Challenges in developing countries e health
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ITU Workshop on “ E-health services in low-resource settings: Requirements and ITU role ” (Tokyo, Japan, 4-5 February 2013). Challenges in developing Countries & E-Health. Rajendra Pratap Gupta, Member , World Economic Forum ’ s Global Agenda Council – Digital Health 2012-14

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Challenges in developing countries e health

ITU Workshop on

“E-health services in low-resource settings: Requirements and ITU role”

(Tokyo, Japan, 4-5 February 2013)

Challenges in developing Countries & E-Health

Rajendra Pratap Gupta,

Member , World Economic Forum’s Global Agenda Council – Digital Health 2012-14

[email protected]


Challenges in developing countries e health

eHealth was born out of the challenges of - constrained financial resources, Clinical resources, infrastructure, increasing need of healthcare in rural / remote settings and advancements in ICT

Rajendra Pratap Gupta


Challenges in developing countries e health

eHealth is no more an innovation now. It is a basic necessity of every healthcare system

Rajendra Pratap Gupta


Ehealth push pull

eHealth – Push & Pull

MCH – IMR – MMR

Rural Health

Health Screenings

Secondary prevention amongst affluent class – NCDs

Second opinion or referrals & tele-radiology

Geriatric Care

Medical tourism


Priorities for the developing world

Priorities for the Developing World

  • MDGs 4 & 5 – MCH

  • Healthcare delivery in rural areas

  • NCDs

  • Training of *HCWs

    * HCW – Healthcare Workers


Mdgs 4 5

MDGs 4 & 5

  • In India , MMR is 212 / 100,000 live births . 1 death every 10 minutes.

  • Target is to get MMR down to 109 / 100,000 live births by 2015

  • IMR is 48 / 1000 live births & needs to be brought to 42 / 1000 by 2015


Jeevandainee project maharashtra

Jeevandainee Project - Maharashtra


Sample report high risk patients

Sample report – High risk patients


Tracking high risk pregnant women

Tracking high risk pregnant women


Outcome

Outcome

  • Cost of intervention per village < $ 100

  • In a year and half of being in operation;

  • Maternal mortality dropped from 91 /100,000 to 51 / 100,000

  • A drop of 43.95 % in MMR


Healthcare delivery in rural areas

Healthcare Delivery in Rural areas

  • 70 %( about 830 million ) of India’s population lives in rural areas

  • India has about 6,40,000 villages

  • Absenteeism of doctors is 40 % in rural settings


Ehealth delivering in low resource settings

eHealth delivering in low resource settings

Equipment

  • Stethoscope

  • Temperature

  • Blood Pressure

  • ECG

  • SPO2 (opt)

  • Service is operational in several regions in India

    • More than 677 village centers in UP, Bihar, Tamil Nadu, AP, Maharashtra, Tripura, MP & Karnataka.

  • More than 200,000 consultations, Rs. 20-200 fee, sustainable village centers

  • Covering 40 Mn population. To increase to 70 Mn by end of 2013.

  • 30-40% traffic of patients who have earlier visited for a different ailment


Rural health centre

Rural Health Centre


Challenges in developing countries e health

NCDs

  • 53 % of all deaths in India due to NCDs ( WHO ). This is set to increase by 18 % in the next 10 years ( WHO).

  • * Raised blood pressure prevalence is 32.5 % ( approx. 396 million )

  • * Raised blood glucose prevalence is 10 % ( Approx. 122 million )

    *estimates as per WHO. http://www.who.int/nmh/countries/ind_en.pdf


Challenges in developing countries e health

NCDs

  • Government has already started a mass screening program

  • Crossed 14 million screenings

  • India needs a mass secondary prevention program for NCDs, using mHealth / eHealth.


Ehealth has the solution for rpm

eHealth has the solution for RPM*

  • Biometric Screening

    • SpO2

    • Blood Pressure

    • Blood Sugar

    • Spirometry

    • Total Cholesterol

    • ECG

    • Triglyceride

    • Body Composition

    • HBA1C

    • Ultra-sound

    • X-Ray

    • Doctor consultation

    • * Remote Patient Monitoring


Training of hcws

Training of *HCWs

  • India has approx. 866000 *ASHAs

  • No. of ASHAs to increase in future

  • A new 3 year course for HCWs (Rural)

  • Training , capacity building & re-training - a big challenge !

    * HCW – Healthcare Workers. ASHA- Accredited Social Health Activist


Mhealth addressing the challenge

mHealth – addressing the challenge

  • 360 degree approach to communication

  • Launched 4 months ago

  • Covers 29 million population / 8 districts

  • Trained 40,000 workers

  • 1 million minutes of talk time used by Health workers

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Challenges for ehealth

Challenges for eHealth

  • Lack of data in support of eHealth

  • Successful & scalable eHealth projects

  • Technical competence amongst policy makers to understand eHealth


Challenges for ehealth1

Challenges for eHealth

  • VOI ( Value On Investment ) should be considered for eHealth and not just financial ROI ( Return On Investment ).

  • BOO ( Build , Own & Operate model ) or BOOT ( Build , Own , Operate & Transfer model ) under PPP ( Private Public Partnership model ).


Conclusions and recommendations

Conclusions and Recommendations

When it comes to eHealth , we have achieved ‘technical maturity’ , but the lack of ‘organizational maturity’ is proving to be a big bottleneck in unlocking the potential of eHealth

Rajendra Pratap Gupta


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