Health IT

Just wanted to follow up with more specifics. We're still gathering information about how IT capabilities can be beneficial. For example, in some of our discussions with some of the lemongrass farmers, particularly leaders of co-op groups, they've said that mobile devices have been immensely beneficial for them for communication. They only require general meetings with all the members once every few months.

In our personal observations and experiences so far, we've also noticed that netbooks are extremely useful for project work requiring a great deal of transportation, adding value with portability and long-lasting power.

Also, we've been learning that our project also involves workers who spend most of their time in the field/farms and require continuous instructions from the coordinator. So we're going to try offloading the solar charger to them to see what their experiences are with it.

But at the same time, we want to keep ideas for IT improvements open-ended to solicit responses with other creative IT ideas for a project of our nature. We currently have the following items to use:

Small solar chargers
Netbook, mouse, mousepad
Quad-band unlocked phones, w/ camera, web-browser
Bluetooth keyboard
External hard drive
Skype ...

Just wanted to follow up with more specifics. We're still gathering information about how IT capabilities can be beneficial. For example, in some of our discussions with some of the lemongrass farmers, particularly leaders of co-op groups, they've said that mobile devices have been immensely beneficial for them for communication. They only require general meetings with all the members once every few months.

In our personal observations and experiences so far, we've also noticed that netbooks are extremely useful for project work requiring a great deal of transportation, adding value with portability and long-lasting power.

Also, we've been learning that our project also involves workers who spend most of their time in the field/farms and require continuous instructions from the coordinator. So we're going to try offloading the solar charger to them to see what their experiences are with it.

But at the same time, we want to keep ideas for IT improvements open-ended to solicit responses with other creative IT ideas for a project of our nature. We currently have the following items to use:

Small solar chargers
Netbook, mouse, mousepad
Quad-band unlocked phones, w/ camera, web-browser
Bluetooth keyboard
External hard drive
Skype headsets
USB Memory sticks
Ubuntu Linux, OpenOffice
Polaroid pogo mini printer & paper

Thanks!
Alex

Hi Alex,
It'd be great if you could give us more of an idea of what the need you are looking to fill is. After knowing that we can think about what technologies fill that need. The list you provided is pretty comprehensive as to the equipment that you can take, but you'll need to figure out how this fits into what the farmers actually want/need to use.

Warm regards,

Joaquin

In response to your original interest "Income Generating Projects for HIV/AIDS patients" I'd like to point you to Dr. Richard Komp http://www.mainesolar.org/Komp.html who has already worked in many places creating a 'cottage industry' of solar panel manufacturing.

As a productive income generator.. something to think about.

@Joaquin

For SHIP, our focus probably won't be directly related to the delivery of or adherence to treatment, but more on the operational and administrative aspects of the project, such as data entry, record keeping, file sharing, power support, documentation, and more broadly speaking, improvements in efficiency, lowering costs, etc. If you’ve had experiences with directly improving health delivery using non-specific devices (or possibly interfacing or integrating the equipment listed with medical-specific devices), please do share.

Some needs the project staff has identified relate to the lack of power for farmers, field workers, and research assistants who spend most of their time in the field and require the use of cell phones and laptops frequently. So we hope the solar chargers can help with additional power support for mobile devices, and the portability and long battery life of netbooks would specifically suit their computational needs.

SHIP is also currently lacking a camera to document farmer activities and environments, so the quad-band unlocked phones w/ cameras will hopefully solve that problem (simple and obvious, I know, but hopefully a suitable fix).

Many of the benefits of the equipment that we are providing for the project are fairly obvious, but ...

@Joaquin

For SHIP, our focus probably won't be directly related to the delivery of or adherence to treatment, but more on the operational and administrative aspects of the project, such as data entry, record keeping, file sharing, power support, documentation, and more broadly speaking, improvements in efficiency, lowering costs, etc. If you’ve had experiences with directly improving health delivery using non-specific devices (or possibly interfacing or integrating the equipment listed with medical-specific devices), please do share.

Some needs the project staff has identified relate to the lack of power for farmers, field workers, and research assistants who spend most of their time in the field and require the use of cell phones and laptops frequently. So we hope the solar chargers can help with additional power support for mobile devices, and the portability and long battery life of netbooks would specifically suit their computational needs.

SHIP is also currently lacking a camera to document farmer activities and environments, so the quad-band unlocked phones w/ cameras will hopefully solve that problem (simple and obvious, I know, but hopefully a suitable fix).

Many of the benefits of the equipment that we are providing for the project are fairly obvious, but we’ll try to observe if there are any unintended or indirect benefits that come out of their use. One comment that our project coordinator mentioned was that even with computers, the extensive traveling and handling that the research assistants and field workers need to do has already damaged a few laptops. So the lightweight, portability, and long battery life of netbooks seem like the most appropriate choice for them. The coordinator also shared how on one occasion, the staff was visiting a patient and wanted to take some photos but lacked a camera. So one member happened to have their laptop with them which had a webcam, and he used that to take photos and videos of their visit.

There are a few anecdotes of unconventional and improvised uses of technology we’d love to hear about, but we’d mainly appreciate any feedback and experience you have with just improving the operational aspects especially of managing small income-generating projects and/or health delivery in resource-constrained settings with the equipment we have.

Best,
Alex

Ok, I understand slightly better. One other anecdote which your note reminded me of was that Holly Ladd from Satellife mentioned that when they were implementing handhelds I believe in Uganda, they found that users wanted to have books that they could read in the handheld (specifically for them it was the Bible), but I think you could take this as a way for the users to have access to literature or other things that they could read. This however, would impact the amount of battery life.

Another project that comes to mind is the FirstMile Solutions where they used store-and-forward technology to connect areas that otherwise would not have internet (http://www.nextbillion.net/blog/2006/08/11/well-do-the-dirty-work-how-firstmi...) i.e. your laptops could be mini email servers for the people of that community, so that when they were at different posts, they could write emails or ask questions and when the laptops were back where there was internet could send those off. Again, something not so obvious, but perhaps could be useful.

Also, a way of using technology to promote political support was the stop the stock campaign where using cell phones groups were able to catalog the ...

Ok, I understand slightly better. One other anecdote which your note reminded me of was that Holly Ladd from Satellife mentioned that when they were implementing handhelds I believe in Uganda, they found that users wanted to have books that they could read in the handheld (specifically for them it was the Bible), but I think you could take this as a way for the users to have access to literature or other things that they could read. This however, would impact the amount of battery life.

Another project that comes to mind is the FirstMile Solutions where they used store-and-forward technology to connect areas that otherwise would not have internet (http://www.nextbillion.net/blog/2006/08/11/well-do-the-dirty-work-how-firstmi...) i.e. your laptops could be mini email servers for the people of that community, so that when they were at different posts, they could write emails or ask questions and when the laptops were back where there was internet could send those off. Again, something not so obvious, but perhaps could be useful.

Also, a way of using technology to promote political support was the stop the stock campaign where using cell phones groups were able to catalog the number of stock outs I believe in Kenya and hence pressure the government to do something about it.

Finally, our group at Partners In Health performed a randomized controlled trial of the impact of using handhelds in collecting tuberculosis laboratory information from 126 health centers in Lima, Peru and found that times, errors and the number of work hours required decreased. You can view the article here (http://www.ghdonline.org/tech/resource/cost-and-implementation-analysis-of-a-...).

Hope these help,

Joaquin

___________________________________________________________________
NLM Fellow, Decision Systems Group, Brigham & Women's Hospital
Research Fellow, Partners In Health
Moderator, GHDOnline.org

Actually, Joaquin, we never did offer the bible for our program, but
some of users downloaded it to their handsets themselves! In Uganda we
have provided medical text books, treatment guidelines and drug
references on the mobile devices. We also package and send out
continuing ed modules on specific topics three times per week, as well
as articles from the local newspapers. We have developed a program
called GUIDE that takes content and converts it for display on a cell
phone in a manner that preserves the original formatting including
tables, charts and diagrams. In South Africa we have converted the
national primary care treatment guidelines for display on the handsets
(smartphones). They also have hospital guidelines and are getting
regular uploads of new content. If you are interested in seeing the
content from the US you can send a text message to short code 51684 an
enter either SA or Uganda and see the content.
for more information www.healthnet.org.
Holly Ladd


Holly Ladd
VP and Center Director
AED-SATELLIFE Center for Health Information and Technology

Thanks Holly, and sorry if my memory failed me.

Alex, today, the journal Health Affairs has published an entire issue on eHealth in Developing Countries which you might find interesting (http://www.healthaffairs.org/). One of the articles in there is a systematic review of eHealth Technologis which I helped to write. If you'd like more information about it please email me off list ().

Blaya JA, Fraser HSF, Holt B. "E-health technologies show promise in developing countries." Health Aff (Millwood). 2010;29(2):243-50

Warm regards,

Joaquin

Dear Joaquin,

Thank you for sharing!

The latest Health Affairs issue on eHealth is a great resource and your article very helpful.

Best regards,

Jeff

Jeffrey M. Blander Sc.D
Fogarty International Center Fellow (Tanzania)
Co-leader Technology Innovation Working Group
Harvard Initiative for Global Health (HIGH)

Another thing that might be of interest is this book that just came out.
SMS Uprising: Mobile Activism in Africa

Edited by Sokari Ekine

http://fahamubooks.org/book/?GCOI=90638100577370

SMS Uprising provides a unique insight into how activists and social change advocates are addressing Africa's many challenges from within, and how they are using mobile telephone technologies to facilitate these changes.

This collection of essays by those engaged in using mobile phone technologies for social change provides an analysis of the socio-economic, political and media contexts faced by activists in Africa today. The essays address a broad range of issues including inequalities in access to technology based on gender, rural and urban usage, as well as offering practical examples of how activists are using mobile technology to organise and document their experiences. They provide an overview of the lessons learned in making effective use of mobile phone technologies without any of the romanticism so often associated with the use of new technologies for social change. The examples are shared in a way that makes them easy to replicate - 'Try this idea in your campaign.' The intention is that the experiences described within the book will lead to greater ...

Another thing that might be of interest is this book that just came out.
SMS Uprising: Mobile Activism in Africa

Edited by Sokari Ekine

http://fahamubooks.org/book/?GCOI=90638100577370

SMS Uprising provides a unique insight into how activists and social change advocates are addressing Africa's many challenges from within, and how they are using mobile telephone technologies to facilitate these changes.

This collection of essays by those engaged in using mobile phone technologies for social change provides an analysis of the socio-economic, political and media contexts faced by activists in Africa today. The essays address a broad range of issues including inequalities in access to technology based on gender, rural and urban usage, as well as offering practical examples of how activists are using mobile technology to organise and document their experiences. They provide an overview of the lessons learned in making effective use of mobile phone technologies without any of the romanticism so often associated with the use of new technologies for social change. The examples are shared in a way that makes them easy to replicate - 'Try this idea in your campaign.' The intention is that the experiences described within the book will lead to greater reflection about the real potential and limitations of mobile technologies.

Edited by Nigerian activist Sokari Ekine, who runs the prize-winning blog Black Looks<http://www.blacklooks.org/>, the book brings together some of the best known and experienced developers and users of mobile phone technologies in Africa, including Juliana Rotich from Ushahidi<http://www.ushahidi.com/> in Kenya, Ken Banks of Kiwanja.net<http://www.kiwanja.net/kenbanks.htm>, and Berna Ngolobe of WOUGNET<http://www.wougnet.org/> in Uganda.