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Barriers & opportunities to adoption: perspectives from Bangladesh

Joint ITU-WHO Workshop on e-Health Standards and Interoperability (Geneva, Switzerland, 26-27 April 2012). Barriers & opportunities to adoption: perspectives from Bangladesh. Dr Sultan Shamiul Bashar, Medical Officer Management Information System DGHS , MOHFW , Bangladesh

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Barriers & opportunities to adoption: perspectives from Bangladesh

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  1. Joint ITU-WHO Workshop on e-Health Standards and Interoperability(Geneva, Switzerland, 26-27 April 2012) Barriers & opportunitiesto adoption:perspectives from Bangladesh Dr Sultan Shamiul Bashar, Medical Officer Management Information System DGHS, MOHFW, Bangladesh e-mail: dr.bashar@mis.dghs.gov.bd

  2. Introduction Before explaining these perspectives, please allow me to give a brief overview of: • health care infrastructures & • eHealth in Bangladesh In our view, adoption of standards & interoperability framework in eHealth needs consideration from 2 perspectives: • National • Global

  3. Health Care Infrastructures 18,000 community clinics

  4. ehealth found phenomenal changein 3 years from 2009 ehealth vision 2016 Digital Bangladesh 2021 5-yrHPNSDP 2011-2016 with ambitious ehealth plan National Health Policy 2011 with ehealth as a major component

  5. ehealth found phenomenal change… Internet Connectivity • Currently 1,000 places, national to sub-district • To scale to 20,000 places (USCs to CCs) by 2 yrs DHISv2.7 • Currently collecting data for >5,000 health facilities (national to union level) • To be scaled soon to >20,000 health facilities Tele-medicine • 8 centers with quality video • Web camera in all district & sub-district hospitals • Soon to be scaled to CCs

  6. ehealth found phenomenal change… Hospital automation with OpenMRS 1 yr • 3 hospitals (all modules) • All district & sub-district hospitals (2 modules) 5 yrs • All hospitals (all modules) Databases • HRM, PDS, Field Staff Info • Supply Chain Management • Health Facility Database • Others mhealth • Pregnancy care advice by SMS • Complaint-suggestion box • Health Statistics Distribution System • Bulk SMS for health staffs Geneva, Switzerland, 26-27 April 2012 6

  7. Recognition One of top 11 Global Innovations in 2011 The Manthan Award South Asia National Digital Innovation Awards 2010 & 2011 United Nations Digital Health for Digital Development Award 2011

  8. Barriers & Opportunities:National Perspective Barriers • Lack of knowledge among database developers about • standardization & • interoperability • Lack of knowledgeable & skill staffs in public sector • Policy makers want quick solutions • Inadequate communications & TAs from DPs • Inadequacy of freely available standards Problem • Databases flourishing both within & outside health sector • They lack uniform coding system for locations, common fields & options • Opportunity of interoperability is being missed • Hardware & network choice also often lack standardization

  9. Barriers & Opportunities:National Perspective Opportunities • MoH initiative to form multi-sectoral & GO-NGO-DP National HIS Steering Committee for interoperability & standardization issue • A HL7 committee exists • We prefer OpenSource SW (compatible with IMR, SDMX-HD, ICD-10, HL7 (e.g., DHIS, OpenMRS) • Hardware choice follows ministry-wide approach ehealth in preliminary stages - Still have time The Highest level Policy Support – Digital Bangladesh 2021 The country started initiative to develop Common National Coding System & Standards

  10. Conclusions & Recommendations • Improve availability knowledge & practice of ehealth standards & inter-operability in developing countries • Ensure free & easy accessibility of ehealth standards • Improve DP coordination for ehealth • Increase ehealth TA for developing countries • Increase TA to developing countries with advancing situation of ehealth for generating global ehealth knowledge for replication • Consider geo-locations & common demographics to include for standards development

  11. Thank you! Woman receiving prescription from from Union Information & Service Center given by doctor at our office

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