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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
                           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                QuickTime™ and a
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• The Global Fund to fight
  AIDS, Tuberculosis and                                    QuickTime™ and a
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• Roll Back Malaria                                                   QuickTime™ and a
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                     Lecture 8
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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

                                              Lecture 8
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• 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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                                                            Lecture 8
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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
                                            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
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• Personal connections                                         TIFF (U nco mpre sse d) de comp ress or
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    Dr. Alasdair Unwin working
     on malaria in suppport of
     Tanzanian Ministry of
     Health
• CD-ROM on malaria
    In partnership                                                     m
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    ICT4D web-solution
    http://www.gg.rhul.ac.uk/ict4d/Mal                                 m
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                                          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/hom
      e/




                             Lecture 8
  Delivering medical practices



• Telemedicine in                               QuickTime™ and a
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• 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
                                                       QuickTime™ and a
    Ayurvedic doctors diagnose and          TIFF (Uncompressed) decompressor
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     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
                                                     Qu ickTime™ a nd a
• Women are treated by                    TIFF (Uncomp ressed) d ecompr esso r
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  women
• Wider healthcare is
  promoted by field workers
• Local workers speak local
  languages                                           Qu ickTime™ a nd a

• Provides some
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  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

								
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