This document outlines a research plan to develop a framework for designing and deploying e-health systems in developing countries. The goal is to answer the main research question of how to support developing countries in developing health management systems. The plan includes conducting a literature review to identify challenges, interviewing stakeholders in Afghanistan to understand challenges in their health system, and developing a framework to address these challenges. Qualitative research methods like surveys, interviews, focus groups and purposive sampling will be used to collect data on the key challenges.

1. Institute of Informatics,
Tallinn University
2014
A framework for designing and
deploying e-health systems in
developing countries
Abdul Wahid Samadzai
PhD Student
David Lamas, Vladimir Tomberg
Supervisors
Institute of informatics
Tallinn University
2015

2. Research Problem
Research Goal
Research Questions
Definitions
Challenges Document
Plans for this academic year
Agenda

3. There is a lack of the systematic framework for
designing and deploying e-health systems in
developing countries
Research Problem

4. The goal is to develop and evaluate a
systematical approach for designing and
deploying e-health systems in the developing
countries
Research Goal

5. The main research question is:
How to support developing countries in development
of health management systems, in terms of horizontal
technology transfer between developed and
developing countries, considering the inherent
constraints and limitations.
Research Questions

6. In order to answer to the main question, we need
to answer to following sub-questions:
What are the main challenges and prerequisites for e-Health
systems in developing countries?
What practices gathered from scenarios in developed
countries can be applied for developing countries and what
practices cannot?
What kind of parts designing and deploying e-health systems
framework should consist of?
Research sub-questions

7. The World Health Organization broadly defines
Electronic Health (E-health) as being “concerned
with improving the flow of information, through
electronic means, to support the delivery of health
services and the management of health systems”
.
‣ In another word E-health is better healthcare and
a healthier life through digital technology.
Electronic Health

8. Health information systems (HIS) are the systems
for collecting and processing health data from
different sources.
HIS have become a fundamental component for
increase the health systems in developing
countries.
Health Information system

9. Health information system emergence has
therefore lead to shifting from paper based to
computer-based ways of processing health
information.
This shift has increased the opportunities of
manipulating patient data efficiently.
Health Information system(2)

10. The field of Information and Communication
Technology (ICT) combines science and
technology.
Human computer interaction for development
(HCI4D) provides a focus for that
interdisciplinary dialogue.
Overview of Information and
Communication Technology (ICT)

11. This document included:
1. Short abstract
2. Introduction (defines a problem, define
questions, to write why this is important)
3. Several sections, according to the needs.
Challenges Document

12. A) To collect challenges and prerequisites (what
we do need in developing countries for building e-
health systems, what infrastructure and other
important conditions?) from literature,
B) At the end of this document to build a table
with collected challenges and prerequisites.
C) To place in the document extended Concept
Map.
Challenges Document

13. ● I read some articles about concept map to use it
as a sense-making tool. I use it with purpose of
summarizing the ideas from articles;
● I started a work on literature review. For this
purpose I read articles about E-health system in
developing countries;
● I identified a set of specific challenges in e-
health system field;
Current work

14. Challenge name Challenge
description
Found in country Source
Infrastructures e-health system need for
infrastructures
India, Kenya, Macpherson Yvonne and
Chamberlain Sara
Economy For design good health
system we need to good
economy. In most
developing countries the
people have poor economy.
Developing countries Lewis Trevor, Synowiec
Christina, Lagomarsino
Gina and SchweitzerJulian
Central point The central point is
necessary for e-health
system. The health system
manager can control the
all health system.
Bangladesh, Pakistan Ouma Stella, and
Herselman M.E.,
Internet connection The internet connection is
necessary or good e-health
system.
Developing countries MacPherson Yvonne and
Chamberlain Sara
Academic staff E-Health system need to
best academic staffs for
good health service.
Kenya, India,
Bangladesh…
MacPherson Yvonne and
Chamberlain Sara
Challenge in developing
countries

15. Challenge name Challenge
description
Found in
country
Source
Transportation Transportation is the big
point for e-health system to
rural area
Developing countries Roberto J Rodrigues,
Cost and time lack The cost of infrastructure
and time is very important
in health system sector
Developing countries Roberto J Rodrigues,
Lack of proficient human
source staff and lack of
trainings to produce this
staff
The computerized
information system wants
experienced people for its
effective action. Training is
one of the aspects for use
of any new technology.
Developing countries Hanson K, Ranson MK,
Oliveira-Cruz V, Mills A
Patient education The patient education and
skill is necessary of e-
health system
Developing countries James G. Kahn, Joshua S.
Yang and James S. Kahn
Challenge in developing
countries (2)

16. Challenges identified up to now
Infrastructures
Economy
Central point
Internet connection
Academic staff
Transportation
Cost and time lack
Lack of proficient human
resource staff
Lack of trainings
Patient education

17. To submit a paper “Challenges and
Opportunities in eHealth: the Afghan
Scenario”
To conference The Fourth International
Conference on e-Technologies and Networks
for Development (ICeND2015)
Plans for this academic year

18. The proposed structure for the chapter:
◦ ICT4D (ICT for development) (overview of the
concepts);
◦ e-Health (overview of the concepts);
◦ Examples of success cases;
Plan Introduction Chapter

19. ◦ Challenges (1. Literature review; 2. Initial field
research - Afghanistan related challenges);
◦ Potential transforms (analysis of possibilities in
Afghanistan context);
◦ Selected case study
Plan Introduction Chapter(2)

20. Qualitative research is about finding out not just
what people think but why they think it. It’s about
receiving people to speak about their opinions so
we can know their motivations and feelings.
Face-to-face interviews and group discussions are
the good way to receive this type of in-depth
feedback.
Approach

21. Qualitative research can be important when we
are developing new products (e-health system for
Afghanistan) or coming up with new marketing
initiatives and we want to test reactions and
improve our approach.
In this research we used the survey qualitative
research for data collection from hospitals in
Afghanistan. The survey is a best approach of
data collection in this research.
Continue…

22. The word of survey is used most often to describe
a method of collecting information from a sample
of individuals.
The purpose of this survey was collecting
information about problem and challenges are
exist in health system in Afghanistan.
Survey

23. Surveys can be divided into two broad categories:
the questionnaire and the interview.
Questionnaires are usually paper-and-pencil
instruments that the respondent completes.
Interviews are completed by the interviewer based
on the
Types of Surveys

24. The qualitative research interview search for
describe and the meanings of central subjects in
the life world of the subjects.
Interview is the oral conversation between two
people with the objective of collecting relevant
information for the purpose of research.
Interview

25. Focus groups could provide information about a
range of ideas and feelings that individuals have
about certain issues, as well as helpful the
differences in perspective between groups of
individuals.
Focus group

26. We used the focus group interview for achieving
data from the groups of doctors, nurses,
managers and patients. We had a questionnaire
for collecting data about the health system
challenges and problem in Afghanistan.
Hospitals Focus Group

27. The important step in preparing the focus group
interview for collecting information about the
challenges and problems in health system in
Afghanistan is the development of a set of
questions which encourage participants to
respond and request the information needed from
the group.
Focus Groups question methods

28. There are five general types of questions used in
focus group interviews. We have these types of
questions for interview.
• Opening questions are used to get people talking and
feeling comfortable. They should be easy to answer, but
should not emphasize differences among group
members.
• Introductory questions are used to get the group to start
thinking about the topic at hand. They help focus the
conversation.
Types of questions

29. • Transition questions provide a link between the
introductory questions and the key questions. They
typically ask participants to go into more depth than
introductory questions.
• Key questions focus on the major areas of concern. The
majority of the time is devoted to discussions of these
questions.
• Ending questions bring the session to closure.
Continue…

30. This research used the opening questions for
focus group interview. The purpose of design this
type of questions is collecting data from the
respondents about some challenges are exist in
Afghanistan heath system.
Focus group health system
question method

31. A sample is a limited component of a statistical
population whose properties are studied to
achieve information about the whole.
Purposive sampling was selected for this research
The sampling has different types, we used the
typical case sampling in this research.
Sampling

32. The typical case sampling imports taking a sample
of what one would call typical, normal or average
for a specific phenomenon.
The typical case sampling in this research focuses
on what is typical, normal, and/or average
(doctors, nurses, manager, and patients)
Typical Case Sampling

33. To cluster challenges by type, e.g. financial,
infrastructure, etc.;
To prioritize challenges by criteria of reach ability and
amounts of resources that they needed to invest
(money, time, people, etc.);
To map these results to situation in Afghanistan and
identify, which challenges are the most critical for
Afghanistan
Immediate planned tasks

34. Thank you!