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Improving health, connecting people: The role of ICTs in the health sector of developing countries
Information for Development Program (Infodev)
May 31, 2006

http://www.eldis.org/cf/search/disp/DocDisplay.cfm?Doc=DOC22557&Resource=f1ict

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Executive Summary
This framework paper is aimed at policy makers who are involved in the development or management of programmes in the health sector in developing countries. It provides a ‘snapshot’ of the type of information and communication technology (ICT) interventions that are being used in the health sector, and the policy debates around ICTs and health. It draws from the experience of use in both the North and South, but with a focus on applicability in the South to identify the most effective and relevant uses of ICTs.

The paper describes the major constraints and challenges faced in using ICTs effectively in the health sector of developing countries. It draws out good practice for using ICTs in the health sector, identifies major players and stakeholders and highlights priority needs and issues of relevance to policy makers. The paper also looks at emerging trends in technologies that are likely to shape ICT use in the health sector and identifies gaps in knowledge.

For the purposes of this paper, ICTs are defined as tools that facilitate communication and the processing and transmission of information by electronic means. This definition encompasses the full range of ICTs, from radio and television to telephones (fixed and mobile), computers and the Internet.

This paper sees health as a complex interaction of biomedical, social, economic, and political determinants. It places the discussion of health firmly in the poverty and development debates and pays particular attention to how ICTs can best be used to move towards achievement of the Millennium Development Goals (MDGs), as part of poverty reduction strategies and in order to improve the health of the most poor and vulnerable people.

There has been considerable international discussion about the potential of ICTs to make major impacts in improving the health and well being of poor and marginalized populations, combating poverty, and encouraging sustainable development and governance. Used effectively ICTs have enormous potential as tools to increase information flows and the dissemination of evidence-based knowledge, and to empower citizens. However, despite all its potential, a major challenge is that ICTs have not been widely used as tools that advance equitable healthcare access.

A critical mass of professional and community users of ICTs in health has not yet been reached in developing countries. Many of the approaches being used are still at a relatively new stage of implementation, with insufficient studies to establish their relevance, applicability or cost effectiveness (Martinez, et al, 2001). This makes it difficult for governments of developing countries to determine their investment priorities (Chandrasekhar and Ghosh, 2001). However, there are a number of pilot projects that have demonstrated improvements such as a 50% reduction in mortality or 25-50% increases in productivity within the healthcare system (Greenberg, 2005).

The examples in this paper show that ICTs have clearly made an impact on health care.

They have:

• Improved dissemination of public health information and facilitated public discourse and dialogue around major public health threats
• Enabled remote consultation, diagnosis and treatment through telemedicine
• Facilitated collaboration and cooperation among health workers, including sharing of learning and training approaches
• Supported more effective health research and the dissemination and access to
  research findings
• Strengthened the ability to monitor the incidence of public health threats and respond in a more timely and effective manner
• Improved the efficiency of administrative systems in health care facilities.

This translates into savings in lives and resources and direct improvements in people's health. In Peru, Egypt and Uganda, effective use of ICTs has prevented avoidable maternal deaths. In South Africa, the use of mobile phones has enabled TB patients to receive timely reminders to take their medication. In Cambodia, Rwanda, South Africa and Nicaragua, multimedia communication programmes are increasing awareness of how to strengthen community responses to HIV and AIDS. In Bangladesh and India, global satellite technology is helping to track outbreaks of epidemics and ensure effective prevention and treatment can reach people in time.

Experience demonstrates that there is no single solution that will work in all settings. The complexity of choices of technologies and the complexity of needs and demands of health systems suggests that the gradual introduction, testing and refining of new technologies, in those areas of health care where there is a reasonable expectation that ICTs can be effectively and efficiently used, is more likely to be the successful way forward.

Some innovative leaps may also be possible as technology is evolving rapidly. Wireless applications, increased use of mobile telephony and combinations of technology working together are some of the trends identified in this paper that suggest new opportunities.

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