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Using ICTs to Address HIV/AIDS in Humanitarian Emergencies

Responding to humanitarian emergencies poses a complex set of challenges that is exacerbated in areas where high rates of HIV/AIDS exist. The number of people living with HIV/AIDS hovers around 33 million and the vast majority live in sub-Saharan Africa, bringing to the forefront the complex interactions between HIV/AIDS, food security, livelihoods, and humanitarian action. This unique set of issues leads to the question of whether ICTs can be leveraged to address HIV/AIDS challenges in humanitarian crises, and if so, which groups are already doing so.

ICTs have been a used as a means for addressing HIV/AIDS issues in humanitarian situations by global aid agencies. The United Nations (UN) has recognized the impacts on HIV/AIDS on food security and is responding by integrating HIV into humanitarian responses. A priority for the UN Office for the Coordination of Humanitarian Affairs (OCHA) has been to “ensure a sustained flow of information and analysis on AIDS and [HIV] needs of populations in humanitarian situations” by producing reports, web specials, audio reports, fact files, etc. on the Integrated Regional Information Networks (IRIN) website. For example, IRIN radio produced a weekly 10-episode radio drama on HIV and AIDS for Somalis to listen to in the crisis country. The drama started on October 15^th and can be heard on the IRIN website.

FilmAid screening film at Kenyan refugee camp

Photo credit: FilmAid

Nongovernmental organizations are also using ICTs to address HIV/AIDS in humanitarian situations. FilmAid provides knowledge and empowerment to people suffering the effects of war, poverty, displacement or disaster through informational films. The organization works with communities to create films that are appropriate to the local context and relevant to community issues. One of the issue areas that FilmAid focuses on is Health & Safety, including HIV/AIDS. The organization has created various films relating to HIV/AIDS issues, such as a series of PEPFAR films that were shown in a Dadaab refugee camp in Kenya. The PEPFAR films were developed with the communities in Dadaab and promoted the prevention of mother-to-child HIV transmission, the uptake of voluntary counseling and testing (VCT), and abstinence.

The human rights organization WITNESS has created a video that tells the story of people living with HIV/AIDS in the war-torn Eastern region of the DRC, shown below. The film advocates for the provision of free testing, increased access to medical care, and prevention outreach in an area that desperately needs it.

These cases show that ICTs can be leveraged to address HIV/AIDS issues in humanitarian emergencies on many different levels, such as information flow, education, and advocacy. There is vast potential for increased ICT to more effectively and quickly address HIV/AIDS issues in humanitarian crises.

December 1, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Mobile Health App Launched in Kenya Will Increase Access to Healthcare Information

MedAfrica, the Nairobi-launched mobile health app that makes basic health information more readily available through phones, is generating buzz in mHealth for Africa.

The app was developed by the start-up tech firm, Shimba Technologies, and boasts a sustainable, innovative business model. Shimba CEO Steve Mutinda says the tech company “aims to achieve by creating platforms that facilitate dissemination of information and build communities around the different issues and conditions [in health] while at the same time converging all stakeholders and amplifying their efforts.”

The platform provides information such as doctor and hospital listings, drug authenticators, and lists of symptoms with suggestions for self-diagnosis. This sort of symptom checking could be very useful in countries like Kenya, where as little as 14 physicians exist for every 100,000 people. Members of MedAfrica explain that because the app is providing such valuable information to clients, as well as recommending good doctors and dependable, lab-tested drugs, users are willing to pay for the service.

Originally meant to provide health information solely in Kenya, MedKenya was the overall winner for the East African mobile tech event Pivot25 competition. Changing the name to broaden the app’s potential scope, MedAfrica presented at Demo Fall 2011; in video below, VentureBeat interviews Mutinda and a colleague.

The best news about the launch of the app is its potential scalability. The organization wants to use its launch in Kenya as a road map to scale the product to other African countries. MedAfrica’s mission is to reach every household in Africa.

The content for the app will come from partners such as the Nairobi Hospital and open data from the Kenyan government. During the launch, Kenya’s ICT Board Chairwoman Catherine Ngahu called on other medical institutions, physicians, and health providers to supply content for the app as well.

Given Kenya’s track record in developing some of the most innovative apps in Africa, if not the world, it’s no surprise that MedAfrica has garnered so much attention and holds so much hope for expansion.

November 9, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Originally posted on the GBI Portal

Monitoring and Evaluation in mHealth: Opportunities and Challenges

Last week’s mHealth working group meeting laid out the opportunities, challenges, and potential of monitoring and evaluation (M&E) within the mHealth sector.

JhPiego circumcision promotion through texting service

Poster in Swahili promoting male circumcision through SMS service, part of Jhpiego program

Several experts in the field presented their experiences of monitoring and evaluating mHealth projects, emphasizing the considerable potential that mobile projects offer in generating robust and accurate data. Kelly L’Engle, a behavior scientist at FHI 360, discussed the need for M&E in order to gauge the impact of mHealth. She claimed that mHealth technology is not being fully leveraged and that the current mHealth research “doesn’t provide evidence on actual impacts…or answers to critical research questions…”

James BonTempo from Jhpiego presented on evaluating behavior change evidence from a text message project that promotes male circumcision (MC) for HIV prevention in Tanzania. He referred to this evidence extraction as “mining the data exhaust” – that is, the data generated as a byproduct of ICTs, the “trail of clicks” that ICT users leave behind.

The MC program offered a toll-free text-messaging/SMS service. With the service, individuals could request to receive information on the benefits of MC (using key word: TOHARA), where to find MC services (WAPI), as well as receive follow-up care information after undergoing the circumcision (BAADA). While the SMS platform was intended to capture requests to the three keywords and generate access logs for system performance monitoring, Jhpiego has analyzed this data in order to see if there was a relationship between requests for the MC data and actual utilization of MC services.

Jhpiego male circumcision project in Tanzania- behavior change evaluation

Potential link to behavior change in Jhpiego male circumcision project

The data set included 12,056 keyword requests sent by 4,954 users. After performing a Chi Square analysis on the data, the project team found that requests for information on the benefits of MC (TOHARA) was not strongly associated with going to receive the circumcision. However, it was found that those who requested where to find the data (WAPI) did have a statistically significant association with undergoing the circumcision. These results are consistent with pathway models of behavior change, indicating that those who simply wanted to know more about MC were not quite prepared to undergo the procedure, but those looking for service availability were ready to use the services.

The associations found in this particular project imply that providing text or voice messages that tell people where to get a particular service could be more effective in encouraging clients to utilize that service. M&E that finds results such as these could help project leaders design SMS services that generate more useful data.

Like most forms of M&E, there are limitations on findings that use mobile data. There is a lot of information that mobile devices do not provide, such as which phones belong to whom and who actually sends the text messages; this makes it difficult to link messages to specific individuals. In the MC case, data analysts found an association, but did not necessarily know the nature of the association. It can also be challenging to find the time or manpower to rake through the massive amount of data that is produced by mobile devices.

While M&E in mHealth has its limitations, it is difficult to find data that can be collected and analyzed as quickly, cheaply, or easily using other means. Paper, radio, and television simply do not offer the same kind of easily-mined data exhaust that mobile does.

October 25, 2011/by actualize

Agriculture, Health, Health, Health Systems, Originally posted on the GBI Portal

Will Nigeria Turn to mHealth to Achieve its Healthcare Goals?

Nigeria may be joining a number of African countries in prioritizing mHealth as a way to improve the country’s troubled healthcare system. At a recent mobile Health workshop in Nigeria that was put together by the African telecommunications company MTN, stakeholders voted for the nation to adopt a mobile healthcare system.

Omobola Johnson, Nigeria's Minister of Technology and Communications

According to some, Nigeria is among the countries leading the way in using mobile health services. Several mobile companies operate there, with MTN serving the largest population percentage followed by Globacom, Zain and Etisalat. The Nigerian Communications Commission estimates that around 105 million of the country’s 155 million people were subscribed to a mobile service provider in August 2011.

Nigeria faces many challenges in expanding its healthcare system, such as a lack of infrastructure, a shortage of trained healthcare professionals, high illiteracy rates and unreliable power sources. The nation’s government has made some efforts to address these challenges in order to meet the Millennium Development Goals. The National Primary Healthcare Development Agency operates under the Health Ministry to promote and support the development of a high quality primary healthcare system.

Photo credit: eHealth Nigeria

But is the Nigerian government prioritizing mHealth as a means to improve healthcare delivery? Omobola Johnson, Nigeria’s recently appointed Technology and Communications Minister, has been pushing toward nationwide mobile coverage as well as the implementation of emergency call centers and phone lines. However, when Johnson revealed the Ministry’s mandate at the end of August, the use of mobile devices for improved healthcare was not mentioned specifically.

Many individuals, private companies, civil society organizations, and aid agencies feel that Nigeria should embrace mHealth as a mechanism for repositioning the country’s healthcare system. Through fuller adoption of mHealth into the healthcare delivery system, many more people could be reached. But the government will need to place mHealth at the top of the agenda and support mHealth initiatives should the emerging field succeed in improving Nigeria’s healthcare.

October 19, 2011/by actualize

Agriculture, Health, Health, HIV/AIDS, Maternal & Child Health, Originally posted on the GBI Portal

Scalable and Replicable: ICT4Health is Chosen Theme for UN South-South Awards

Digital Health 4 Digital Development was the theme of choice for the 2011 South-South awards that took place earlier this week. The United Nations-supported awards ceremony, held September 19th, honors governments, organizations and individuals accelerating progress toward the Millennium Development Goals (MDGs), and this year awards were given for utilizing ICTs for the advancement of the MDG health goals.

Prime Minister of Bangladesh receives South South award from

Photo Credit: thefinancialexpress-bd.com

The awards were organized by South South News, a digital media platform launched by the United Nations General Assembly High-level Committee in 2010. The platform disseminates development news and allows countries in the global South to share best practices in advancing implementation of the MDGs. As health remains a high priority within the international development field, with three of the eight MDGs calling for health improvements by 2015, this year South South chose the “catalytic and unifying force of ‘digital health’” as its focus.

Awardees were recognized for policies, programs and projects that address global health using ICTs as a mechanism for “scalability and replicability of the broad development agenda.” Awards were given on health categories such as Women and Children’s Health and HIV/AIDS, TB and Malaria with special consideration given to achievements in the fields of mobile, broadband, Internet, medical, and pharmaceutical applications.

Among the winners was Bangladesh’s prime minister Sheikh Hasina who received recognition for the use of ICTs in addressing women and children’s healthcare. The government of Bangladesh has made increasing the use and availability of ICTs a priority over the past decade, declaring IT a “thrust” sector and implementing a national ICT policy in 2002. The prime minister has been a catalyst for ICT development in Bangladesh, launching the Digital Bangladesh 2021 program, reducing taxes to make computers and other electronics more affordable, and giving free internet services to schools. This is not the first time she has been recognized for her ICT work in the country. The PM noted during the ceremony that most of Bangladesh’s 11,000 community health clinics have been digitized, allowing for free treatment of diseases like malaria and AIDS and reducing maternal and infant mortality rates.

Use of PDA by the nurses at ICDDRB hospital in Dhaka, Bangladesh

Photo credit: Bytesforall "ICT4Health" Network

Other development agencies and UN-affiliated organizations are also choosing to give awards to those using ICTs to advance public health initiatives. The Elena Pinchuk ANTIAIDS Foundation, rising from the work of UNAIDS High Level Commission on HIV Prevention, has launched a competition to find innovative start up projects that use social media and mobile phones for HIV prevention. The competition is taking applications until October 1^st and the winners will receive up to $10,000 to implement one-year projects.

As global health becomes a pressing priority, it is essential to utilize, innovate, and increase access to ICTs within the healthcare sector. The South South awards have set a precedent by recognizing the success of ICT4Health in accelerating the Millennium Development Goals and could encourage Global South countries to follow in the footsteps of nations like Bangladesh.

September 22, 2011/by actualize

Agriculture, Family Planning, Health, Health Systems, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

New app gives Thailand’s healthcare chance to go paperless

A doctor using the Family Folder Collector app on an Android pad, collecting information on a member patient. Photo Credit: bangkokpost.com

Thailand’s public health system has developed a mobile app for Android enabled tablet PC’s to monitor and collect household information on patients. The app, called Family Folder Collector (FFC), was developed by a research team at the National Electronics and Computer Technology Centre (Nectec).

Nectec researcher Watcharakon Noothong said the application comprises three major programs, including a walking map, genogram (a pictorial display of a patient’s health and family relationships) and Java Health Center Information System (JHCIS) synchronization.

FFC is designed to make life easier for public health workers who collect data on patients and for patients who are on time sensitive treatment schedules and cannot travel to health stations at any given moment for treatment.

The app is free. The only cost to utilize the service is paying for the tablet PC’s which is being covered by the province’s public health office.

Here are some of the features and capabilities of the FFC app:

Google maps shows the exact location and number of households in a given area
Genograms can be displayed
Chronic disease frequency can be color coded on a house-to-house basis
The program can collect and store other vital data, such as a patient’s weight, height, blood pressure and pulse rate, and even calculate a patient’s body mass index (BMI) automatically.
The program provides forms for treatment results, initial symptoms, health recommendations, and health behaviors
Doctors can schedule future appointments with patients
In the near future, the program will also be able to send an SMS to alert patients to get treatment at the health station.

All the collected data is updated and stored on the Android device then synchronized to the JHCIS database server. Public health workers were trained on how to properly input data into the tablet PC’s before pilot testing started. Of a total of 25 districts in the province of Ubon Ratchathani, eight are running the pilot trial of the FFC program, which, in its first phase, covers 123 health stations.

Ubon Ratchathani was chosen as the province since its existing IT infrastructure can accommodate sophisticated ICT’s for healthcare. There are over 1.8 million people in the province, all of whom will be accounted for by health workers using the FFC app.

This do-it-all app is a valuable tool for public health officials and physicians in Thailand. FFC can potentially replace the paper based system of collecting data and monitoring patients in Thailand.

The FFC application can display a genogram, monitor chronic diseases with Google Maps, and locate the house coordinates using a GPS system. Photo Credit: bangkokpost.com

The potential benefits of using this service are bountiful. Patient data will be gathered much easier and will be much harder to lose over time. Doctors can schedule appointments and prescribe treatments without physically seeing patients. Also, analysis of patient data will be faster, more efficient and more accurate.

Thailand may experience a revolution in healthcare if this service lives up to its potential. Currently, each health station has one tablet PC equipped with the program. The FFC application is expected to run throughout the province covering all 346 health stations by 2012.

Furthermore, according to Sinchai Tawwuttanakidgul, director of ICT Centre, Office of the Permanent Secretary, Ministry of Public Health, today there are some 45 provinces that are ready to switch from their paper-based system to the FFC mobile application. It sounds like Thailand is ready to experience that revolution soon.

August 11, 2011/by actualize

Tag Archive for: public health

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