTeH)

eHealth : the promise of ICT for improving health in Africa, by Prof. S. Yunkap Kwankam Executive Director International Society for Telemedicine and eHealth (ISfTeH)

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    • 1. eHealth : the promise of ICT for improving health in Africa Prof. S. Yunkap Kwankam Executive Director International Society for Telemedicine and eHealth (ISfTeH)‏
    • 2. Focus of health investment should be on improving sector productivity, cannot just increase funding The most effective way to improve productivity is to improve health systems Source: Nicholas C. Petris Center on Health Care Markets & Consumer Welfare (UC Berkeley), WHO, A Handbook of Cultural Economics (James Heilbrun)‏ Level of HC spending is a function of GDP/capita regardless of external funding Health spend per capita (2005)‏ GDP PPP per capita (2005)‏ R 2 = 0.94
    • 3. Effectiveness of health spending widely variable Health outcomes not tightly linked to income level Variation in health outcomes highlights considerable room for improvement of inefficient and ineffective health systems Source: WHO GDP PPP per capita (2005)‏ Log GDP/Capita (PPP) vs Childhood (<5) Mortality Childhood (<5) Mortality (per 1000)‏ Country A Country B Country Y Country X Countries with similar health outcomes but very different profiles Countries with similar profiles but very different health outcomes
    • 4. Source: WHO
    • 5. Challenge - local capacity for eHealth
      • Low institutional capacity
        • Infrastructure and connectivity‏
        • Legal and regulatory environment
        • administrative structures
      • Limited human capacity
        • ePractitioners – health workers capable of leveraging ICT in their clinical or other activities
        • Informed citizen transformed from passive observer to active participant in the care giving process
        • eHealth professionals often not included in the HRH calculus of many countries
        • Lack of eHealth corps within MoH, with career prospects (schemes of service) to attract and retain them
    • 6. Countries with a critical shortage of health service providers (doctors, nurses and midwives)‏
    • 7. eLearning easing healthcare HR crisis in Kenya 2 In Kenya, chronic shortage of highly skilled nurses
      • Enrolled Nurses (ENs) comprise 70% of nursing and 45% of the health workforce in Kenya
        • First point of contact for communities, but are inadequately skilled to manage new and re-emerging diseases like HIV/AIDS
      • PPP led by the Nursing Council of Kenya (NCK), the African Medical and Research Foundation (AMREF) and Accenture to upgrade 22,000 ENs from ‘enrolled’ to ‘registered’ level within 5 years via eLearning (distance education through ICT) methods
      Promising progress since start of program in Sep. 2005 As of Nov. 2006, 3,265 nurses upgraded 27 colleges and schools participating including AMREF’s Virtual Nursing School Over 100 computer-equipped training centers set up in 8 provinces, including remote and marginalized districts eLearning can reach goal w/in next decade versus >200 years w/ traditional classroom methods (K)‏
      • ~2,800 ENs upgraded/yr
      • Cum. cost ~ $2.5M
      • ~$114/nurse
      22,000 ENs to upgrade
      • ~100 ENs upgraded/yr
      • Cum. cost ~ $50M
      • ~$2,273/nurse
      eLearning vs. traditional methods for upgrading ENs Traditional classroom method eLearning Results do not just represent dramatic cost and time improvements over status quo, they are nearly impossible without use of ICT Source: Source: WHO, AMREF website
    • 8. Challenge – eHealth “pilotitis”
      • Conclusions of a workshop organized by the DSF and WDSA, Lyon November 2008
      • eHealth initiatives often small-scale and not commensurate with the size of the problem
      • No repository of information and knowledge on what is happening where, how well it works and why
    • 9. Organized eHealth profession in countries
      • National professional societies –
        • Stewards of the profession in country
        • Watchdog of the industry
        • affiliated with regional and international federations such International Society for Telemedicine and eHealth (ISfTeH)‏ and International Medical Informatics Associations (IMIA)‏
      • National eHealth Councils
        • Advisory body to governments on ‏eHealth matters – patterned after national AIDS Councils
        • A forum for public debate‏ on issues of ICT I health with all major stakeholder groups represented
      • Develop evidence – modeling and analysis, identify trends and project future needs
    • 10. WHO definition of eHealth
      • eHealth – ICT for health
      • What produces health?
      • Where can we bring ICT to bear on this production?
      • Redress the overwhelming focus on health care
      • To the neglect of other influence pathways to good health:
        • Water and sanitation
        • Food and nutrition
        • Housing and shelter
        • Education
    • 11. Africa Health Infoway- an organizing framework An integrated district health network for Africa AUC's Pan-Africa eNetwork project eAfrica Commission's eSchools project Millennium villages etc
    • 12. ISfTeH International eHealth Registry
      • To address one of two Lyon recommendation on eHealth
      • Comparable information on eHealth projects around the globe
      • Shared freely
      • Linked to other repositories of information on ICT in health
    • 13. Conclusion
      • Promote a continent-wide vision, with local insights
      • Human resources are the key
        • eHealth predicated on the triad of People Processes and Technology, with people resources as the key
      • Partnerships are the modeling
        • Local, national and continental networks
      THINK BIG - START SMALL - ACT NOW
    • 14. Thank you [email_address] [email_address]

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