Some of the most promising and clearly demonstrated applications for ICT in development are in the improvement of health care delivery. Experience to date suggests there is a number of specific ways ICT can be applied to achieve better health outcomes.8
ICT is being used in many developing countries and communities to facilitate remote consultation, diagnosis and treatment. In Gambia, for example, nurses in remote villages use digital cameras to download images of symptoms onto a PC and transfer them to nearby towns for examination by doctors. The same model is being applied to facilitate collaboration among physicians themselves. When an expert opinion is required, doctors in rural towns in Gambia send the images captured by the nurses to specialists in the United Kingdom for advice. The principle of ICT-facilitated collaboration extends to medical research also. This is illustrated in West Africa, where malaria researchers use a network of satellites and ground stations to submit data for clinical trials conducted at tropical disease research facilities in London and Geneva.
Health workers in developing countries are accessing relevant medical training through ICT-enabled delivery mechanisms. Several new malaria Internet sites for health professionals include innovative 'teach and test' self-assessment modules. In addition, centralized data repositories connected to ICT networks enable remote healthcare professionals to keep abreast of the rapidly evolving stock of medical knowledge. In Bangladesh, for example, the local MEDINET system provides access to hundreds of medical journals via email for less than US$1.50 per month.
When applied to disease prevention and epidemic response efforts, ICT can provide considerable benefits and capabilities. Public broadcast media such as radio and television have a long history of effectively facilitating the dissemination of public health messages and disease prevention techniques in developing countries. The Internet also can be utilized to improve disease prevention by enabling more effective monitoring and response mechanisms. For example, across Sub-Saharan Africa, the Internet is used to monitor daily cases of meningitis and to help coordinate mass vaccination programs when threshold levels are reached.
A number of countries, such as Estonia and Costa Rica, have invested in ICT to improve the administrative efficiency of their public health systems and ICT can also be applied to improving the efficiency of medical facility administration through, for example, the streamlining of medical procurement or the creation of patient record databases.
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SatelLife's HealthNet Application Model: HealthNet is a system of local telecommunications sites used to provide low cost access to healthcare information in developing countries through a link to basic email. Users—mainly physicians and medical workers—connect to the network through local telephone nodes to access services such as physician collaborations, medical databases, consultation and referral scheduling, epidemic alerts, medical libraries, email and shared research reporting databases. HealthNet is provided by a non-profit organization, SatelLife, with assistance from local and international donors. Illustrative Impact: HealthNet is used by 19,500 health care workers in more than 150 countries worldwide. The development impact of HealthNet has been most prevalent in Africa, where the model has contributed to increased rural and urban connectivity, capability building among the user community, increased demand for IT services, and in some cases, commercially viable IT service enterprises. For example:
Many physicians in developing countries rely on HealthNet as their sole source of information on the treatment of AIDS and tropical diseases, essential drugs, pediatrics and public health promotion. Challenges: Although HealthNet has made a real contribution, important challenges remain. Implementations in Africa have not always delivered the hoped-for level of success due to a number of factors, including: a lack of reliable and affordable telecommunications and power infrastructure; the failure and high cost of local Internet service providers (ISPs); unfavorable regulatory, licensing and taxation regimes; insufficient grant sustainability; poor organizational design; and user dissatisfaction with low band-width and delayed response. Sources: www.healthnet.org; HealthNet management interviews and project reports (2000); ITU (1999).
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