1. ICTs for Social & Behavioural
Change in Health
Syed S. Kazi
Programme Head, Policy & Governance
Digital Empowerment Foundation, New Delhi
October 26th, 2013
Glocal University
1
6. Challenges in Health Governance & Delivery
•
•
•
•
Information & Content dissemination
Monitoring & Tracking
Inter personal communication
Training of frontline workers
6
7. ICTs & Information Dissemination
• Remote dissemination
• Mass dissemination
• Information portability, text messaging and
data downloading
• Timely and accurate information
• Flexibility of communication
7
8. Monitoring & Tracking
• Capacity of ICT (mobile) platforms to monitor
and track development schemes /
programmes
• Managing the life cycle of a project through
data capturing and activity monitoring
• Track doctor attendance, presence of project
staff, maintaining time table, sending progress
updates
• Text & image compatibility
8
9. Training of Front Line Workers &
Interpersonal Communication
• Mobile and other devises experimented to serve
training needs in front end service delivery
• Relevance in flagship programmes like National
Rural Health Mission (NRHM)
• Equipping each worker with a mobile phone / tablet
/ ipad and adequate training serves vast unmet
needs of health information dissemination, tracking
of progress of health schemes, and solves key
health issues on the spot through interpersonal
communication support services.
9
10. ICTs @ Health Services
MHSM SMS Toolkit, Uttar
Access to relevant information
Documents Printing / Photo Printing/ Scanning
Filling an online RTI
Pradesh application
Online Learning and Practice Centre
The project Maternal Health Services on Mobile (SMS
Digital Public Library
Toolkit) – MHSM, aims at providing critical Reproductive
and Child Health (RCH) related information services to
the pregnant and lactating women apart from their
families and health workers through mobile phones, using
localized SMSs in Hindi. The project is implemented in
the Ghatampur block of Uttar Pradesh Kanpur Dehat
(Rural) District of Uttar Pradesh.
10
12. Mobile Kunji, Bihar
The basic problem faced by the health workers across
the State of Bihar is lack of proper tools through which
they could convince the rural families on preventive
and curative health behaviours. The project since 2010
provides frontline health workers with innovative job
aid called ‘Mobile Kunji’ to function better in health
care services delivery. With the aid of Mobile Kunji,
workers with adequate training use mobile tools to
effectively disperse health messages and increases the
demand of health services.
12
14. Chanderi Tele-Health Project
DEF & Media Lab Asia has implemented telemedicine facility
at Community Health Centre (CHC), Chanderi and Distt.
Hospital, Ashok Nagar (MP) under the CIIDP project dated July
01, 2013. The services of Telemedicine Operators placed
under the close supervision of Chief Medical Officer CHC,
Chanderi and Civil Surgeon Cum Chief Hospital
Superintendent, Distt Hospital Ashoknagar.
Healthcare services under the telemedicine facility includes
Data collection (EMR) of rural patients using ‘Tele Health
Monitor’, Data transfer/Teleconsultation with speciality
doctors and Participation in the ‘Health Campus’ as and
when organized by the local authorities.
14
16. CommCare Jharkhand
CommCare is a job aid tool. This application
contains mobile illustrations and audio messages
covering need-to-know topics in antenatal care
which an ASHA/ Sahiya can use to educated
pregnant women in her village, regardless of their
level of literacy through mobiles. CommCare
leverages multimedia capabilities of common
phones to deliver educational information to
anyone, regardless of their level of literacy.
16
18. HealthPhone, Maharashtra
The project was launched to provide families with their
own personal mobile reference library and guide to
better health practices. HealthPhone's health and
nutrition content includes timing births, safe
motherhood and new-born health, breastfeeding,
immunization, diarrhoea, and more serious illnesses.
The content is pre-loaded on popular low-cost models
of mobile phones – no signal is required, nor cost and
knowledge to download videos and other media.
18
20. mDiabetes, All India
mDiabetes was launched across India in January
2012. The objective of this initiative was to
disseminate vital information about Type 2
Diabetes and what life style changes one should
make to prevent diabetes through mobile alerts
in 12 languages. Mobile phone users are sent
these carefully designed alerts which would be
useful reminders for adults about healthy living
as a way to prevent diabetes.
20
22. E-Mamta – Mother & Child Tracking
System (MCTS), Gujarat
The project ‘E-Mamta’- Mother & Child Tracking System
(MCTS) is uniquely designed and executed in government
health facility across Gujarat to accommodate for gaps in
ensuring comprehensive maternal and child health
services in rural as well urban areas. Since 2010, the
application is being implemented in all 26 districts of
Gujarat. Value added features under E-Mamta included
SMS service, Online Immunization record, weight chart for
pregnant woman.
22
24. Pharma Secure -Verify My Medicine service
Established in 2010, empowers consumers with the
ability to verify the authenticity of their prescription
medicines using an everyday mobile device, enabled
through various channels like SMS,the connection to
a Call Centre and the internet.This means that any
patient can authenticate a lifesaving medicine
through a SMS or via a call which minimizes the risk
of patients to consume counterfeit, spurious, falsely
labeled or even fake medicines every day all over
India. About 300 million packages have already been
secured by the Pharma Secure system in over 20
states of the country within the past 3 years.
24
26. Health Help Center – ICT Healthcare
Helpline and EMS
Health Help Center (HHC) is an Information
Communication Technology (ICT) enabled health
care service established in 2011 which delivers
services round the clock (24/7) and presents an
initiative under the Department of Medical
Services, Ministry of Health in Bhutan. The
services delivered include Emergency Response
Services and Healthcare Helpline Services.The
services are delivered through the toll free
number 112 which is accessible from mobile
phones, fixed land lines and PCOs.
26
28. Tripura Vision Centre Project
• Conceived by the Department of Health and Family Welfare,
Government of Tripura, the Tripura Vision Centre project is a
breakthrough in delivering eye-care services to the previously unreached rural citizens of the state. Through a decentralized
approach, the project aims at improving access to quality, primary
and preventive eye care for patients through tele-ophthalmology.
• A total of 40 Vision Centres have been be deployed in three phases
to render the service across Tripura. In Phase I, the pilot Vision
Centre was set up in Melaghar block in April 2007 where more than
4,800 patients have been screened till date. Based on the progress
made at Melaghar, the project network was expanded to 10 blocks
in West Tripura district. The second phase also comprised of
digitalization of patient medical records in the Vision Centres and
setting up of an independent wireless network with a bandwidth of
256 Kbps. The third phase is still continuing and deployment is
happening in another 29 locations.
28
30. Mother and Child Tracking System
(MCTS), Ministry of H&FW, India
A name, address and telephone based Mother and Child
Tracking System (MCTS) is a new initiative of the Ministry of
Health and Family Welfare since 2010, and is seen as an
effective example of leveraging Information Technology for
ensuring delivery of full spectrum of healthcare and
immunization services to pregnant women and children up to
5 years of age. The system employs mobile-based SMS
technology to communicate with grass roots level health care
services providers, health and family welfare policy makers,
health managers and health administrators at different tiers
of the health care delivery system.
30
31. ICTs @ Health SBC Impact
Informed &
Aware
Decision
making
Economic /
Social Capital
Gains
Timely
remedy &
changes
Governance
&
democracy
Entitlement
gains
Stable
community
31
32. ICTs @ Health SBC Model
Social
Business
Inclusive
32
33. ICTs @ Health SBC: The Emerging Scope
•+ 3
milion
•+ 5
million
Health
workers
Rural
India
• 70%
PHCs &
others
Mobiles
• + 80
million
33
34. ICTs for Health SBC: Few Perspectives
Development
Perspective
Industry
Perspective
Research
Perspective
Government
Perspective
34
35. ICTs for Health SBC: Scope for E&H & GLOCAL UNIV.
Advocacy
Research
Interventions &
Partnerships
35
36. ICTs as effective tools for Health SBC: Hurdles
Lack of ICT culture
• Digital Exclusion: whether social /
commercial motive
• Digital illiteracy
• ICTs like mobile not a utility devise
• Local language content gap
• Interoperability crisis
• More of text, less of audio-visual
content
• Process complexity than simplicity
• Shorter project duration
• Lack of community ownership
precedence and model
• Cost overriding factor
36
37. What needs to be looked into?
Policy environment
(networks, devises,
services,
innovations)
Economic
capacities
Social capital
Improving access
(geography,
population
segments)
Content & Services
37
38. ICTs as tools for Health SBC: Key Considerations
What
behavioural
change required
Conducive social
environment key
to individual
behavioural
change
Need to create
'WE' from 'I'
ICTs as tools
for Health
SBC: Key
considerations
Need to benefit
from the process
and not just
technology
Good governance
to help make
wise choice
38