Post on 20-Jun-2015
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Improving sustainability of primary e-healthcare projects in rural areas of developing countries
Inés Bebea González
ines.bebea@ehas.org
Project Manager at Fundación EHAS
PHD Student at Universidad Rey Juan Carlos
Motivation
• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICTs to improve healthcare
processes in rural areas of developing countries.
Motivation
• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICTs to improve
healthcare processes in rural areas of developing countries.
• Work areas– R & D in ICT technologies and telemedicine services
• Long distance voice and data connectivity
• Telemedicine
– Advice and evaluation of primary healthcare processes using ICT
– Education and knowledge transfer on ICT solutions• Capacity building
• Technology transfer
• High-level education (Engineering, Msc, PhD)
Motivation
• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICT to improve
healthcare processes in rural areas of developing countries.
• Work areas– R & D in ICT technologies and telemedicine services
• Long distance voice and data connectivity
• Telemedicine
– Advice and evaluation of primary healthcare processes using ICT
– Education and knowledge transfer on ICT solutions• Capacity building
• Technology transfer
• High-level education (Engineering, Msc, PhD)
• Traditionally in Latin America: Peru,
Bolivia, Ecuador, Colombia and Cuba
Motivation: Improve public Healthcare to the rural
3 billion people live in rural areas of developing countries
Source: Worldmapper.org (retrieved March 2011)
Motivation: Apply e-Healthcare in rural areas
Rural regions characterised by isolation and unavailability of resources
Operation and maintenance of ICTs is hard
Few ICT initiatives in developing countries are sustainable
Motivation: Apply e-Healthcare in rural areas
Rural regions characterised by isolation and unavailability of resources
Operation and maintenance of ICTs is hard
Few ICT initiatives in developing countries are sustainable
But, hey, sustainability is complex!
Technology Public InstitutionsRoad Infrastructure User Acceptance Cost
Maintenance & Logistics Operational CapacityPatient Acknowledge Health Policy
Telecom Regulations etc.
Motivation: Apply e-Healthcare in rural areas
Rural regions characterised by isolation and unavailability of resources
Operation and maintenance of ICTs is hard
Few ICT initiatives in developing countries are sustainable
But, hey, sustainability is complex!
What if we could measure & fit sustainability of ongoing ICT initiatives?
Technology Public InstitutionsRoad Infrastructure User Acceptance Cost
Maintenance & Logistics Operational CapacityPatient Acknowledge Health Policy
Telecom Regulations etc.
Context: EHAS-Napo case study
Context: EHAS-Napo case study
• Rural Health Network– Reference Hospital
– 3 Health-care Centers
– 12 Health Posts
• Distances are 30-50 km (over 500 km end-to-end)
• Infrastructure:– River transport
– Unstable power supply
– VHF/HF radios if any
– 90% out of cellular coverage
• Scarce cualified health & ICT staff
Context: EHAS-Napo case study
• Rural Health Network– Reference Hospital
– 3 Health-care Centers
– 12 Health Posts
• Distances are 30-50 km (over 500 km end-to-end)
• Infrastructure:– River transport
– Unstable power supply
– VHF/HF radios if any
– 90% out of cellular coverage
• Scarce cualified health & ICT staff
Context: EHAS-Napo case study
• Rural Health Network– Reference Hospital
– 3 Health-care Centers
– 12 Health Posts
• Distances are 30-50 km (over 500 km end-to-end)
• Infrastructure:– River transport
– Unstable power supply
– VHF/HF radios if any
– 90% out of cellular coverage
• Scarce cualified health & ICT staff
Context: EHAS-Napo case study
• Rural Health Network– Reference Hospital
– 3 Health-care Centers
– 12 Health Posts
• Distances are 30-50 km (over 500 km end-to-end)
• Infrastructure:– River transport
– Unstable power supply
– VHF/HF radios if any
– 90% out of cellular coverage
• Scarce cualified health & ICT staff
Context: EHAS-Napo case study
Napo telemedicine network provides– Broadband wireless connectivity using WiLD Technology (WiFi
modified for long distances)– Voice services based on IP telephony and videoconference,– Data applications with Internet access, mailing and messaging, e-
learning, support for telediagnosis, teleconsultation and telepresence.– Systems autonomy via solar power.
Context: EHAS-Napo case study
• Network topology • Transportation Times
Context: EHAS-Napo case study
• Problems encountered:– Low availability of e-
Healthcare services
• High time to recover from failures
• Main failures:– Lightening damage to
equipment– Inaddecuate battery usage– IP telephony degradation due
to PBX version conflicts
Research methodology
• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)
• Action Research
Research methodology
• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)
• Action Research
• Factor-based Approach
Research methodology
• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)
• Action Research
• Factor-based Approach
Management Framework for Sustainable rural e-healthcare provision (Bebea, 2011)
Next steps...
I. Explore additional concepts to help analysis: Capability Framework (Grunfeld, 2007), Communication Framework (Barroso, 2007), Risk Theory, Institutional Theory, Actor Network Theory.
II. Design action frameworks for technical – institutional – financial factors
III.Consider a 2nd case study based on rural e-health
IV.Analyse sustainability assessment through “risk measurement”
Improving sustainability of primary e-healthcare projects in rural areas of developing countries
Inés Bebea Gonzálezines.bebea@ehas.org
Thank you for your attention!Questions?