CID Archive: Events Archive: Past Conferences
eHealth in Developing Countries The Future of Health Care?
18 June 2001
Kennedy School of
Government, Harvard University
Organized by the Information Technologies Group at the
Center for International Development within the
Digital Nations Consortium
Background | Topics | Workshop Report
Developing countries are facing a dire health crisis with millions of people dying each year from basic health care deficiencies. Major threats to public health stem from a shortage of health professionals, inadequate health education, and out of date clinical treatment. Lack of access to accurate and timely health information is an important contributory factor. The social and economic burden of disease in the developing world is further worsened by the feedback link between health and economic development.
Information and communication technologies (ICTs) have the potential to help improve the delivery of information and services to the healthcare community and to end-users in developing countries. ICTs cannot solve the global health care crisis single-handedly, but tele-diagnosis, distance learning, practitioner and citizen information networks, and other applications offer powerful tools to overcome some of the shortcomings and weaknesses caused by breakdowns in information-sharing, learning and management - crucial factors for a well-functioning health care system. In considering the role of ICTs in the area of health, there are many issues deserving consideration, including:
How much of a priority should ICTs be within health care planning, when many health care systems lack funds for basic medicine, health care facilities and personnel?
What is the relative value of up-to-date health information in an under-funded health system?
What are the technical challenges to use ICTs to provide accurate and timely health information to the developing world?
Are ICTs efficient means of improving public understanding of health and wellness when infrastructure, literacy and other factors limit effective access to ICTs?
Can ICTs be used appropriately to train health professionals?
How can we understand the readiness of a developing country to effectively implement technology solutions within its health care system?
What are the major challenges to establishing sustainable models (financial, administrative, training, etc.) of health services provision using ICTs in developing countries?
Triggered by these questions, the Information Technologies Group at the
Center for International Development (CID) at Harvard University
organized a workshop on Information Technology for Health in Developing
Countries. The objective of this workshop was to bring together key experts
on information and communications technology (ICT) and health to discuss and
identify issues that are critical to health and wellness - and understand
how the healthcare systems of the developing world can benefit from ICTs.
Ultimately the mission of this meeting was to understand how new technologies
can be appropriately employed to improve health in the world's poorest
nations. We sought to learn from both projects now underway and past
experience, with an eye to developing new approaches and initiatives to
bring these powerful tools to bear on what, in many ways, we consider to be
at the very core of social and economic development.
Background | Topics | Workshop Report
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 informationThe Value of Information
What health information is valuable to developing countries?Viability & Investment
Economic sustainability and technical capacity of ICT-health projects in developing countriesTraining
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:
Background | Topics | Workshop Report
You may view a copy of the
Workshop Report released after the
completion of the conference document as a
PDF.
Background | Topics | Workshop Report
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