By Obaid Khan, Humanitas Global
With a global consensus on the Sustainable Development Goals, there is a renewed focus on ‘Big Data’ to design and implement evidence-based initiatives. In a world with more than 7 billion mobile cellular subscriptions and 3.2 billion internet users around the world, Information and Communications Technologies (ICTs) can play an instrumental role in generating data points for cross-sectional, longitudinal studies and much more. The scope of ICTs in helping achieve SDGs is unimaginable. With limitless opportunities associated with communications technology, this blog will restrict focus to employing ICTs to improve health outcomes in resource-constrained settings.
Implementation of ICT-based platforms in low-resource settings presents novel challenges that need cost-effective solutions. Mobile phones are often viewed as useful instruments to improve health outcomes through enhanced accessibility, outreach and efficiency of provided services. Employing cellular phones in the health sector is often categorized under the umbrella of Mobile Health/m-Health. According to one WHO report, the most prevalent use of m-Health is in the categories of health call centers, emergency telephone services and telemedicine globally. The associated initiatives range from screening patients for disaggregated data, monitoring, treatment compliance and surveillance to health education, mobile money, emergency response and feeding real-time data to electronic platforms. There is limited evidence of the impact of ICTs on health outcomes over time due to a lack of longitudinal studies but cross-sectional data reveals improvement in immediate outputs. SMS Reminders have been shown to improve treatment compliance of HIV-infected adults and health workers’ adherence to malaria treatment guidelines in Kenya. HP and mPedigree started an initiative that allows patients to check the authenticity of medicines, a common challenge, with the use of basic cell phones in Ghana, Nigeria and Kenya. Another example, mTrac, is used in Uganda to track disease outbreaks and keep stock of medicines through a network of community health workers and health facilities. These examples illustrate the effectiveness of ICTs in improving health outcomes within resource-constrained settings. Sustainable change warrants technological initiatives to be coupled with dynamic complementary policies.
There are numerous examples of ICTs being used in the healthcare sector to improve efficiency, outreach and accessibility through m-Health, e-Health and Electronic Platforms. However, one must bear in mind that m-Health and e-Health tools cannot provide standalone sustainable health solutions. A more comprehensive policy framework requires cross-sector collaboration to have a far-reaching impact on the overall well-being of individuals and communities. The essence of SDGs lies in the inter-connectedness of the goals and targets. Aiming for lasting effects on the health of a community necessitates a concerted multi-disciplinary approach.
An unchartered territory in the realm of health-related ICTs is developing a broad-based system of linkage between the financial and health sector. A meaningful collaboration between the financial and health institutions can translate into a tangible solution to address the demand-side budget constraints that prevent vulnerable populations from following through on health care activities and services. The underlying rationale is to incentivize intended health seeking and utilization behavior through conditional cash or credit transfers and ICTs can prove to be a crucial tool in providing an integrated platform to be used by both sectors. A unified framework that links credit payments to healthy behaviors in low-resource settings can act as a way forward for improving health outcomes in the long-term through enhancement of capabilities. Tying credit eligibility to better health seeking and providing behaviors through ICTs can be used a social protection scheme. Different tiers of compliance can be linked to different sets of incentives. For example, small cash amounts can be paid to the parents for getting a child immunized for the first time. For timely immunizations, the household becomes eligible for credit. Finally, for immunization completion, the household gets insurance coverage for its basic health needs. ICTs can be used to extract disaggregated data of the households for case detection and notification, monitoring and evaluation, SMS reminders, active surveillance for outbreaks, mobile money for cash transfers and pay-for-performance and credit ratings based on compliance level.
Multi-pronged approaches, that foster collaborative efforts across sectors, may be the active ingredient in achieving the SDGs by 2030. Health of an individual is determined by various micro and macro level factors such as the socio-economic status, educational level, health systems, health coverage, inter-institutional linkages and macro-economic policies of the government. ICTs should not be viewed only as a tool for facilitating procedures, but a portal which provides an avenue for meaningful partnerships that translate into sustainable developmental solutions.