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June 18th, 2001 |
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Topics Covered
Following are the discussion topics of the workshop covering the
most critical issues related to the use of ICTs in improving health and wellness in the
developing world:
Provision of Access: The
value and provision of health-related information
The Value of Information: What
health information is valuable to developing countries?
Viability & Investment: Economic
sustainability and technical capacity of ICT-health projects in developing countries
Training: Distance learning, web-based learning of physicians, healthcare practitioners and pharmacists
Provision of Access: The challenges and successful approaches to providing healthcare information in remote and impoverished areas.
Global health today is marked by a persistent deep divide in access to health services, paralleling the divide in information and communications technology. To attain the goal of equitable access to health care, the essential underpinnings must be in place. That is, relevant information - and the technologies to deliver it - must be widely available and effectively used. Telehealth applications have great potential for improving health services delivery, primarily by increasing the quality, relevance and flow of information to health professionals. However, we are far from having exploited this promise. This is due not only to financial, technological and infrastructure challenges, as the term "digital divide" suggests, but also because we tend to overlook the real needs of the user, which vary greatly due to educational, social and cultural differences as well as language. The value of one technology or communication medium over another is not always apparent as no single technology makes another obsolete (e.g. telephone and radio, TV, computers). The key is to use different technologies strategically to solve specific problems and improve on existing ways of working. The full benefit of Internet technologies will only be apparent when they meet real needs and add value to health services delivery.
The Value of Information: What health information is valuable to developing countries?
With the rise of the Web and the Internet there is substantial interest in the role of IT in international development. Many groups have identified access to modern communications as a key aspect of development, spawning such phrases as the "Digital Divide" and e-Development. Those of us who travel to the developing world regularly often rely on an Internet connection to maintain our projects and many aspects of our lives in remote areas. We struggle to connect through strange phone systems and ISPs, and relax with a sense of triumph when the email goes through!
There seems little doubt that certain tasks are much easier with digital communications, and in addition the cost of sending email is often much lower than other methods of (semi) instant communication. But are these tools really useful to people who live in developing countries? Are the costs of setting up systems and communications, providing power and maintenance and especially training worth while? Could better results be achieved with conventional approaches such as improving physical infra-structure and education.
This question is especially pertinent in a highly information intensive field such as medicine. Research in the last year can and often should directly impact current patient treatment such as new, more effective drug regimes or evidence that established approaches are not effective. Knowledge about epidemiology and public health may allow rapid action to prevent or control epidemics and ensure that sufficient supplies of drugs and equipment are available in hard to reach areas.
How do we value information and communications in health care projects? What proportion of a funding should go to IT and communications rather than drugs, training and other traditional health care needs? To answer this requires knowledge of not only technical solutions and available resources but also determination of the most critical components of good healthcare systems.
Many discussions of this topic seem polarized between the "all" or the "nothing" camps. These questions can only be definitively answered by careful studies of the role of information in health care and the impact of IT in particular projects. However in this meeting we will address the existing evidence in and how studies may be designed to determine what works and what is necessary or even essential. We will draw on the experience of many attendees who have set-up health IT projects in developing countries and studied or grappled with the role of IT in their projects.
Viability & Investment: Economic sustainability and technical capacity of ICT-health projects in developing countries
Many countries in the developing world are conducting pilot projects or actual projects in health care that are funded through various sources from international donor and aid agencies to local non governmental organizations.
But, are these projects sustainable? How long will they last?
This breakout session will discuss and brainstorm ideas related to maintenance of IT-related healthcare projects in developing countries. Several cases and lessons learned will be presented during this session. Investment in IT and Health in developing nations is also viewed as a critical problem for development. Typical donor funding usually lasts for a few years and then is cut off. This is definitely not a recipe for sustainability. Several issues emerge, such as ownership, assessment/evaluation and business models that are needed to maintain project success.
Training: The use of information and communications technologies to train healthcare professionals
Developing countries face severe constraints in fulfilling training needs among healthcare providers. Scarce public resources, and, in many countries, the challenge of HIV/AIDS, place ever-rising pressures on limited training facilities. The situation has been framed in dire terms for many countries, particularly those in sub-Saharan Africa. Information and communications technologies (ICTs) offer one possible approach for meeting the challenge of providing high quality training for healthcare providers. As new technologies, such as wireless communications and broadband channels, become more widely available, the opportunities to use ICTs to train healthcare professionals may become increasingly feasible and attractive. This session seeks to draw from our experience in using ICTs for training, in order to address some key questions about health and ICTs in developing countries: