There are tons of examples of how technology is transforming global health, including this recent video from The World Bank.
The Pacific region contains many countries with populations spread across large distances and the Kingdom of Tonga is one of them. Containing 170 islands, Tonga has unique development challenges. According to the video, there are only about 55 doctors in Tonga serving a population of 100,000. Medical assistants and nurse practitioners serve the areas outside the main islands, thus access to doctors is limited. Also, Internet in Tonga is very expensive and provides limited bandwidth.
To address these two issues, The World Bank, along with its partners, constructed an 827 kilometer underwater fiber optic cable that connects Tonga to the Southern Cross Cable Network via Fiji and helps improve Internet services. So what impact does this have on healthcare? Increased bandwidth allows hospitals and health professionals to get what they need, improves information collection, leads to better diagnoses, and allows them to liaise with partners overseas to ensure best treatment for patients.
We all recognize that technology has a strong impact on many aspects of our lives (for better or worse). The benefits associated with the intersection of technology and healthcare is very interesting and becomes even more interesting when you examine the effects it has in rural versus urban areas. This video clearly highlights work done in rural areas where access is a huge problem. Watching it reminded me of an article I read in the New York Times last year about a failed MNCH project. The project failed because researchers took a model that was successful in rural areas and tried to replicate it in an urban setting.
That said, when it comes to global health, some people believe there are greater gains to be had in rural areas where successes are “easier” to achieve and measure. What is your opinion?
This new video from UNICEF starts with the story of an Indian woman who safely delivered a healthy baby in a clinic, under medical supervision, thanks to a partnership between UNICEF and her local government. Prior to their intervention, the majority of women in her district in the Indian state of Madhya Pradesh were delivering babies at home because health facilities were few and far away, and there was no transportation available.
Over five years, UNICEF worked with the Madhya Pradesh government to make major changes, including:
- Upgrading health centers
- Providing new equipment
- Hiring new nurses
- Improving hospitals with a newborn care units
- Funding an ambulance service
- Creating a call center to coordinate ambulance trips
Now, five years after UNICEF began their work, the woman’s district reports the lowest maternal mortality rate in the entire state. Every year, half a million women use the ambulance service to ensure safer deliveries, and 50,000 newborns are saved in the newborn care units. UNICEF’s work has been so successful that the Madhya Pradesh government is scaling up and replicating it elsewhere in the state and other Indian states are also interested in implementing the programs.
One of the newborns in the video had a lung problem and was also underweight because his mother had not been eating properly. The narrator mentioned that many babies in the unit were underweight. While the video focused on the help the new care unit was able to provide to these newborns, my thoughts went elsewhere. UNICEF’s work has made a big difference, but the small fact about the prevalence of underweight newborns reinforced the fact that there are many larger underlying factors and social determinants at play that will continue to challenge progress and positive changes in developing countries. UNICEF’s innovative programs were definitely successful in tackling the delivery and newborn care issues in the region, but the video also (unintentionally) illustrated the general complexity of global health and development challenges.
“Don’t let complexity stop you. Be activists. Take on the big inequities. It will be one of the great experiences of your lives.”
– Bill Gates
mHealth, defined as the use of mobile technology to support healthcare, is arguably one of the hottest global health trends right now. With rapid advances in mobile technologies and applications, along with the continued growth of cellular networks, mHealth has the potential to address some of the biggest healthcare challenges in the world, including access and affordability. It’s becoming more and more integrated into healthcare systems as it can significantly cut costs and increase the reach of healthcare services in both middle- and low-income countries.
This video, released last month at the Social Good Summit during UN General Assembly Week in New York City, provides the following example of the kind of impact mHealth can have in developing countries:
- Challenge – Most women around the world only have one prenatal visit with a healthcare worker. However, one billion women in developing countries have access to a mobile phone.
- Solution – Use SMS and voice messaging to provide mothers with important information in their native language at each stage of pregnancy and throughout the first full year of the child’s life.
During my last trip to Nigeria I had my first personal experience with mHealth. Upon arrival, I purchased a basic Nokia bar phone and SIM card. While playing around with the phone, I stumbled upon the Nokia Life Tools app which is a standard, built-in feature on some models of Nokia bar phones. The app provides healthcare, entertainment, agricultural, and educational information. The healthcare section peaked my interest as it includes sections for MNCH advice, men’s health, women’s health, and chronic disease information. First, you enter basic details about yourself (sex, age, language, etc.), then you scroll through and subscribe to whichever topics you’re interested in. The MNCH advice section parallels the example in the video above. It delivers weekly developmental information during pregnancy via SMS and continues with child development tips for the first few years after pregnancy. The only costs associated with the app are standard text messaging fees.
In addition to patient education, health workers and providers also use mHealth for data collection, disease surveillance and management, treatment support, direct care, and more. Developing countries are definitely embracing the movement and driving innovations in mHealth, making it an exciting field with the potential to transform healthcare all over the world.
The Millennium Development Goals (MDGs) are goals the United Nations and its global partners established in 2000. There are eight goals focused on addressing worldwide social issues including poverty, health, hunger, inequality, education, environment, and sustainability with the target to make measurable improvements in all these areas by 2015.
Earlier this month, UNICEF released a report outlining trends and progress towards MDG 4, which is to reduce the under-five mortality rate by two-thirds between 1990 and 2015. The report highlights work being done to meet this MDG, as well as challenges and disparities that have slowed progress.
One of the biggest takeaways from the report is that Ethiopia has already achieved MDG 4 despite facing major obstacles such as a severe shortage of health professionals (there is only one doctor for every 36,000 people). The driving forces behind this achievement included strong commitment from the Ethiopian government, support from external organizations, and the use of innovative programs to reach communities throughout the country. Ethiopia joins Bangladesh, Liberia, Malawi, Nepal, Timor-Leste, and United Republic of Tanzania as another high-mortality country that reached MDG 4 before 2015.
This news is quite timely considering the 68th session of the UN General Assembly opened last week with a focus on defining a post-2015 development agenda. As 2015 approaches, I am eager to see increased analysis of MDG progress and heightened discussions among members of the international development community about what’s next for global health. Stay tuned!