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ICT for Development e-Health: telemedicine and health information initiatives. ICT4D Lecture 8 Tim Unwin. Outline. The global health agenda E-health Information Delivering practices Examples Global organisations Information and prevention Telemedicine. Health related MDGs.
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ICT for Developmente-Health: telemedicine and health information initiatives ICT4D Lecture 8 Tim Unwin
Outline • The global health agenda • E-health • Information • Delivering practices • Examples • Global organisations • Information and prevention • Telemedicine Lecture 8
Health related MDGs • Goal 4: reduce child mortality • Target 5: reduce by two-thirds (1990-2015) the under-five mortality rate • Goal 5: Improve maternal health • Target 6: reduce by three-quarters (1990-2015) the maternal mortality ratio • Goal 6: Combat HIV/AIDS, malaria and other diseases • Target 7: halted by 2015 and begun to reverse the spread of HIV/AIDS • Target 8: halted by 2015 and begun to reverse the incidence of malaria and other major diseases Lecture 8
ICTs and the health agendas • Three core areas • Health management systems • Information and prevention • Medical practices • Key drivers • Experiences from north America and Europe • Particularly in telemedicine initiatives • Pharmaceutical industry: the money in medicine • Expanded markets • But also a concern to use the potential benefits for greater good Lecture 8
ICTs and the health agendas • Long experience of ICTs in health • Theatre, dance, film, video in health education • ‘Traditional’ telemedicine • Australian flying doctor service in 1920s • Potential of new technologies • Very high cost of medical diagnosis equipment • Samples and images can be sent digitally • Use of consultants contacted by ‘phone/digitally • Saves time at a distance • Making information relevant and appealing • Managing large amounts of data Lecture 8
E-health • Information • Managing health information • Hospitals • Diseases • Maximising health benefits for populations • Disseminating information on health care and prevention • Health workers • General public • Delivering medical practices • Telemedicine initiatives Lecture 8
Global Health Initiatives and ICT • World Health Organisation • The Global Fund to fight AIDS, Tuberculosis and Malaria • Roll Back Malaria Lecture 8
e-Health initiatives • Africa: Health Information Systems (HIS) http://www.afro.who.int/his/index.html • But not particularly active • South-east Asia • Telematics and IT programmes • Americas • Telemedicine initiatives • As yet, mainly pilot schemes • Little evidence of ability to deliver initiatives at scale Lecture 8
The Global Fund http://www.theglobalfund.org/en • A financial instrument created in 2002 • $3 billion committed in 128 countries (Feb 2005) • Nothing on ICT or e-Health on site! Lecture 8
Malaria kills 1 million people a year • RBM Partnership • Launched in 1998 by WHO, UNICEF, UNDP and World Bank • Now has more than 90 partners • ICT based work • Multimedia online resources • http://www.rbm.who.int/cgi-bin/rbm/rbmportal/custom/rbm/home.do • Mainly use in information dissemination Lecture 8
Information disssemination • Soul City, South Africa • Imfundo’s support for fight against malaria and HIV/AIDS Lecture 8
Soul City South Africa • Soul City: Institute for Health and Development Communication http://www.soulcity.org.za • A South Africa NGO • Established 1992 • Especial focus on HIV/AIDS • Different media • Television • Six series, each of 13 episodes • Radio • Six series, each of 45 episodes in 9 languages • Print Lecture 8
Soul City South Africa • Evaluations • 47% of people in SA say it is main source of info about HIV/AIDS on TV • Strong positive correlation between behaviour and exposure to Soul City • Soul City is as well known as Coca Cola in South Africa • Materials used in 11 African countries Lecture 8
Imfundo support for malaria • Imfundo agendas • Seeking relevance • Tanzania • Personal connections • Dr. Alasdair Unwin working on malaria in suppport of Tanzanian Ministry of Health • CD-ROM on malaria • In partnership • ICT4D web-solution • http://www.gg.rhul.ac.uk/ict4d/Malaria.html Lecture 8
Imfundo and the Interactive Health Network - HIV/AIDS • Database on digital information on HIV/AIDS • Ready access to a wealth of digital materials • Searchable by types of user and types of information • Users can provide comments on the resources • Developed through partnership • http://hivaids.digitalbrain.com/hivaids/homepage/home/ Lecture 8
Delivering medical practices • Telemedicine in South Africa • Jiva teledoc in India Satellite link to rural hospital in Mali www.satexpo.it/en/ news-new.php/3?c=42700 Lecture 8
Telemedicine in South Africa • Telemedicine Research Centre • Established by Medical Research Council in 1999 • Designed to evaluate relevance of international expertise for Africa • Findings: telemedicine enables • Access to specialist radiologists within hours rather than days • Improved diagnosis by community service doctors • Local treatment of some patients, thus reduced transfers • Reduced professional isolation of doctors in rural areas Lecture 8
Telemedicine in South Africa • University of Transkei http://telemed.utr.ac.za • Open Source telemedicine initiative • Web-links • Pathology • Pathopic (Basel) http://alf3.urz.unibas.ch/pathopic/e/intro.htm • Telemedicine • Health information • Online teaching resources • Potential is there • But not much evidence of high usage Lecture 8
Jiva: sustainable healthcare in rural India • Jiva Institute • Non-profit Research and Development Institute founded in 1992 • Health, Education and Social Enterprise • Health activities • Ayurveda website - the world’s first • Holistic, healing science • Ayunique - online consulting • Teledoc - healthcare for all • Ayurbuyer - online store • Jiva College of Ayurveda Lecture 8
Jiva Teledoc • Based in village in Haryana • Won World Summit Aware • Practice • Healthcare workers record diagnostic data • Use Java enhanced mobile ‘phones to transmit data • Ayurvedic doctors diagnose and prescribe treatment • Medicines are then delivered by field workers to patients • Costs 70 rupees ($1.50 per consultation) Lecture 8
Jiva Teledoc social returns • Patients have affordable treatment • Women are treated by women • Wider healthcare is promoted by field workers • Local workers speak local languages • Provides some employment in rural areas Lecture 8
Conclusions • Much is technically feasible • High cost end: telemedicine • Lower cost: considerable health information • Importance of combining multi-functional access points for information • The role of Telecentres • Yet, the potential of e-Health has still to be realised • Why is this? Lecture 8