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

 

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.

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.

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.

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.

 

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

On June 6th, 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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Medic Mobile, a mobile health non-profit based in Washington D.C., announced the development of the first mobile SIM application for healthcare on June 6th. SIM apps can operate on 80% of the world’s phones ranging from $15 handsets to Android smart phones, so their potential use means reaching unimagined levels in data collection.

The SIM applications are menu based applications on mobile phones that reduce costs and increase accessibility for patients. Says CEO Josh Nesbit on his blog, “I can imagine all eight million global community health workers utilizing SIM applications to support their work and improve the lives of their patients.” Through these applications, patients don’t need to see a doctor, they can simply register their health data through the app and the data gets sent to health professionals who send feedback.

Medic Mobile is a pioneer in developing SMS based communication solutions. The organization started out with a project in Malawi where their SMS services saved clinical staffers 1,200 hours of patient follow-up time, thousands of dollars in costs and doubled the number of patients who were treated for Tuberculosis. Perhaps their most well known project came after the earthquakes that devastated Haiti. Mobile Medic created an SMS database where people could text the number “4636” to be tagged, mapped and subsequently assisted. Thousands of victims were rescued with this service.

SMS and SIM application based healthcare services can serve as a blueprint in the developing world to alleviate health burdens. Over half of all Africans use mobile technology, and according to an ITU report, over 70% of low and middle-income countries utilize mobile technology. Mobile technologies dominate any other technology in the developing world. They are cheap and conveniently accessible.

Photo Credit: Medic Mobile

Nesbit sees great potential and envisions applications that help patients schedule appointments, access remote consultations and connect with health care professionals during a medical emergency. Nesbit’s products are proof that mobile phones can be a game changer in providing healthcare. They can essentially serve as health professionals at any place and any time. Not even the developed world can claim that.

Medic Mobile, a mobile health company started in college by Josh Nesbit, is a trailblazer in the field.

Haiti’s post-quake food security show signs of improvement, which may get even better with the right mix of policy priorities. Although the Caribbean nation remains more food insecure than it was prior to the January 2009 earthquake, it is 13 percent more food secure than it was in the immediate aftermath of the earthquake.

In order for Haiti to meet the needs of its 2.5 to 3.3 million people thought to be food insecure, there ought to be a raft of bold nationally-led agricultural policies and projects. Haiti is in a prime position to chart this course due to its central position in the U.S initiated Feed the Future investment plan. This country-led initiative aims to foster food security and agricultural development in a truly endogenous manner. In other words, Haitians, like other Feed the Future countries, will have ownership over the process.

Although Haiti’s agricultural productivity hinges on a myriad of bold policy initiative, in my view, two things top the agenda: 1) The establishment of a national ICT policy with key focus on agriculture; and 2) The decentralization of agricultural management and educational facilities.

Despite demonstrable economic gains worldwide from ICTs in agriculture, Haiti still lacks a national ICT policy. A clear ICT policy will provide a guide for action for multilateral agencies, national action and NGO involvement in the ICT for agriculture sector. Haitian farmers are subjected to ad hoc marketing systems, a wide range of anthropogenic shocks, natural disasters, and limited information to make sound cost-benefit analysis. A solid national ICT policy will provide a basis for Haiti and its transnational donors to tackle these challenges in a coordinated manner—eliminating the well-entrenched culture of duplication.

It is imperative that the state take a lead on this to build its credibility and bring order to a development landscape dominated by NGOs—there is one NGO for every 3, 000 Haitian. Since the 1970s , NGOs have steadily gained a toehold in the country. This is largely because of the perception of endemic corruption within the Haitian government.

While I believe that ICTs ought to be used at all three major stages in the agriculture sector –pre-cultivation, crop cultivation and harvesting, and post harvest— it is most critically needed at the first juncture, pre-cultivation, crop selection, land selection, accessing credit and itemizing when to plant. If given the information for the proper selection of the best crops to plant according to their land type, access to input and generous credit, Haitian farmers will be well positioned to make proper cost-benefit analysis and thrive.

To achieve this, the ICT policy must emphasize the use of GIS and remote sensing. GIS and remote sensing technologies may be used to gather information on soil quality and available water resources. This will aid irrigation strategies in Haiti where water management is poor. Further more, the ubiquitous nature of cellphones in Haiti means that this information may be easily disseminated. Farmers may also be alerted about where to get seeds/other inputs and access credit.

To this end, Haiti ought to decentralize its agricultural framework. Haiti has evaded decentralization proposals for decades, but as the post-quake scenario shows, new life ought to be bred into this initiative with urgency. One third of newborn babies are born underweight. Acute under nutrition among children under five years old is five percent and a third of them suffer from chronic under-nutrition.

The collaborative work being done by the Les Cayes campus of the University of Notre Dame d’Haiti (UNDH), an innovative agronomy school, attests to the importance of decentralization. “The University uses its 40 acre farm as a catalyst for outreach, to assist poor farmers in building sustainable livelihoods, to map and protect biodiversity, and to expand civic participation among the rural poor.” Through these interventions, UNDH seeks to contribute to sustainable development and governance, important factors in rebuilding Haiti after the earthquake.

 

The emergence of IBM’s Spoken Web, a mobile innovation that eliminates literacy as a precursor to access the internet, is a game-changer in the ICT for Agriculture sector.

Unlike other efforts to bridge the global information divide, even people with limited to no functional literacy skills will find Spoken Web user-friendly. With nearly 800 million functional illiterates around the world, the inability to read remains a major impediment to the use of ICT4D. This is most acute in the most remote parts of the developing world where livelihoods and agriculture are inextricably linked.

The mobile innovation is essentially a world wide network of VoiceSites joined to make the Spoken Web. Its most essential hardware is a telephone, which people use to browse VoiceSites by saying keywords, also known as VoiLinks.

This rapidly progressing network of voice recordings is predicated on a system called VoiGem, which simplifies the process of creating voice-based applications. VoiGem is unique compared to existing interactive voice response technology because it allows users to create their own VoiceSites that consists of voice pages (VoiceXML files) that may be linked. Each page is identified by the user’s phone number. This identification mode allows the user to easily edit VoiceSites and pages from their phone.

The mobile-centric nature of this development reflects a global trend and complements a development need, particularly for agriculture. Although small scale farmers, scattered across some of the most far-flung places around the globe, make up a large portion of the 5 billion people without access to the internet and computers, a growing number of these people own cellphones. In fact, farmers constitute a strong contingent among the 3 in 4 people worldwide who own mobiles. Although only a fifth of those with mobile subscriptions worldwide have access to mobile broadband services, the International Telecommunication Union (ITU) “predicts that within the next five years, more people will hop onto the Web from laptops and mobile gadgets than from desktop computers”.

As more farmers join the growing legion of wired folks, they will have faster and more reliable opportunities to access and share information. This development will reduce information asymmetries, structure and strengthen agricultural markets by bringing the internet to parts of the world where small scale farmers, consumers, middlemen and traders have limited knowledge about where to access and trade food.

The technology is also culturally appropriate given the oral nature of many cultures in the developing world. Farmers will also have the opportunity to efficaciously share valuable indigenous farming retentions.

As with most things, the Spoken Web also comes with challenges. Chief among the challenges is that though voice-recognition technology can match search terms against a previously processed index of recorded voice sites, it presents cumbersome results. However, the technology is being refined to be more precise. Precision is especially important because farmers and other end-users will not be able to retain all the information found on lengthy voice pages/sites, and they may not have the literacy skills to jot down points. Interestingly though, the Spoken Web comes with a fast-forward feature that enables the user to listen as if they were skim-reading.

Despite these challenges, the technology has been successfully piloted in eight Indian villages. It is now a central part of farming and health-care delivery in four Indian states, parts of Thailand and Brazil.


U.S leadership on global food security will get a major boost for the fiscal year 2011. This follows strong bipartisan support from Congress for a $1.15 billion budget to tackle food security issues around the world. Last week, USAID Administrator Dr. Raj Shah announced that nearly $1 billion will go towards Feed the Future, a global initiative launched by President Obama in 2009 to tackle hunger through sustained and endogenous multi-stakeholder partnerships.

Dr. Raj said, “$90 million will be spent on strengthening our nutrition programming”. Since the world food crisis in 2008, which caused riots in several countries and toppled governments, food security and agriculture grew in prominence on the international agenda.

He says, pending congressional approval, the agency will contribute $100 million to the Global Agriculture and Food Security Program, a joint multilateral trust fund established in partnership with the World Bank, to address food security and agriculture globally. Since its conception in 2009, the fund attracted nearly $1 billion  from donors, and allocated over $330 million to eight countries.

Conflict, natural disasters and the slow integration of ICT into agricultural policy remains a major impediment to food security and  the improvement of livelihoods. Nearly 2 billion people worldwide are unable to grow or get enough food to eat. Most of those affected by chronic food security problems live in rustic areas, where they have limited information about where to access and trade food, in the least developed countries.

The World Bank has warned that the problem is likely to become even more intractable in the next two decades. According to the Bank’s report, Reengaging in Agricultural Water Management: Challenges and Options, “by 2030 food demand will double as world population increases by an additional two billion people. The increase in food demand will come mostly from developing countries.” The publication says improved food security depends on increased agricultural productivity and improved water management across the developing world.

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