Health – Page 6 – Integra LLC

Agriculture, Health, Health, Health Systems, Mobile, Originally posted on the GBI Portal

ICT’s in Health: A Crash Course

The world of ICT is expanding into the health sector, and their interactions are garnering more and more attention by the day. Therefore, we must be mindful of the beginnings and demarcations of ICT usage in health. After all, we can’t know where we are going unless we know where we came from.

Current ICT for health news in the developing world is dominated by initiatives using mobile telephony; the bread and butter of mHealth. This is not a total shock since over 85% of the world now has mobile coverage. Moreover, there are over 5 billion people on Earth with a mobile phone, and 3.5 billion of them are in developing countries. As a result, mHealth initiatives are booming in developing countries, especially in Africa and South Asia.

But what about other forms of ICTs that play a role in healthcare? What are they and how do they work? This crash course on the intersection between ICT and Health will explore the different avenues within that intersection and how to distinguish them from one another to prevent confusion.

Avenues of ICT and Health

Avenues are the different types of structured practices that implement ICTs in the health field. An avenue in the intersection of ICT and health will utilize old technologies, new technologies or a convergence of both in a structured and systematic way to achieve positive health outcomes. These are the different avenues:

eHealth: The term eHealth refers to the practice of using and being supported by electronics in healthcare. eHealth is the umbrella concept for many other avenues of ICT and health such as telemedicine and mHealth. The term is interchangeably used with health informatics by some experts. The term characterizes a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology. According to the World Health Organization (WHO), eHealth is the quintessential embodiment of the intersection of ICTs and health. Electronic health record systems, health information systems, mHealth and telemedicine all fall under the jurisdiction of eHealth.

Telemedicine: Technically, telemedicine has been around for decades, ever since doctors on one end of the phone have consulted patients on the other end of the phone. It pertains to providing remote clinical care through forms of telecommunication and information technologies. What distinguishes telemedicine from telehealth, since they are sometimes incorrectly used interchangeably, is that the former delivers clinical care while the latter offers clinical and non-clinical care such as health research and education. Telemedicine services include live patient consultation over phone or video, remote patient monitoring, medical and health information acquisition, and emergency telemedicine.

mHealth: Also called mobile health, mHealth is a form of eHealth that uses mobile devices such as mobile phones and PDA’s for health services. The Global Observatory for eHealth (GOe) defined mHealth as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices. mHealth capitalizes on mobile telecommunication services such as SMS, general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology.

Health Informatics: This is the field that aims to analyze the information needs of consumers, implement ways to disperse information to consumers and health professionals, and integrate consumer preferences into medical information systems. The field uses devices, resources and methods to store, obtain, retrieve, and disseminate information for healthcare purposes. Health informatics mostly uses computers but also takes advantage of clinical guidelines, advanced medical devices, and ICT services.

July 19, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Mapping for Informed Decision Making in Rwanda

Mapping and Geographic Information System (GIS) have long been used in Rwanda for sectors such as agriculture and economic growth. The need for these innovative tools and skills, however, are just now being recognized in other fields, including health. As a monitoring and evaluation expert, I have seen how useful geography and maps can be to monitor and improve programs, and I was interested to learn more about how they were being used and enhanced in the field.

For four days, I joined 18 public health professionals at a GIS training in Kigali, Rwanda, organized by MEASURE Evaluation and Monitoring and Evaluation Management Systems (MEMS) and supported by USAID in collaboration with National AIDS Control Commission (CNLS ). The participants represented many local Rwandan organizations such as MEMS, the Ministry of Health, the Center for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics (TRAC Plus), and National University of Rwanda’s School of Public Health.

Andrew Inglis and training participants use qGIS and local data to produce maps that can be used for monitoring HIV programs.

GIS is a unique tool that allows people to interact with their data. Rather than comparing data in charts or graphs, mapping data through geography allows data users to identify essential trends and associations that may not be apparent in other formats. By building local capacity in GIS, we are expanding “evidence-based decision making” for high quality and strategic health programs.

There was a lot of enthusiasm during the training about GIS. The training provided an excellent forum for the participants to talk about innovative ways they are already using the GIS tool. Participants discussed plans to create new programs that would allow for better ownership and monitoring, to improve supply chain management, and to integrate services, all things that will support and enhance the projects that USAID and its partners are implementing.

MEASURE Evaluation trainers, Andrew Inglis and Clara Burgert, introduced the concept of GIS maps and their ability to link to a database that is capable of capturing, storing, querying, analyzing, displaying and outputting data. In addition to teaching concepts such as how to interpret maps and how to effectively use spatial data, the training provided participants an excellent opportunity to gain practical experience.

Prior to the training, data was collected from each of the representing organizations so they could to make a map during the training and present to the group. All the participants also left with qGIS, an excellent free mapping tool, giving them something to work with as they began to hone their new skills and build their organizational capacity.

Andrew Inglis is a firm believer building capacity through the use of geographic and spatial data for program planning, implementation, monitoring, evaluation and advocacy. He explained, “The goal of capacity building is to turn potential into reality. During the January 2011 stakeholders meeting the potential value of GIS towards evaluation of HIV prevention programs were recognized, however, the lack of capacity within the national institutions is a major barrier. The aim of the capacity building is to start to realize this potential and reduce the capacity barrier to the use of GIS within national institutions.”

After the training, MEASURE Evaluation wrapped up the week with an Open Forum, hosted by the CNLS, inviting participants and other stakeholders to discuss how best to put these newly acquired skills to use. The goal was to create linkages between the HIV/AIDS and health sectors (and other related sectors) and to promote the sharing and use of data linked to geography in Rwanda. It was energizing to be there, discussing with Rwandan colleagues how they can use GIS and mapping tools to connect better with each other, improve the way they plan, implement and monitor health services, and ultimately improve the health outcomes in their country.

As Solomon Kununka, Management Information Systems Specialist from MEMS, put it, “This has initiated me into the GIS community. Now I want even more training. But, I have the basics. I can make maps for my supervisor and me, to be used for decision making.”

July 18, 2011/by actualize

Agriculture, Family Planning, Health, Health, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Delivering babies in Ghana just got a little easier

Pregnant woman on phone. Photo Credit: MOTECH

A new mobile phone service was recently launched in Ghana that provides free access to health information in ensuring safe pregnancies. The service, aptly named Mobile Midwife, offers text or voice messaging on maternal health to pregnant women.

Mobile Midwife was developed as part of the U.S. based Grameen Foundation’s MOTECH Ghana initiative, funded by the Bill & Melinda Gates Foundation. It is just one more result of rising donor attention to mHealth services. Its creation continues a trend of mHealth initiatives being churned out in Africa.

Educating women and making them aware of the maternal health risks associated with pregnancies are the cornerstone goals of the service. To make it convenient for the user, the service comes in several different languages, and is presented by text or voice via mobile phones. Additionally, the messages are time specific concurring with the woman’s stage of pregnancy.

When a pregnant woman registers for the service, they are asked to give the expected due date for delivery of the unborn child and their location. Then, periodically, the woman receives messages informing when appointments are due or overdue to remind them to visit the health clinic for check-ups.

The users also get reminders for specific treatments, information about milestones in fetal development, nutrition facts, tips on the benefits of breastfeeding and other pregnancy-related and prenatal health information. It also provides information that demystifies local pregnancy myths and helps users overcome the widespread fear of visiting doctors or health clinics.

MOTECH also rolled out a similar mobile health service earlier in the year that enables nurses in rural Ghanaian health facilities to automate much of their record keeping and reporting, which formerly took 4-6 days per month. The service is in the form of a java–based mobile phone application.

Both Mobile Midwife and the application mentioned above have made life easier for everyone involved in the process of delivering a baby.

One Ghanaian mother said to Grameen, “I would like to advise my pregnant friends to go to the hospital to enroll into MOTECH, to listen to the messages and also to practice what is said because it helps a lot…I used to be scared about pregnancy but now with the messages I am no longer scared and it has taken away my worries and that we feel ok and then the pregnancy is ok.”

This service is extremely pertinent since Africa exhibits some of the worst maternal health records in the world. Fourteen of the fifteen countries with the highest rates of maternal mortality in the world are in Africa. Furthermore, African countries are far behind in meeting Millennium Development Goals set for 2015; especially for those associated with maternal health. Perhaps services like this can lend a helping hand.

July 18, 2011/by actualize

Agriculture, Health, Health, Health Systems, Mobile, Originally posted on the GBI Portal

MIT researchers link camera technology to healthcare

MIT researchers recently created a smartphone device designed to detect cataracts. Called Catra, the device uses “off -the-shelf components” as opposed to the highly expensive and highly space consuming technologies normally used to detect cataracts.

Using Catra device on smartphone. Photo Credit: EyeCatra

The research group is part of the MIT media lab that won the MIT Global Challenge competition back in May. Taking advantage of mobility through mobile phones and an inexpensive design, Catra was designed for use in the developing world.

The device, which attaches to the screen of a smartphone, costs about $2, whereas a slit lamp examination conventionally used to examine cataracts cost up to $5,000. And unlike conventional slit lamp examinations, Catra does not need a skilled human operator to administer the test and read the results, Catra does everything for the patient.

Catra utilizes a technique, which allows the user to respond to what they visually experience. It scans the lens of the eye section by section. The user then sees projected patterns and presses a few buttons to map the light attenuation in each section of the eye. This information is collected by the device creating an attenuation map of the entire lens. This allows individuals to monitor the progression of the severity of the cataract on their phones.

Catra vs. Slit Lamp technology. Photo Credit: MIT

This is not the MIT media lab’s first project to improve the health of the eye. They are working on a series of projects involving eye care. They developed and released Netra, an application and smartphone attachment for eye exams via mobile phone, last year.

Cataract is a condition where clouding builds up in the lens of the eye. It is the leading cause of avoidable blindness worldwide. Furthermore, ophthalmologists, doctors that specialize on the eye, are scarce in the developing world with one ophthalmologist per million people in some areas. When cataract leads to vision loss, it prevents people from being productive citizens in their community. It leads to high levels of illiteracy and poverty, and can impair a society’s economic and health sectors.

Using mHealth to tackle cataract is a crucial development. However, smartphones are not ubiquitous in the developing world. And it’s for a reason. Even though the Catra device may be cheap, the phones on which they operate are much more expensive. This needs to be considered when implementing Catra on a wide scale in the field. However, with the potential of this kind of technology, it is likely that MIT media lab will find a way.

July 14, 2011/by actualize

Agriculture, Connectivity, Education, Health, Originally posted on the GBI Portal

Kenya university to roll-out e-care

Kenya’s Kenyatta University

Kenya’s Kenyatta University’s referral hospital’s doctors and interns are getting a boost in the services they are able to provide to patients with the establishment of an e-care system that will enable them to consult with doctors and experts across the globe.

According to Vice-Chancellor Olive Mugenda, the new e-technology will enable patients to receive the appropriate care needed inside the country, and not be forced to travel abroad to consult other experts. The move is likely to see Kenyans overall health costs reduced.

The KES Sh9 billion (about USD $100 million) hospital, funded by the Chinese and Kenyan governments, will also connect medics at the referral hospital with those in rural areas.

Mugenda says the facility would have a cancer unit and a geriatric wing to provide health care for the old. ”The need for a cancer unit is justified by the increasing cases of the disease among our people,” says Mugenda.

The university will, on 8 July 2011, officially launch a centre to equip students with the necessary skills to be job creators.

The Business Innovation and Incubation Centre will offer students office space, Internet facilities, capital to start businesses and assistance in marketing their products.

Janan Yussif

July 7, 2011/by actualize

Agriculture, Family Planning, Health, Health, Health Systems, Infectious Diseases, Maternal & Child Health, Mobile, Nutrition, Originally posted on the GBI Portal

New mHealth service gives Iraq options for monitoring health

Iraq’s largest private telecommunications company, Asiacell, announced this week the launch of its mobile health content download and SMS service which is now available to its prepaid and postpaid subscribers. Asiacell is the only mobile telecom company providing coverage for all of Iraq.

An Iraqi man holds a cell phone. Photo Credit: Mario Tama, Getty Images

The new service offers information on various health practices which can be discriminately selected by the user. Asiacell offers a weekly and a daily health update service. The daily health updates include information on women’s health, men’s health, children’s health, dieting, mental health, and diabetes. Albeit a little more limited, the weekly updates is a downloadable service which only cover topics such as sports and fitness, mental health, and emergency medicine.

Customers can subscribe to the daily SMS service, by sending a blank SMS message to the toll-free short code “2330”, and then send their preferred health topic, which they can choose from a list that will be automatically sent via SMS, to short code “2331”. This service costs IQD 2,500 ($2.14) per month.

Subscribers can also download content on a weekly basis by sending the number “1” to short code “2332” for sports and fitness information, or to “2333” for mental health information, or to “2334” for emergency medicine information. This service costs IQD 2,000 ($1.71) per month.

A similar service operates in India called mDhil which uses SMS to send health messages on various topics. The service overcame social stigmas regarding certain topics of health such as reproductive health, and became one of the most successful mHealth programs in India. Asiacell’s new service faces identical hurdles in Iraq and hopes to prevail like mDhil did.

Photo Credit: Asiacell

Asiacell is the only telecom provider to cover all of Iraq. They provide services to nearly 8 million of the estimated 31 million living in Iraq. This is remarkable given that just 5 years ago under the reign of Saddam Hussein, less than one million Iraqis had access to land lines and the average civilian did not have access to a mobile phone. Despite that and the war which ruined telecommunication infrastructure, Iraqis now have steady access to telecom services, especially mobile phones.

It is probably due to the increased access to information that has led Iraqis to become more health conscious claims Asiacell. Dr. Mustafa Adil, an Iraqi physician, said that maintaining a healthy lifestyle has become a major concern for communities, as people are more aware of the importance of following the latest health advancements and practices. He explained that Asiacell’s Mobile Health service supports the healthcare sector’s goal to promote sound health habits.

July 6, 2011/by actualize

Agriculture, Health, Health, Health Systems, HIV/AIDS, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Mobile health quizzes get a 2.7 million Euro boost

Text to Change (TTC), an mHealth non-profit organization based in the Netherlands, announced earlier this month that they will receive a €2.7 million grant to expand its services. TTC provides an SMS-based educational service to improve the health of citizens in eight countries in Africa and one in South America.

Already a big contributor in mHealth development, TTC hopes to become a leader in the field with the reception of its multi-million Euro grant from the Dutch Ministry of Foreign Affairs via Connect4Change (C4C), a consortium funded by the Dutch Ministry of Foreign Affairs that develops mobile based solutions on issues of poverty in Africa and Latin America. TTC will partner with C4C to expand its services to 11 more countries in Africa and South America by the end of this year.

Implementing ICT in the 11 countries is a top priority for both TTC and C4C. They are hoping the mutual partnership will make establishing ICT services an easier task as the expansion continues. According to TTC, the game plan calls for TTC to provide “low” technologies like SMS and mobile voice services while C4C provides “high” technologies such as mobile internet and video transfer. Therefore, TTC and C4C will play different roles.

C4C will also invest its time reaching out to local entities on the ground to strengthen ICT networks. TTC will focus on improving health outcomes through their established mobile phone initiatives.

TTC sets up their mobile platform through the recipient country’s mobile service infrastructure already in place. They then subscribe mobile phone users to their programs which use SMS communication to inform people of HIV testing, treatment clinics, and other health related services at no cost to the recipients.

TTC SMS system Photo Credit: TTC

TTC programs offer the information through a free educational quizzing service where participants are quizzed about a specific health topic. As participants answer the questions correctly, they are sent more rounds of questions, again at no cost. If the participant can answer enough questions correctly, he/she receives incentives such as phone credit, t-shirts and health products.

Thus far, TTC has reached thousands of individuals with their programs on HIV/AIDS, malaria, and reproductive health. Furthermore, to assess the impact of ICT in the countries they are currently working in, TTC will even conduct large scale ICT evaluations over the next few years in those countries.

TTC is poised to make an impact in ICT through their mobile services. Their work is just another example of how mobile phones are being used as a medium to educate, inform and save lives. The tag-team partnership with C4C will be expanded to all 11 target countries by the end of this year. However, we will have to wait some time before confirming the outcome of this joint strategic approach.

June 27, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Infectious Diseases, Mobile, Originally posted on the GBI Portal

Camels and SMS: Transporting vaccines in resource poor areas

Camel without refrigerator attached. Photo Credit: Art Center College of Design

The PATH initiative, which advances malaria vaccines, recently predicted that over ten times more vaccine storage will be needed in the developing world over the next 15 years. However, transporting and managing vaccines in developing countries faces many obstacles, including inhospitable climates, poor infrastructure, lack of electricity and disparate communities.

As a result, over 1 million people die every year in developing nations due to vaccine-preventable diseases. In some cases, vaccines may be reaching these populations, but when they do, they are no longer functional because they were not adequately cooled. Most vaccines must be stored within a certain temperature range in order to remain functional. Health organizations are increasingly turning to technology to help them do just that.

Fridge about to be loaded onto camel. Photo Credit: Art Center College of Design

Many NGOs and ministries of health make use of mobile vaccine refrigerators that harness solar energy to power the internal chamber that holds the vaccines. A particularly innovative and resourceful vaccine refrigerator came on the backs of camels. Naps’ Camel Fridge was designed back in 2005 and operates off of solar power. The fridge uses solar panels to harness energy, and sits on the backs of camels that transport the fridges to rural destinations. Over 1,500 of these camel fridges have been sold to WHO and UNICEF programs.

But if a shipment of vaccines arrives spoiled, it is important to know where in the logistics chain the temperature was breached so that changes can be made to prevent a recurrence.

However, some issues with these mobile refrigerators are temperature maintenance and vaccine spoilage. A practical gadget that has made cold chain storage more efficient is a technology that involves vaccine monitoring. SmartConnect, a technology developed by Inveneo that uses existing cell phone networks for data communication, can monitor vaccines by sending information about the arrival time and temperatures of vaccines in transit. That way, officials will know not only if a vaccine has spoiled, but when and where the problem may have occurred.

Sure Chill Vaccine Refrigerator Photo Credit: True Energy

SmartConnect is not the only project making use of SMS technology. True Energy’s Sure Chill Vaccine Refrigerators, which are WHO pre-certified, can store vaccines at a constant optimal temperature, without power, for up to ten days while using a vaccine vial monitoring system that records temperature changes and can send an SMS to indicate those changes.

True Energy has already shipped multiple units to Senegal and Vietnam under project Optimize, a WHO/PATH collaboration, and aims to ship many more units to countries like South Sudan, Kenya, Nigeria, Yemen, India and many more.

Incorporating mobile monitoring technologies and improving the efficiency of the fridges could make a tremendous impact on the success of many vaccination programs. And if PATH’s prediction rings true, they will be greatly needed.

June 24, 2011/by actualize

Agriculture, Agriculture Markets, Environment, Extension Service, Farmer to Farmer, Health, Originally posted on the GBI Portal, Sustainable Agriculture

Tackling Poor Access to Farm Extension Services with ICTs

Poor access to farm extension services is still a major impediment to agricultural productivity and the improvement of rural livelihoods. But, increasingly, ICTs are playing a central role in enabling and facilitating the provision of demand-driven extension services. This marks a shift from highly inefficient public sector extension delivery models, under which farmers and rural communities had little/no opportunity to articulate their own needs.

Despite the ICT-enabled shift towards more democratic/pluralistic, demand driven and efficient extension services in some places, there is still a far way to go before game changing impacts are made.

A silver laptop with a blank screen and black buttons on bright green grass

CTA/ARDYIS Facebook Photo

Although the use of conventional technologies such as radio and television, and even new ICTs, is commendable, many “model projects” reach too few people and are unsustainable.

But the emergence of multiple players in the evolving extension services landscape—NGOs/CBOs, private sector actors, and farmers as extension service users and sharpers, among others—presents broad opportunities. The main opportunity I foresee is that of a firmer platform for articulating the need for better telecommunications policies, which will benefit extension services and the broader range of development objectives that hinge on access to ICTs.

Consequently, agricultural planners and policy-makers ought not to be particularly concerned with specifically enabling the integration of ICTs into pro-poor extension service delivery. While that is a desirable objective, it ignores the broader picture—poverty reduction.

Strategic agricultural planning recognize that ICT-based solutions for agricultural problems are not all sector specific. In much the same way that the major agricultural challenges operate on a macro-level, by cutting-across sectors, the solutions must stem from holistic observations and responses.

Indeed, any ICT intervention that improves the livelihoods of the rural poor is likely to have positive (direct and indirect) impacts on agricultural value chain management—planning, productivity, and marketing. This is true to the extent that rural economies are largely agrarian. So, any challenge to improving the general livelihood of the rural poor will adversely affect agricultural productivity— be that challenge inadequate health services, poor resource management, natural disasters, anthropogenic shocks, minimal access to education, financial services and poor infrastructure, etc.

So, strengthening extension services will require tackling more systemic problems… seeing the forest and not just the trees.

June 13, 2011/by actualize

Agriculture, Health, Health, Health Systems, Infectious Diseases, Mobile, Originally posted on the GBI Portal

HP plans to provide mobile technology to tackle malaria

Nurse using app on Palm Pre 2 smartphone in Botswana. Photo Credit: HP

On June 6^th, Hewlett Packard (HP) announced it will collaborate with a non-profit organization in Botswana to provide technology to monitor and treat malaria outbreaks. HP announced it will begin a yearlong clinical trial that will equip medical professionals in Botswana with Palm Pre 2 smartphones designed to collect information on malaria outbreaks.

HP will supply the technology to the non-profit group Positive Innovation for the Next Generation (PING) who will train health workers to collect the data on malaria outbreaks. The data will be collected and stored through an application on the smartphones provided. The application can store photos, videos, audio files as well as GPS information which can be used to generate a geographic map of the areas affected by outbreaks, which has never before been done in Botswana.

The program hopes to increase the rates of mosquito net distribution and provide advanced warnings to regions at risk of an outbreak. Within a day, health workers can achieve results that would normally takes weeks to produce.

Malaria is one of the most widespread infectious diseases, and according to the World Health Organization (WHO), takes nearly one million lives every year, mostly in Africa. WHO has predicted as much as 10% of the African population is under the threat of malaria. Therefore, controlling outbreaks and being able to predict devastating malaria epidemics is crucial to alleviating its burden.

What’s also noteworthy here is that HP is plunging into the mobile health monitoring market, one example of HP’s plans to contribute to global healthcare. Instead of putting money into pockets, HP is aiming to contribute technology and other innovative solutions to tackle challenges that are hindering healthcare around the world. This shouldn’t surprise anyone however, since HP was one of the founding members of the mHealth alliance.

This program indicates the rising importance of mobile health technology as a key player in tackling health burdens in developing countries. Using mobile technologies, whether to collect data from isolated populations or to monitor disease prevalence presents an avenue for NGO’s and governments to reduce health service costs and increase accessibility. HP hopes to scale up this program to all of Africa, contingent upon success in Botswana.

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June 10, 2011/by actualize

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