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 underfive 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
• The Global Fund to fight
AIDS, Tuberculosis and
Malaria
• Roll Back Malaria
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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
 Dr. Alasdair Unwin working
on malaria in suppport of
Tanzanian Ministry of
Health
• CD-ROM on malaria
 In partnership
 ICT4D web-solution
 http://www.gg.rhul.ac.uk/ict4d/Mal
aria.html
Lecture 8
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Imfundo and the Interactive
Health Network - HIV/AIDS
• Database on digital information on HIV/AIDS


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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 South
Africa
• Jiva teledoc in India
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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
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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
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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
 Ayurvedic doctors diagnose and
prescribe treatment
 Medicines are then delivered by
field workers to patients
 Costs 70 rupees ($1.50 per
consultation)
Lecture 8
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Jiva Teledoc social returns
• Patients have affordable
treatment
• Women are treated by
women
• Wider healthcare is
promoted by field workers
• Local workers speak local
languages
• Provides some
employment in rural
areas
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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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