Improving sustainability of primary e-healthcare projects in rural areas of developing countries

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Improving sustainability of primary e-healthcare projects in rural areas of developing countries Inés Bebea González [email protected] Project Manager at Fundación EHAS PHD Student at Universidad Rey Juan Carlos

description

This a brief presentation about the starting proposal for my PhD thesis. The presentation was given at IPID Conference 2011 in Lugano and discussed with the audience.

Transcript of Improving sustainability of primary e-healthcare projects in rural areas of developing countries

Page 1: Improving sustainability of primary e-healthcare projects in rural areas of developing countries

Improving sustainability of primary e-healthcare projects in rural areas of developing countries

Inés Bebea González

[email protected]

Project Manager at Fundación EHAS

PHD Student at Universidad Rey Juan Carlos

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Motivation

• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICTs to improve healthcare

processes in rural areas of developing countries.

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Motivation

• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICTs to improve

healthcare processes in rural areas of developing countries.

• Work areas– R & D in ICT technologies and telemedicine services

• Long distance voice and data connectivity

• Telemedicine

– Advice and evaluation of primary healthcare processes using ICT

– Education and knowledge transfer on ICT solutions• Capacity building

• Technology transfer

• High-level education (Engineering, Msc, PhD)

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Motivation

• Fundación Enlace Hispano Americano de Salud– International NGO promoting an appropriate use of ICT to improve

healthcare processes in rural areas of developing countries.

• Work areas– R & D in ICT technologies and telemedicine services

• Long distance voice and data connectivity

• Telemedicine

– Advice and evaluation of primary healthcare processes using ICT

– Education and knowledge transfer on ICT solutions• Capacity building

• Technology transfer

• High-level education (Engineering, Msc, PhD)

• Traditionally in Latin America: Peru,

Bolivia, Ecuador, Colombia and Cuba

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Motivation: Improve public Healthcare to the rural

3 billion people live in rural areas of developing countries

Source: Worldmapper.org (retrieved March 2011)

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Motivation: Apply e-Healthcare in rural areas

Rural regions characterised by isolation and unavailability of resources

Operation and maintenance of ICTs is hard

Few ICT initiatives in developing countries are sustainable

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Motivation: Apply e-Healthcare in rural areas

Rural regions characterised by isolation and unavailability of resources

Operation and maintenance of ICTs is hard

Few ICT initiatives in developing countries are sustainable

But, hey, sustainability is complex!

Technology Public InstitutionsRoad Infrastructure User Acceptance Cost

Maintenance & Logistics Operational CapacityPatient Acknowledge Health Policy

Telecom Regulations etc.

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Motivation: Apply e-Healthcare in rural areas

Rural regions characterised by isolation and unavailability of resources

Operation and maintenance of ICTs is hard

Few ICT initiatives in developing countries are sustainable

But, hey, sustainability is complex!

What if we could measure & fit sustainability of ongoing ICT initiatives?

Technology Public InstitutionsRoad Infrastructure User Acceptance Cost

Maintenance & Logistics Operational CapacityPatient Acknowledge Health Policy

Telecom Regulations etc.

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Context: EHAS-Napo case study

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Context: EHAS-Napo case study

• Rural Health Network– Reference Hospital

– 3 Health-care Centers

– 12 Health Posts

• Distances are 30-50 km (over 500 km end-to-end)

• Infrastructure:– River transport

– Unstable power supply

– VHF/HF radios if any

– 90% out of cellular coverage

• Scarce cualified health & ICT staff

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Context: EHAS-Napo case study

• Rural Health Network– Reference Hospital

– 3 Health-care Centers

– 12 Health Posts

• Distances are 30-50 km (over 500 km end-to-end)

• Infrastructure:– River transport

– Unstable power supply

– VHF/HF radios if any

– 90% out of cellular coverage

• Scarce cualified health & ICT staff

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Context: EHAS-Napo case study

• Rural Health Network– Reference Hospital

– 3 Health-care Centers

– 12 Health Posts

• Distances are 30-50 km (over 500 km end-to-end)

• Infrastructure:– River transport

– Unstable power supply

– VHF/HF radios if any

– 90% out of cellular coverage

• Scarce cualified health & ICT staff

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Context: EHAS-Napo case study

• Rural Health Network– Reference Hospital

– 3 Health-care Centers

– 12 Health Posts

• Distances are 30-50 km (over 500 km end-to-end)

• Infrastructure:– River transport

– Unstable power supply

– VHF/HF radios if any

– 90% out of cellular coverage

• Scarce cualified health & ICT staff

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Context: EHAS-Napo case study

Napo telemedicine network provides– Broadband wireless connectivity using WiLD Technology (WiFi

modified for long distances)– Voice services based on IP telephony and videoconference,– Data applications with Internet access, mailing and messaging, e-

learning, support for telediagnosis, teleconsultation and telepresence.– Systems autonomy via solar power.

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Context: EHAS-Napo case study

• Network topology • Transportation Times

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Context: EHAS-Napo case study

• Problems encountered:– Low availability of e-

Healthcare services

• High time to recover from failures

• Main failures:– Lightening damage to

equipment– Inaddecuate battery usage– IP telephony degradation due

to PBX version conflicts

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Research methodology

• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)

• Action Research

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Research methodology

• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)

• Action Research

• Factor-based Approach

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Research methodology

• Qual & Quant research review• Problem analysis through Logical Framework Approach (LFA)• Sustainable ICT Framework Analysis (Sunden, 2006)

• Action Research

• Factor-based Approach

Management Framework for Sustainable rural e-healthcare provision (Bebea, 2011)

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Next steps...

I. Explore additional concepts to help analysis: Capability Framework (Grunfeld, 2007), Communication Framework (Barroso, 2007), Risk Theory, Institutional Theory, Actor Network Theory.

II. Design action frameworks for technical – institutional – financial factors

III.Consider a 2nd case study based on rural e-health

IV.Analyse sustainability assessment through “risk measurement”

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Improving sustainability of primary e-healthcare projects in rural areas of developing countries

Inés Bebea Gonzá[email protected]

Thank you for your attention!Questions?