ICT for Developmente-Health: telemedicine and health information

initiatives

ICT4D Lecture 9Tim Unwin

Lecture 9

Outline

• The global health agenda• E-health

Information Delivering practices

• Examples Global organisations Information and prevention Telemedicine

Lecture 9

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 9

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 9

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 9

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 9

Global Health Initiatives and ICT

• World Health Organisation

• The Global Fund to fight AIDS, Tuberculosis and Malaria

• Roll Back Malaria

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• 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

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Lecture 9

• 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!

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• 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

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Information disssemination

• Soul City, South Africa• Imfundo’s support for

fight against malaria and HIV/AIDS

Lecture 9

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 9

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 9

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

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Lecture 9

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/homepa

ge/home/

Lecture 9

Delivering medical practices

• Telemedicine in South Africa

• Jiva teledoc in India

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Satellite link to rural hospital in Maliwww.satexpo.it/en/ news-new.php/3?c=42700

Lecture 9

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 9

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 9

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 9

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)

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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

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Lecture 9

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?