Information and communication technologies and health in low income countries: the potential and the constraints
01 Jan 2001-Bulletin of The World Health Organization (World Health Organization)-Vol. 79, Iss: 9, pp 850-855
TL;DR: The potential offered by technological progress in the information and communication technologies (ICTs) industries for the health sector in developing countries is outlined, some examples of positive experiences in India are presented, and the difficulties in achieving this potential are considered.
Abstract: This paper outlines the potential offered by technological progress in the information and communication technologies (ICTs) industries for the health sector in developing countries, presents some examples of positive experiences in India, and considers the difficulties in achieving this potential. The development of ICTs can bring about improvements in health in developing countries in at least three ways: as an instrument for continuing education they enable health workers to be informed of and trained in advances in knowledge; they can improve the delivery of health and disaster management services to poor and remote locations; and they can increase the transparency and efficiency of governance, which should, in turn, improve the availability and delivery of publicly provided health services. These potential benefits of ICTs do not necessarily require all the final beneficiaries to be reached directly, thus the cost of a given quantum of effect is reduced. Some current experiments in India, such as the use of Personal Digital Assistants by rural health workers in Rajasthan, the disaster management project in Maharashtra and the computerized village offices in Andhra Pradesh and Pondicherry, suggest creative ways of using ICTs to improve the health conditions of local people. However, the basic difficulties encountered in using ICTs for such purposes are: an inadequate physical infrastructure; insufficient access by the majority of the population to the hardware; and a lack of the requisite skills for using them. We highlight the substantial cost involved in providing wider access, and the problem of resource allocation in poor countries where basic infrastructure for health and education is still lacking. Educating health professionals in the possible uses of ICTs, and providing them with access and "connectivity", would in turn spread the benefits to a much wider set of final beneficiaries and might help reduce the digital divide.
Citations
More filters
TL;DR: In this article, the authors explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries and find that ICT infrastructure in Africa lags behind that in other regions.
Abstract: OBJECTIVES This study aimed to explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries. METHODS Educators (deans and heads of medical education) in English-speaking countries across Africa were sent a questionnaire to establish the current state of ICT at medical schools. Non-respondents were contacted firstly by e-mail, subsequently by two postal mailings at 3-month intervals, and finally by telephone. Main outcome measures included cross-sectional data about the availability of computers, specifications, Internet connection speeds, use of ICT by students, and teaching of ICT and computerised research skills, presented by country or region. RESULTS The mean computer : student ratio was 0.123. Internet speeds were rated as 'slow' or 'very slow' on a 5-point Likert scale by 25.0% of respondents overall, but by 58.3% in East Africa and 33.3% in West Africa (including Cameroon). Mean estimates showed that campus computers more commonly supported CD-ROM (91.4%) and sound (87.3%) than DVD-ROM (48.1%) and Internet (72.5%). The teaching of ICT and computerised research skills, and the use of computers by medical students for research, assignments and personal projects were common. CONCLUSIONS It is clear that ICT infrastructure in Africa lags behind that in other regions. Poor download speeds limit the potential of Internet resources (especially videos, sound and other large downloads) to benefit students, particularly in East and West (including Cameroon) Africa. CD-ROM capability is more widely available, but has not yet gained momentum as a means of distributing materials. Despite infrastructure limitations, ICT is already being used and there is enthusiasm for developing this further. Priority should be given to developing partnerships to improve ICT infrastructure and maximise the potential of existing technology.
42 citations
TL;DR: Decision support technologies have considerable potential to improve coverage and quality of health care for the poor and where there is no doctor, but the unreceptive attitude of public health workers would need to be overcome.
Abstract: Objective. The objective was to test whether a decision support technology for non-physicians can increase health care utilization and quality. Design. Before and after measurements were taken from a systematic random sample of patients and staff at randomly assigned intervention and control facilities. Setting. The study took place at primary health facilities in rural Tamil Nadu, India Participants. One thousand two hundred and eighty-six patients and 82 staff were interviewed. Intervention. A computer-assisted decision support technology was introduced to assist with patient screening. Main outcome measures. Outcome measures included new patient visits per month, a Global Patient Assessment of Care Index, and health worker attitude variables. Results. There was a difference of difference of 430 new patient visits per month at the intervention sites (P = 0.005), an increase from baseline of 18% at intervention sites compared with a decline of 5% at control sites. The intervention was associated with significant improvements in a Global Patient Assessment of Care Index (mean difference of difference 7.9, P < 0.001). The largest gains were made in patient communication, technical quality, and general satisfaction with care. The attitudes of public health workers toward the new technology and their jobs did not change. Conclusions. Decision support technologies have considerable potential to improve coverage and quality of health care for the poor and where there is no doctor, but the unreceptive attitude of public health workers would need to be overcome. Application of these technologies should take advantage of their popularity with patients and the opportunity to work through the private sector.
40 citations
Cites background from "Information and communication techn..."
...The few studies from developing countries have shown that they are safe and potentially useful [18–24]....
[...]
TL;DR: A panel of medical informatics specialists, clinical human immunodeficiency virus (HIV) specialists, and program managers suggests a minimum data set for supporting the management and monitoring of patients with HIV and their care programs in developing countries.
39 citations
01 Jan 2013
TL;DR: This study comparatively evaluates the quality of two tools, cTAKES and MetaMap, as well as of a recently proposed annotation approach from the authors' group for annotating medical forms, and investigates how to improve the match quality of the tools by post-filtering computed annotations aswell as by combining several annotation approaches.
Abstract: The annotation of entities with concepts from standardized terminologies and ontologies is of high importance in the life sciences to enhance semantic interoperability, information retrieval and metaanalysis. Unfortunately, medical documents such as clinical forms or electronic health records are still rarely annotated despite the availability of some tools to automatically determine possible annotations. In this study, we comparatively evaluate the quality of two such tools, cTAKES and MetaMap, as well as of a recently proposed annotation approach from our group for annotating medical forms. We also investigate how to improve the match quality of the tools by post-filtering computed annotations as well as by combining several annotation approaches.
37 citations
TL;DR: The pilot telemedicine programme in Cambodia confirms the value of email support for non-physician health-care workers in the developing world and reduces patients requiring off-site referral for completion of laboratory testing.
Abstract: An email-based telemedicine service was implemented in two remote village communities in Cambodia. Volunteer physicians at the Brigham and Women's Hospital, Massachusetts General Hospital and the Sihanouk Hospital Center of Hope in Phnom Penh provide monthly consultations to the local clinicians. Between February 2001 and May 2005, there were 469 teleconsultations. The 214 telemedicine cases involving new patients managed in the first 28 months were reviewed. The mean duration of the chief complaint at the initial patient visit was 37 months for the first six months and had dropped to eight months by the end of the study period. Of 63 adult patients surveyed, all were either satisfied (54%, n = 34) or very satisfied (46%, n = 29) with their experience in the telemedicine clinic. About 78% (n = 49) were willing to pay, on average, 0.63 US dollars for their visits. The introduction of basic point-of-care laboratory testing in November 2004 was associated with a reduction in patients requiring off-site referral for completion of laboratory testing (69% before to 35% afterwards, P < 0.001). The success of the pilot telemedicine programme confirms the value of email support for non-physician health-care workers in the developing world.
36 citations
References
More filters
Book•
01 Jan 1999
TL;DR: The Public Report of Basic Education in India presents a comprehensive evaluation of the educational system in India with an extensive survey of 200 villages in five states.
Abstract: The Public Report of Basic Education in India presents a comprehensive evaluation of the educational system in India. Based on an extensive survey of 200 villages in five states of Bihar, Madhya Pradesh, Uttar Pradesh, Himachal Pradesh, and Rajasthan, the report gives a voice to thousands of parents, teachers, and children.
439 citations
TL;DR: This is a fascinating collection of essays exploring "why some people are healthy and others not," from a variety of disciplines and theoretical perspectives that challenges the widespread belief that health care is the most important determinant of health and argues for a more comprehensive and coherent understanding of the determinants of health.
Abstract: This is a fascinating collection of essays exploring \"why some people are healthy and others not,\" from a variety of disciplines and theoretical perspectives. It represents the efforts of a group of researchers from diverse backgrounds who have met intermittently over the last five years as part of the Canadian Institute for Advanced Research. Their common focus was to understand the determinants of a population's health. The book's point of departure is that \"factors in the social environment, external to the health care system, exert a major and potentially modifiable influence on the health of populations through biological channels that are just now beginning to be understood.\" (p. 23) Via this observation, the volume challenges the widespread belief that health care is the most important determinant of health and argues for a more comprehensive and coherent understanding of the determinants of health. This thesis is lucidly presented in the introductory chapter. Evans brings together findings from a number of studies that provoke fundamental questions about our understanding of health.
359 citations
TL;DR: In this paper, composite solar cells of improved efficiency comprise two cells of different characteristics arranged in optical series but electrically insulated from each other, each cell is of larger crystal grain size than its substrate, which grain size is achieved by growing the cell semiconductor on a molten intermediate rheotaxy layer of a suitable semi-conductor which solidifies at a temperature below the melting temperature of the solar cell.
Abstract: Composite solar cells of improved efficiency comprise two cells of different characteristics arranged in optical series but electrically insulated from each other. Preferably, each cell is of larger crystal grain size than its substrate, which grain size is achieved by growing the cell semi-conductor on a molten intermediate rheotaxy layer of a suitable semi-conductor which solidifies at a temperature below the melting temperature of the solar cell semi-conductor. The substrate and the intermediate rheotaxy layer of the overlying cell are transparent to that fraction of sunlight which is utilized by the underlying cell. Various configurations of overlying and underlying cells are disclosed.
299 citations
Book•
01 Jan 2000
TL;DR: In this paper, the successful use of information and communication technology (ICT) in rural development is discussed, and sixteen case studies are presented, which spell out the various applications of ICT that have made a difference in the delivery of services or products in rural India.
Abstract: This book documents the successful use of information and communication technology (ICT) in rural development. The book begins with an introductory chapter that traces the history of ICT use in rural India, examines some of the problems that have afflicted the implementation of rural development programmes, at the same time showing how ICT applications could help overcome them, assesses the early efforts in ICT use, and proposes a scheme by which to classify ICT applications. Written by administrators who lead projects in their areas, sixteen case studies follow, which spell out the various applications of ICT that have made a difference in the delivery of services or products in rural India. Among the services covered are health care, milk distribution, disaster management, postal services, telephones, and services for the disabled. These applications of ICT cover the use of simple and inexpensive technologies at one end, and sophisticated satellite-based communication at the other. An important collection that delineates the main elements of a strategy that can be used by governmental agencies to derive maximum developmental impact from investments in ICT
85 citations