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National Framework for mHealth: Ethiopia

Ethiopia is at a pivotal moment in its efforts to improve the health status of its people and move the country into a new phase of social and economic development. The country’s massive Health Extension Program (HEP) program has placed over 34,000 community health workers in 14,000 health posts in less than 8 years. Now, health authorities are exploring ways to improve the program with mobile solutions.

Sponsored by The Bill & Melinda Gates Foundation, Vital Wave Consulting authored the “mHealth in Ethiopia: Strategies for a new Framework” report for the Ethiopian Ministry of Health. The report offers a framework for addressing specific information, communication and inventory management issues with mHealth interventions.

Download the report by clicking the link below – and let us know what you think in the comments!

Initiative:

Evidence Commons

Maternal Newborn mHealth

April 10, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Inaugural meeting of the Technology Standards & Interoperability Working Group

The inaugural meeting of the mHealth Alliance’s Technology Standards & Interoperability Working Group was held on December 20th, 2011. There were 11 attendees representing varied groups including: donors, academics, implementers, clinicians and technology providers. A zip file is attached to this blog; it contains an audio recording of the meeting (with the chair’s thanks to Ricardo Leitao of Andago).

The (draft) mission of this new working group is to: Achieve alignment on and adoption of standards which support greater interoperability amongst mHealth deployments to ensure improved continuity of care, technology re-use, and cost effectiveness. The mHealth Alliance’s two key strategic focus areas for 2012 are: Evidence and Interoperability.This working group is intended to give effect to the latter.

There was helpful and insightful discussion regarding the ways both a “top down” and a “bottom up” approach can usefully inform the group’s activities — with examples given of each. As a “homework assignment”, group members will digest and comment on the two work items that are already posted to HUB, and will begin posting other artefacts (requirements docs, architecture diagrams, etc.) that provide informative examples from initiatives in the field. We will also start to catalogue a list of projects (especially open source examples, please) that illustrate “going to scale” with m/eHealth technologies in low resource settings.

I wish to thank the attendees for their active and helpful participation. I also hope that the audio recording will help others who were unable to make the scheduled time-slot to “join” and would welcome any and all comments (please post to this blog) they might like to add.

Our next meeting will be scheduled early in the new year. Between now and then, I wish everyone a safe and happy holiday season and all the best in 2012!

-Derek Ritz

Initiative:

mHealth Systems Integration

December 22, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

AfriHealth Conference, Nairobi, 30 November – 1 December 2011

AITEC announces expert speaker line-up for AfriHealth Conference, Nairobi, 30 November – 1 December 2011

OPENING PLENARY

Consolidating the gains of technological innovation in healthcare through effective management

Professor Yunkap Kwankam, Executive Director, International Society for Telemedicine & eHealth (ISfTeH), Switzerland

Aiming for a more integrated approach in healthcare delivery at national and local levels

Dr Katherine Getao, Head of eGovernment, Office of the President, Kenya

The economics of eHealth

Professor Maurice Mars, Head, Department of Telehealth, University of KwaZulu-Natal & President, South African Telemedicine Association

Ericsson’s mHealth Solutions – use cases and success criteria to enhance healthcare delivery

Rainer Herzog, Head of Strategy & Business Development mHealth & eHealth, Ericsson

mHealth: Turning hype into delivery

mHealth reaches puberty: Hype & hyperventilation

Bright Simons, Founder, mPedigree, Ghana

Using mobile telephony as an innovative communication channel for family planning

Bas Hoefman, Text to Change, Kenya

mHealth and the required ecosystem in East Africa

John Kieti, mLab, Kenya

PLENARY 2

An overview of latest worldwide trends in telemedicine

Frank Lievens, Board Member & Secretary, International Society for Telemedicine & eHealth, Belgium

Addressing the fragile environment of e-health in resource-limited settings

Dr Christoph Larsen, synaLinQ, Vietnam & Kenya

Accessing funding for healthcare initiatives in Africa

Ken Nwosu, eHealth Ontario & McMaster University MSc eHealth Programme, Canada

Pharmaceutical management

Anti-counterfeit systems for pharmaceuticals

David Svarrer, CEO, Digital Age Institute, Kenya

Using IT for improved pharmaceutical care delivery in developing countries: A case study of Benin

Dr Thierry Oscar Edoh,University of Bonn & German Federal Army University of Munich, Germany

Case Studies 2

A Multilingual Expert System for Ubiquitous Diseases Diagnosis (MESUDD)

Dr John Oladosu, Lecturer, Ladoke Akintola University of Technology, Nigeria

Community-based eHealth promotion for safe motherhood- A case study from Khyber Pakhtoonkhwa, Pakistan

Dr Shariq Khoja, Director AKDN eHealth Resource Centre, Aga Khan University, Kenya

Business models for effective service delivery: Rural Health Systems

Changing African healthcare through private sector technology innovations

Steve Landman, CEO, Carego International, Kenya & USA

Leveraging telehealth to improve child maternal health

Iboun Sylla, Business Development Manager, Texas Instruments, USA

National e-health policy development: The Commonwealth approach

Dr Sylvia Anie, Director, Social Transformation Programmes Division, Commonwealth Secretariat, UK, and Dr Adesina Iluyemi and Tom Jones^,Directors, TinTree International eHealth and Consultants, Commonwealth Secretariat, UK

PANEL DISCUSSION

What are the best practice achievements that can be replicated across the continent?

MODERATOR

Professor Yunkap Kwankam, Executive Director, International Society for Telemedicine & eHealth (ISfTeH), Switzerland

PANEL MEMBERS

Lucy Fulgence Silas, Country Director for Tanzania, D-Tree International

Dr Moretlo Molefi, MD, Telemedicine Africa, South Africa

Dr Catherine Omaswa, Chairperson, National eHealth Committee, Uganda

Dr Wuleta Lemma, Director, Tulane Technical Assistant Program (TUTAP) Ethiopia

WORKSHOP 1

Open source healthcare information systems

Nurhizam Safie, United Nations University, International Institute of Global Health (UNU-IIGH), Faculty of Medicine, National University of Malaysia

Open Source health information systems offer an alternative to proprietary healthcare information systems. Currently, most developing countries have a tight financial budget for their healthcare services and cannot afford the high cost of licence fees imposed by proprietary healthcare information system providers. Therefore, open source healthcare information systems are an attractive alternative to be introduced in the healthcare services of developing countries. By using open source healthcare information systems, the healthcare providers such as hospitals and clinics can improve the efficiency of services, reduce licensing and maintenance costs in managing information systems, as well as catering for future scaleability and growth.

Among the available open source healthcare information systems, MEDICAL has been chosen for this workshop because MEDICAL is a multi-user, highly scaleable and centralised system which provides the following functionality:

Electronic Medical Record (EMR)
Hospital Information System (HIS)
Health Information System

This workshop is intended for users who want to get a better introductory functional understanding of MEDICAL. The workshop offers a thorough knowledge in usability and understanding of two critical modules, namely Patient Management and Financial Management.

Objectives

Having attended this workshop, participants should be able to:

Understand the concept of open source health information systems.
Understand the functional concepts of MEDICAL modules, namely Patient Management and Financial Management.
Understand the development concepts and architecture of MEDICAL.
Workshop Content

Introduction to MEDICAL and Basic Settings

Introduction to MEDICAL: Vision and Mission
Architecture: Supported operating systems, databases & ERPs
The modular concept framework
The MEDICAL development environment.
Introduction to Sourceforge and SVN
Introduction to Transifex: The translation and localization portal

Patient Management

Patient registration
Emergency department /ambulatory
Outpatient/In-patient
Admission, discharge & transfer (ADT)
Appointment & scheduling
Resource scheduling
Medical record management
Report & statistics

Financial Management

Charging, billing & invoicing
General ledgers
Accounts receivable/payable
Cash book management
Reporting

WORKSHOP 2

Using theCasemix system for health finance management

Prof Dr Syed Aljunid, Professor of Health Economics and Senior Research Fellow, UN University International Institute for Global Health, Faculty of Medicine, National University of Malaysia

This workshop is designed to introduce participants to the Casemix system for enhancement in quality and efficiency of healthcare services . Casemix experts from the UN University International Institute for Global Health will share their experience in implementing Casemix systems in a number of developing countries globally. The workshop will provide an overview of Casemix, its evolution from the first version introduced in the 1980s by Professor Robert Fetter from Yale University, to the present day where the system has been implemented in more than one hundred countries worldwide. Minimum dataset requirements for Casemix systems will be discussed in detail, including requirements for diagnoses and procedures coding using the ICD classification system. Benefits of using Casemix as a prospective provider payment mechanism under social health insurance programmes will be presented in this workshop. Software currently available to support implementation of Casemix system will be demonstrated including the recently launched the UNU-CBG Casemix Grouper, a universal, dynamic and advanced grouper software. Proposed plan for implementation of Casemix system under the UNU-IIGH programme will be presented in this Workshop.

Workshop Objectives:

At the end of the workshop, participants should be able to:

Understand the concept of the Casemix system
Appreciate the role of Casemix in enhancing quality and efficiency of healthcare services.
Design the basic minimum dataset package for Casemix Implementation.
Have basic knowledge on the use of UNU-CBG Casemix Grouper

Workshop Content:

Casemix:: An introduction
Minimum Dataset for the Casemix system
Supporting software for Casemix
Implementation of Casemix in developing countries for health financing

To register as a delegate, log on to www.aitecafrica.com or email info@aitecafrica.com

September 28, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

How to convey the new WHO Mental Health Intervention Guide to workers in the field?

On paper? Online? On smartphone apps? Via SMS or voice?

This 89 pages mhGAP-IG is issued in 2010 and now available in several languages. The guide consists of decision trees for the most important psychiatric conditions.

1. Use of paper versions:

Reading: Additional shipping and transport costs can be a hurdle in low and middle income countries (LMIC). One can download the guide from the WHO website, but then one faces the high costs of (color) print and copies.

Training: Face2face trainings seem the most ideal option, but the in most LMIC there is a shortage of health tutors. And a face2face training necessitates the movement of the health worker away from the field, which interrupts the delivery of services and is expensive.

2. With the internet/desktop/laptop:

Reading: Distribution on CDs is cheap. Online reading offers also the use of go-to tabs, notes storage, information charts and a find-utility. The main disadvantages of internet/computer is the constant need of a computer nearby and standby, which is a rarity in most LMIC.

Training: Beside the benefits of no travel and no interruption of the daily work, the internet gives health workers also the opportunity to study on own pace and preferred time.

3. With mobile apps on smartphones:

Reading: Smartphones can have a high added value for previously unconnected people. Smartphone prizes drop and they are growing in popularity in LMIC. The guide can be read on an app.

Training: Education via a smartphone apps offers the same benefits as the internet learning, like nice attractive tools and designs. The extra advantages are the pocket format; easy taking it with you.

4. With mobile phones (no wireless internet):

Reading: Service in developing countries will rely heavily on text messaging and voice in the years ahead. One can convey parts of the guide by SMS or voice, piece by piece, or certain parts on request. One can even run an automated SMS reply manager.

Training: Conducting a training in the mhGAP-IG solely by mobile phones is possible, but only an option of one really can’t reach the health worker via another channel.

Conclusions and recommendations:

-Not one of the 4 distribution channels is the best of all, so create materials in all 4

-Concert international and implement what’s most suitable on a local level

-Connect and cooperate with innovators in LMIC

-Look for creative funding channels, including NGOs and telecom providers

-Learn, lend and copy from other health fields, which are a long way ahead in technical innovations.

Full article with links and examples on the in2mentalhealth website

September 20, 2011/by actualize

Environment, Health, Originally posted on the GBI Portal

e-Development in Kenya: Electrifying Villages & the Benefits of ‘Virtual Kenya’

A metal solar panel (Credit: Capital Business)

Previously, I dubbed east-Africa’s ICT hub, Kenya, the Land of the Apps, but Kenya’s wider e-development prospects and challenges are more nuanced than that. We ought to consider a range of intersecting questions.

Last week, I chronicled the Kenyan government’s plans to channel US$10 million into its much vaunted digital village project and plans to provide computers and reliable connectivity to schools across the country.

These bold policy positions are indicative of why Kenya’s success is no fluke. In fact, its concerted focus on and sensitivity to the information poverty of its legion of unconnected people, amid a rapidly transforming and pioneering telecoms sector, is a game-changer. The range of policy positions adopted recently gives credence to this view, particularly the move to rectify the country’s ailing electricity sector and the launch of ‘Virtual Kenya’ last week.

The East-African country will spend US$62 million to electrify 460 trading centers and 110 secondary schools, among other public facilities under the rural electrification program. The ICT sector will also benefit from the $730 million allocated to the Ministry of Energy for the next fiscal year. As I have noted before, this will further bridge the digital divide because none of Kenya’s—or the wider African continent’s— ambitious ICT expansion plans will be achieved without improved electricity infrastructure. According to the World Bank, 70% of Africans are not connected to a power grid.

Resolving the energy sector crisis is pivotal, as it will not only boost the expansion of the ICT sector, but also improve livelihoods. The successful ‘Songa mbele na solar‘ (Move ahead with solar) campaign of 2010 offers lessons, too. It shows that any effort to electrify Kenya’s more rustic regions will require a diversified energy mix—and given the state’s economic constraints, solar—readily accessible and easily tapped—ought to be an integral part of that mix. The ‘Songa mbele na solar” reached over nine million Kenyans, improving productivity by extending business hours, and buttressing lives through reduced air pollution.

It is clear to me that there is a growing, albeit very slow, trend towards merging the questions of sustainable development, particularly clean energy and natural resources conservation, with the ICT4D push. I am inclined to think that the link between the two ought to be further cemented. I consider the launch of ‘Virtual Kenya’, an interactive web platform for charting human environmental health, to be a step in that direction. ‘Virtual Kenya’, which was developed by the Nairobi-based web mapping technology firm Upande Ltd, in collaboration with the US-based World Resources Institute, caters to the needs of Kenya’s unconnected as it comes with “related materials for those with no access to the internet”. So, I think this is important on two fronts: first, it tackles the information divide; second, it broadens the pool of people who have ready access to environmental and health information.

It is easy to imagine the impact this will have on an educational landscape where schools and universities are constrained by outmoded data sets and other resources. Ready access to high quality, spatial data and cutting edge mapping technology on an interactive platform is golden.

For more details on ‘Virtual Kenya’, please go here.

June 27, 2011/by actualize

Economic Growth & Trade, Originally posted on the GBI Portal

US$10 Million for Kenyan Digital Villages and Computers in 2012

Kenya’s ICT sector accounts for three percent of GDP, and it is poised to expand next year. According to estimates for the fiscal year 2012, the government will pump millions into efforts to boost the sector. The state will spend nearly US$10 million dollars to boost exposure to ICTs in schools and far-flung villages.

Finance Minister Uhuru Kenyatta says the state will pump more than US$2.3 million into its much vaunted digital villages project or Pasha Centers. The Minister says the other US$7.5 million will be used to purchase computers for schools across the country. Commentators say this will provide early initiation into the digital world for a broader cross-section of Kenyan youth.

But none of these grand plans will work without major improvement of Kenya’s electricity infrastructure. “Electricity is very essential in the roll-out and running of ICT infrastructure,” says Telecommunications Engineer Esmond Shahonya. The Kenyan government agrees. The East-African ICT hub will spend US$62 million to electrify 460 trading centres and 110 secondary schools, among other public facilities under the rural electrification program. This will further bridge the digital divide.

The ICT sector will also benefit from the $730 million allocated to the Ministry of Energy.

June 21, 2011/by actualize