E-HEALTH

ICT stories from the field

Telephone and Internet based Medical appointments in Mexico

Success strategy: This project is a response of the Director General of Social Security and services to the problem of excessive time  spent to gain access to any of the 168 first-level family Healthcare clinics available nationwide. The project creates a system of medical appointments either by telephone via a toll free number or over the internet. The average time spent waiting to secure medical attention is 4 hours which does not guarantee a physician's attention. The new system handles the appointment schedules of all the family health care clinics in the country. It does assist the clinics to organize their workload .The user selects a date convenient and the available timeslots are presented to the user to select.                                                                                                                                                                                          This project has been given a presidential target which implies that a report of progress is submitted to the presidency monthly. The process ensures that anyone given an appointment is attended to by a doctor. what is required of the patient is to show up at the clinic on the day of the appointment 15 minutes to schedule to announce his attendance showing relevant identity document . The clerk at the clinic then enters the attendance in the system's database. The system also has its own feedback mechanism where users and provide feedback on its efficiency.

This system is currently deployed in no less than 116 clinics in 16 states which includes the capital city Mexico. It provides easy access to health care regardless of distance and location. It has resulted in a reduction in productivity loss which is one of the main advantages of ICT deployment, also as part of the implementation activities of the system, training is provided in the use of the ICTs relevant to the system. Finally the physicians working in the first level attention medical clinics are able to organize their work better and work punctually.

Source: Iconnect –online, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE)

Partners: (ISSSTE), International Institute for Communication and Development (IICD)

 Republic of Korea: Computerizing Medical Claims 

Success strategy: One of the most computerized parts of the health sector in the Republic of Korea is the Health Insurance Review Agency (HIRA), an independent agency set up in 2000 to review and process health claims. With close to 600 million claims a year, HIRA has a strong incentive to promote efficient and timely processing through the adoption of information technology. It has been actively encouraging medical care institutions to adopt electronic data interchange (EDI) technology for submitting claims. HIRA has a backbone network connecting its seven regional offices through high-speed ATM links to the headquarters in Seoul. Medical institutions can log into HIRA’s site to submit their claims.

Although not all health-care providers use the EDI system to make their reimbursement claims, most do. Out of a total of 63,675 medical care facilities, 42,280 are connected to the network and HIRA receives 77 per cent of all claims electronically. An additional 15 per cent are submitted by diskette and the remaining claims are sent in paper format. The benefits of electronic processing have been enormous. Errors have been cut back significantly, and overall wastage of time and resources substantially reduced. Besides making the processing of medical claims more efficient, the system also allows patients to check their medical records. HIRA has a near-term target of having over 90 per cent of medical institutions submitting electronic claims.

For in-depth information: see the ITU case study on Korea

 United Nations Health InterNetwork

Success Strategy: Health InterNetwork is one of four major initiatives of the UN Millennium Action Plan. It aims to bridge the digital divide in health by providing access to high quality, timely information for health professionals, researchers and policy makers in developing countries, using the internet. The core components of this public-private partnership are content, connectivity, capacity building and policy.

Recognizing the negative effects associated with unequal distribution of health-related information throughout the world, the Secretary General of the United Nations called on the World Health Organization (WHO) to bridge the digital divide in health.  Drawing on the expertise of public and private actors, international organizations and NGOs, WHO launched the Health internetwork in Septembre 2000 to address the healthcare information gap that exists between developed and developing countries.  It aims to improve public health by facilitating the flow of health information, using the Internet. The core elements of the project are content, Internet connectivity and capacity building. The seven-year, USD 150 to 200 million project has three key focuses:

• Content creation: On completion of a country assessment study, WHO implementation teams work with academia, private sector and local partners to create an internet portal that gives marginalized groups access to high-quality, contextually relevant content created, where possible, in local/ regional languages.

• Connectivity: Guided by a technology advisory group comprised of UNDP and ITU officials, the project seeks to establish over 10,000 internet access sites over the next seven years.  The WHO will work closely with NGOs and local partners to implement, manage and maintain the internet sites.

• Capacity-building: Realizing that many communities in the developing world lack the skills to effectively use ICTS, the WHO implementation teams will provide hands-on training in a variety of new technology fields, including basic computer and internet workshops.

As a key component of the project, the Health InterNetwork portal provides a vast library of the latest and best information on public health. Users can access more than 1,000 scientific publications, as well as statistical data and information for health policy and practice - essential information for research, and health services delivery. The portal will also make available information technology health applications such as geographical information systems and epidemiological tools, plus courses and training offered through distance learning. Pilot projects are  at present underway in eight countries in Africa, Central Asia and Eastern Europe. 

Deliver effective public health services
Country needs are the basis for content development and selection; for example, publishing local and regional public health information that is currently unavailable electronically is given special attention. A content advisory group guides the selection of core public health content and the process for making it available. The academic and private sectors, along with local partners are contributing their knowledge and experience in developing and publishing information as well as contributing content. The Health InterNetwork seeks also to establish or upgrade thousands of Internet-connected sites in public and not-for-profit institutions in developing countries.

Capacity building: to create an information environment
Health InterNetwork training concentrates on building the skills needed to put information into action: information access and use in daily work, basic computer and Internet skills, and hands-on training to use specialized public health information, literature and tools. A training advisory group is being established to guide the development and delivery of training courses, adapted to fit the needs of institutions with different information environments.

During the first year the Health InterNetwork achieved a major breakthrough on provision of health content. Starting in January 2002, the world's six biggest biomedical journal publishers have agreed to provide access to more than 1,000 of their scientific publications for free or at deeply-reduced rates to medical schools, research institutions and government offices in developing countries. Many other publishers are interested in joining this initiative as it expands.

Several examples of pilot projects could be find on the website of the activity.

The Health InterNetwork was created with one single purpose: to bridge the digital divide in health. Towards that end, health information - relevant, timely and appropriate - must become unrestricted and affordable worldwide, so that all communities can benefit from this global public good.

Target group: Professionals in the field of Medical sciences, large audience

Partners: World Health Organization (WHO) and a large number of partners

Source: WSIS Stocktaking Database and the website of the activity

 Understanding humans

Success Strategy: While based in the United States, the National Center for Biotechnology Information’s (NCBI) efforts to map the human genome is applicable the world over. Created by United States. Senator Claude Pepper in 1988, the NCBI, in tandem with the National Library of Medicine and the National Institutes of Health, has successfully digitized the staggering volume of molecular data that makes up the most complex system in the world: men and women. Upon assuming responsibility for the GenBank DNA sequence in 1992, the NCBI has partnered with computer scientists, molecular biologists, mathematicians and the like from around the world to create electronic databases that help the global scientific community to better understand the human genetic legacy. Drawing on data collected from its European and Japanese counterparts, the NCBI’s efforts not only help to map the human genome, but also provide an online forum for discussing, researching and analyzing diseases and viruses (AIDS) that continue to stifle development in marginalized societies. Through data exchange and knowledge transfers, the research initiatives sponsored by the NCBI and its partners are helping scientists in underprivileged societies more effectively address many of the health-related problems that keeps them at the margins of the global community.

For in-depth information: see http://www.ncbi.nlm.nih.gov

 Isabel.org.uk 

Success Strategy: The United-Kingdom-based Isabel Medical Charity, “Isabel.org.uk”, was designed in response to a misdiagnosis that almost killed a three year-old named Isabel. The parents of Isabel created the site in 2000 to provide clinical decision support for pediatricians in order to avert misdiagnoses and preventable illnesses. At the heart of the site is Autonomy Corporation’s sophisticated cataloging software, which allows members of the medical community to input patient symptoms to retrieve a range of 15 diagnoses from a library of over 3,500 entries. The site also contains an annotated image library that allows doctors to compare x-rays and clinical pictures from a variety of medical fields.

For in-depth information: see the Isabel.org website and the Isabel.org case study

 e-Farmasi - Malaysia

Success Strategy: e-Farmasi is a project that links communities to their neighbourhood pharmacies and provides an impartial database on illnesses and medicines. e-Farmasi will enable the community to access a database of unbiased information about medicines, their use, side effects, directions for use etc.

Using ICT, community members can direct questions to a pharmacist and where appropriate, complete a pharmaceutical transaction over the net. Part of the project also involves the provision of a pharmacy management program to pharmacists -- to help them manage their pharmacy, keep patient medication records and provide pharmaceutical care. The database contains information on over 27,000 products that are nationally registered (NPCB) in both English and Bahasa Malaysia. Medicines can be searched by either ingredient or brand name, assistance is also provided to guide patients towards the right product for non-serious ailments. The site also contains information on a variety of ailments, including diagnostic guides and self-care strategies. The website contains extensive listings of participating and independent pharmacies as well as some non-registered outlets such as apothecaries.

Partners: National Information Technology Council of Malaysia under the Demonstrator Application Grant Scheme (DAGS), jointly developed by the Pharmacy Division of the Ministry of Health, The Malaysian Pharmaceutical Society, and GS Vision Sdn Bhd

Source: The Communication Initiative website and http://www.efarmasi.com.my

 Journey of Life Radio Show - Ethiopia

Success Strategy: A radio serial drama that began airing in 2001 in Ethiopia designed to encourage young adults at risk to protect themselves from HIV/AIDS and unwanted pregnancies by depicting characters engaging in either risky or safe sexual behaviour. The goal is to help Ethiopians understand how easy it is to become infected with HIV, as well as how easy it is to protect oneself from the virus. The radio series "Journey of Life" portrays characters with whom audiences can identify. While vulnerable, these characters are empowered to take steps to protect themselves and their loved ones against unwanted pregnancies and infections.

A final impact evaluation of the 26-week radio soap opera revealed that personal risk perception rose to 66.2% after listening to JOL. While almost all listeners (97.6%) believe that HIV/AIDS is a serious health threat in Ethiopia, they also believe strongly (96%) that they have the power to avoid HIV infection. Most respondents (86.6%) agreed or strongly agreed that after listening to JOL they wanted to change their lives for the better. Specifically, the vast majority of urban youth listeners (95.9%) said that JOL influenced them to protect themselves against HIV/AIDS. Females reported a stronger behavioural impact from JOL than males. 66.2% of urban youth surveyed in the final evaluation agreed that they were susceptible to HIV infection. Most listeners (95.1%) agreed that JOL made them believe there were effective ways to avoid HIV infection. Over 95% of the listeners said that JOL made them feel hopeful about avoiding HIV infection. Almost all of the listeners (97%) agreed that JOL made them believe that having children when they weren't ready was harmful. Females felt greater perceived severity than males from having children when they weren't ready.

Partners: Johns Hopkins University Center for Communication Programs (JHU/CCP); the U.S. Agency for International Development

Source: The communication Initiative website

 Telemedicine in Cambodia

Success Strategy: In Robib, a very isolated village in Cambodia, a nurse and a technician visit once per month to administer medical examinations and treatments for sick patients incapable of traveling to the nearest medical centre or hospital.  When the nurse is unable to diagnose a given ailment on-site, the technician takes a digital photo, which can then be transmitted via a wireless internet connection to a doctor at a medical institution, such as the Harvard Medical School for instance.

For in-depth information: see http://www.itu.int/ITU-D/ict/cs/cambodia/material/KHM%20CS.pdf

 Radio Oxyjeune

Success Strategy: A popular community radio station named Radio Oxyjeune, which broadcasts to a poor suburb of Senegal's capital, Dakar, not only pumps out music and chats to its audience, but takes an active role in its listeners' lives. It broadcasts programmes in both the national and local languages to reach as many people as possible.

Radio Oxyjeune has phone-in shows that regularly tackle subjects many consider taboo such as HIV/AIDS and women's rights. Anonymous interviews with HIV positive individuals have helped to drive home their message in an environment that still attempts to hide from the epidemic. Organizers believe that the use of personal stories is one of the most effective ways to get the message about AIDS across to the community.

The phone-in feature provides an opportunity for two way communication and information exchange within the community using widely accessible mediums. The organizers have recognised that both old and new technologies have the potential to enable various kinds of social change. The philosophy driving their success is that it is what people do with technology rather than the technology itself that is important feature of social change.

Partners: Community youth

Source: The Communication Initiative website and BBC website 

 MEDINFO

Success Strategy: In 1999, the Ministry of Health sought to leverage the power of new technologies to provide health care information for all Hungarians.  By creating MEDINFO, an online reference source and database that is the central node for health care-related communication in the country, the Ministry has made it easier for health care professionals to coordinate activities, while providing the public with a user-friendly interface to access the information they need to maintain mental and physical health.  The site also serves as a repository for information to resources outside of Hungary (e.g. the World Health Organization—WHO). 

For in-depth information: see http://www.itu.int/ITU-D/ict/cs/hungary/material/hungary.pdf 

 MaghrebMed - Tunisia

Success Strategy: MaghrebMed was created as a driver for promoting both health and ICTs, and in particular for taking advantage of endless opportunities that internet provides for dissemination health information and forge new patterns of health behaviour and health best practices. The platform is based on a bunch of thematic websites addressing professionals from the domain as well as the wide public. Human and veterinary health as well as health care are considered as a wide life field and various related aspects, such as history, jurisdiction and deontology are documented and discussed.

The concept of the website is to be a portal providing access to a considerable knowledge resources as well as to specific interests & activities forums opening an opportunity for building virtual communities. The increased, facilitated and interactive access to information on health, health facilities and related activities is expected to contribute to the improvement of the health condition of people in the region over the long term.

Partners: A very large number of institutions, association and companies form the field of health

Awards: Winner of the national contest Best Digital Content and Applications - Tunisia 2005, Category e-Health Nominee for the WSIS-Award 2005, Category e-Health

Source: the MaghrebMed website and the WSIS Stocktaking database

 Royal Perth Hospital

Success Strategy: Laboratory diagnosis of the various types and stages of development of the Malaria parasite is a critical component of effective control and treatment. The Division of Laboratory Medicine at the Royal Perth Hospital in Australia has developed a resource to assist in the learning process for inexperienced technicians and those attempting to address the disease. The information provided on the trilingual website and the CDROM is available in French, English and Spanish.

 The resource combine is based on common e-learning methods and contains valuable database about the disease and its treatment. The most innovative feature of this resource is the interactive “Test and Teach” self-assessment module that presents a series of photomicrographs, which present a series of thick and thin blood films that help learners to improve their identification skills. The teach function presents them with identification hints and while the test slide asks for diagnosis. The slide show randomizes each time and inserts several dummy, asymptomatic slides throughout.

Source::  The Communication Initiative website and the Royal Perth Hospital project website

  SMS Medication Regime- South Africa

Success Strategy: Cape Town, South Africa, has one of the world's highest incidences of TB, largely due to socio-economic and climatic factors. TB patients must strictly follow a difficult drug regime -- four tablets five times a week for six months -- and they often forget to take their medication. Non-compliance with the drug treatment has exacerbated the high occurrence of TB and has created difficulties for the local, overburdened healthcare service.

Dr. David Green, a consultant in Managed Care, developed a service in South Africa that uses the Short Message Service (SMS) to alert tuberculosis (TB) patients to take their medication. At the clinic where the pilot study was conducted, 71% of TB patients had access to a cell phone. Dr. Green enters the names of TB patients onto a database. Every half an hour his computer server reads the database and sends personalized messages to the patients, reminding them to take their medication. The technology that he uses to send out the messages is extremely low-cost and robust: an open source software operating system, web server, mail transport agent, applications, and a database. Currently Dr. Green charges the City of Cape Town R11.80 per patient per month to send out SMS messages.

Initially the SMS message sent to patients read: "Take your Rifafour now." When patients complained about the boring message, Dr. Green sent them a variety of alerts, including jokes and lifestyle tips with the result that he now has as database of over 800 messages that he changes on a daily basis. Of the 138 patients involved in the pilot, there was only one treatment failure. The initiative has led to a significant increase in the recovery rate of patients and could lead to savings for healthcare authorities. This project is being extended nationally and considered for HIV medication.

Target group:  Patients under strict medication

Partners: City Council of Cape Town, U of Cape Town, South African Medical Service Council

Source:  The Communication Initiative website and Bridges.org

 Ciranet.com

Success Strategy: Created by Citibank and Raya Holdings in 2000, Ciranet.com has helped to modernize Egypt’s pharmaceutical community by providing them with an online marketplace.  Targeted at pharmaceutical businesses in Egypt, Ciranet.com offers professionals with an efficient, cost effective and efficient method of e-commerce.  Despite the fact that only 2,000 of the approximately 19,000 Egyptian pharmacies have PCs, Ciranet.com has brought together a variety of necessary business resources, such as a call center support, payment processing and online ordering, in an effort to help transform this segment of the country’s business culture.  Ciranet.com is helping to lay the foundation for Egypt’s e-commerce and knowledge revolutions.

For in-depth information: see  http://www.itu.int/ITU-D/ict/cs/egypt/material/egypt.pdf

  Communications for Better Health (CBH) Programme

Success Strategy: Working in conjunction with the Dreyfus Health Foundation, the HFG has implemented a Communications for Better Health (CBH) programme. CBH programmes are designed to improve accessibility to timely health information.

Ghana was the site of the pilot CBH project and developed into two streams, the first is the medical publication, the Ghana Health Digest. The health digest provides medical practitioners, administrators, and government policy makers and parliamentarians with timely health news and information. The selection of abstracts takes into consideration local health conditions and contains relevant articles written by local health specialists (such as "A Guide to Malaria Prevention and Control"), summaries of findings from community health projects, personal health experiences, interviews, FAQs, questionnaires and answers and quizzes. 

The digest gains mass exposure by the bi-weekly reading of highlights from the digest on the National Morning Breakfast Show on Ghana Television (GTV) and the Daily Graphic Newspaper has featured several articles for their weekly health column. The Health Foundation of Ghana is also in negotiation with Ghana Broadcasting Corporation (radio) to broadcast information from the digest. In the second stream, local databases are created by indigenous health professionals and other interested parties, who, working together, select information from international resources and from in-country or regional colleagues. Solutions to common local health problems are also gleaned from local health professionals. The database of local health information is kept in each country's information centre (head office) in paper format (and often in electronic format, also). People call and visit the centres for local and international medical information. A national version of this database, the African Index Medicus (AIM), is being developed. AIM provides an index of African health literature and information sources using CDS-ISIS software. AIM identifies bibliographic sources and includes databases on information experts and sources of research in health-related areas of African countries.

Target group:  medical practitioners, administrators, and government policy makers and broader audience

Partners: Health Foundation of Ghana (HFG), Dreyfus Health Foundation (DHF), Association for Health Information and Libraries in Africa (AHILA) and the World Health Organization (WHO)

Source:  The Communication Initiative website and DHF Site 

  Women Connect! - Eastern and Southern Africa

Success Strategy: Faced with limited financial resources in an era of increasing social problems, women's organisations in developing nations must find ways to utilise both traditional media to reach their rural audiences and digital media for international audiences to get their messages out and improve women's health and well-being. Women Connect! combines communications and health strategies for the improvement of women's lives by working through women's non-governmental organisations (NGOs) in Uganda, Zambia, and Zimbabwe. Launched in January 1999, the project aimed to strengthen the communication and advocacy skills of women's rights organisations. This strategy aimed at the broader goals of women's empowerment and support in building civil society.

The grant awards allowed groups to implement pilot communications projects suited to their needs, including:

Downloading health information from the internet and repackaging it for bi-weekly email updates to local health service providers and NGOs that lacked updated resource materials.

• Producing a community newsletter soliciting narratives on local approaches to HIV/AIDS education and care, primary health care needs, and economic development projects.

• Producing health programmes on three radio stations – one providing health tips and one featuring dialogue and problem solving with a local personality.

• Training staff in email use for networking and online advocacy.

• Conducting HIV/AIDS outreach to disabled women, who are often left out of national HIV campaigns and often have limited knowledge of prevention of STIs and available services.

• Carrying out a media campaign aimed to increase reproductive and sexual health information and services to adolescents.

Among the outcomes of the initiative are the launching of internet cafés in Zimbabwe and Uganda, training women to use internet and email, developing broader (new) communication skills through ICTs in order to locate, analyse, and adapt health information for repackaging into traditional media printed in local languages.

Target group: Women, vulnerable groups

Partners:The Communication Initiative website ; the Bill and Melinda Gates Foundation; and the University of Southern California (USC) Annenberg Center for Communication; Global Fund for Women.

Source: The Communication initiative website and The Women Connect! and the The Pacific Institute for Women's Health (PIWH) website

  COPE - Australia

Success Strategy: COPE is an independent, non-profit, education and training centre offering high quality community and health services worker training and a broad-based community education program which focuses on strengthening communities, family and relationship education, and life skills education, including skills for living and working. The COPE philosophy believes that there is much to learn from, and with, Indigenous people. This belief has shaped their approach to learning and teaching. They are also committed to the process of reconciliation between Indigenous and subsequent Australians, and in tenants of respect for the rights of all people.

The COPE website serves as a gateway to a host of resources and access points to the organizations various training programs. Some of their programme delivery is conducted online and with internet/email facilitation. Their training for people working in the Community and Health Services sector aims to raise awareness, develop appropriate attitudes towards client values and needs, and develop effective professional strategies and skills. COPE offers the following services:

• Training development

• Resource Development for Community Service Practice

• Consultancy Services for Diversity in the Workforce

• Peer Education

Programs may take the form of Workshops or Action learning projects. Workshops are tailored to meet the needs of the organisation, and delivery times and approach are negotiated with COPE. Action learning projects, take a group of learners and develops their understanding of a chosen topics, and creates and implements an action plan within their agency to make changes to workplace practice. The group is facilitated by an outside trainer and may meet over a period of weeks or months, seeking a range of external input, taking on individual tasks to develop their knowledge and researching their agency needs. The use of ICTs during these training periods is important for information sharing, dialogue, and the exchange of ideas. The website also acts as a resource centre, with searchable access to their library, a collection or recommended readings and reports, tips for stress management, and links to other resource pages.

Target group:  Health services workers

Partners: Relationships Australia (SA)

Source: The Communication Initiative website and the COPE website

 Nepal’s Healthy Network

Success Strategy: HealthNet is a international NGO providing health care information and communication services in the development world. HealthNet Nepal began in 1994, and has since become the premier provider of health care-related information to over 500 users in 134 organizations throughout the kingdom.  By providing services such as e-mail, reports, computerized medical records and statistics, and a comprehensive library of medical information and useful links, HealthNet gives users access to a wealth of information on how to protect themselves from a variety of viruses and diseases.  For instance, Nepal has a chronic problem with water contamination, and HealthNet provides the tools for users to arm themselves with information to avoid or effectively address illnesses related to a given water problem.  HealthNet is currently in the process of updating and expanding its services to all of the country’s health care practitioners. 

For in-depth information: see  the HealthNet website

Background materials: see http://www.itu.int/ITU-D/ict/cs/nepal/material/nepal.pdf

 E-Link Americas: Satellite Connectivity Project - Latin America and the Caribbean

Success Strategy: E-Link Americas is a landmark project aimed at connecting the remote and underserved areas in the Americas using ICTs for social and economic development. E-Link Americas aggregates demand and creates regional infrastructures to offer low-cost, high-speed internet service for social development. Satellite and terrestrial wireless technologies are used to deliver affordable, financially viable, internet access to municipalities, universities, schools, hospitals, telecentres and other community-based organizations in Latin America and the Caribbean. Existing infrastructure are leveraged using wireless fidelity (Wi-Fi) technology, to extend access to businesses and homes.

E-Link's services are based on high-speed internet access through VSAT terminals, which are connected to a satellite gateway in Canada using the Ku band. Each access point can be extended using Wi-Fi technology. E-Link's services are delivered using a broadband VSAT satellite Ku-band hub, low cost digital remote terminals and local terrestrial wireless links to provide uniform access to internet telecommunications resources.

E-Link services are managed by in-country partners generating local employment. In order to provide service to the entire region of Latin America and the Caribbean at affordable costs, E-Link Americas works with Local Service Partners. Local Service Partners act on behalf of E-Link Americas in each country or region. Chile, Colombia, Ecuador, El Salvador, Honduras, Guatemala, Nicaragua, Peru. In addition, when a local organization subscribes to E-Link high-speed internet service, E-Link provides all the necessary equipment, including small satellite dishes and high-speed access devices.

The concept of using open standards such as DVB-RCS and Wi-Fi and the capability of purchasing locally manufactured products and obtaining local support are key differentiators that set E-Link apart from other service solutions.

Partners: E-Link Americas supported by Canadian International Development Agency (CIDA), the World Bank, the OAS, the Institute for Connectivity in the Americas (ICA), and the International Development Research Centre (IDRC)

Source: WSIS Stocktaking Database and the website of the activity

  PATH (Program for Appropriate Technology in Health)

Success Strategy: PATH (Program for Appropriate Technology in Health) is an international, nonprofit, non-governmental organization with headquarters in Seattle, WA, and offices in Washington, D.C., Jakarta, Nairobi, Manila, Bangkok, and Kiev. PATH identifies, develops, and applies appropriate, safe, effective and innovative technology-based solutions to public health problems, particularly in the areas of communicable diseases, family planning, and reproductive health. PATH has developed several innovative programs to in response to the AIDS epidemic, two of which are reviewed below. RiskAdvisor Project In 1995 PATH (Program for Appropriate Technology in Health) developed RiskAdvisor, an easy-to-use interactive software program that allows individuals to assess their personal risk of HIV infection based on their present patterns of behaviour. The program then helps to develop goals to change their behaviour, thereby reducing their risk of infection or transmission. "RiskAdvisor, and computer-based assessment and learning programs like it, hold promise as powerful educational tools by providing simulated experiences that allow individuals to experiment with behaviour change strategies," states Dr. Sharon Baker, University of Washington, School of social work.

RiskAdvisor was designed by HIV counsellors for HIV counsellors to help them talk with their clients about potentially embarrassing topics and to show graphically how behaviour affects risk of exposure to HIV. While many people are knowledgeable about AIDS, even those at high risk of exposure to HIV often do not perceive themselves as vulnerable to infection. Clients have reported feeling more comfortable answering questions about sexual and injection practices when interacting with RiskAdvisor than they would have if being personally interviewed by a counsellor. RiskAdvisor has been translated for use in AIDS prevention programs in Nepal, the Philippines, Indonesia, and Thailand. The program, supplied on 3.5" diskettes, requires a 386 or faster computer with Windows and a mouse. A less explicit version, RiskTeacher, is available for more general risk reduction education, as well as Village RiskAdvisor, a paper-based version of RiskAdvisor. Interactive Games Project

In March 2003, the PATH launched a mass media project that uses a web-based interactive computer game to promote adolescent sexual and reproductive health (ASRH) among young people in Bangkok, Thailand. The game is intended to entertain 13- to 15-year-olds while it educates them. The government of Thailand is supporting the effort by following through on its commitment to provide computers to all schools around the country, including rural sites, and to provide internet connections. Placing the game on the Web allows use of the technology known as "cookies", which enable the project to anonymously keep an ongoing profile of each player and to record his or her accuracy in terms of answering questions in the game. Organizers claim that, in Bangkok, more than 250,000 youth frequent internet cafes per week to play computer games. A pre-test in late 2002 showed a positive reaction to the game.

Target group: Youth, rural communities, broader audience

Partners: M-WEB, Microsoft Games, the Thai Government.

Source: The Communication Initiative website and the PATH website

  Health Information Project - South Caucasus

Success Strategy: This Health Information Project aims to strengthen the health reform in the South Caucasus countries, through the appropriate application of health information technology and information management strategies.

Partners: Canadian International Development Agency - CIDA

Source: WSIS Stocktaking Database

  Nepal Radio and Traditional Media Campaign to Prevent Blindness - Nepal

Success Strategy: A social-marketing-type campaign based on radio, newspapers and traditional media which was used to promote eye-surgery at eye-centres and camps for blindness prevention. The key to the Nepal Blindness Programme's success lies in the mix of attractive social-marketing-type packaging and of traditional communication channels. The main issue addressed was the problem of blindness caused by cataracts and glauchoma and the prevention of blindness through Vitamin A.

The campaign achieved a 74% increase in demand for sight restoring operations during its first year, ensuring that surgical cases at centres rose from about 7,500 in 1985-86 to 11,500 in 1986-87, and that a total of almost 200,00 outpatients were treated in the year of the campaign. In the second year of the campaign, there was a 14% decrease in the surgical caseload and a 5% decrease in outpatients. This can be explained as follows: eye camps were repeatedly held in the same location, so backlogs in areas could well have been treated in the first year.

Partners: Nepal Ministry of Health, World Health Organization (WHO), Nepali NGO: Nepal Netra Jyoti Sangh (NNJS) (Nepal Society for Comprehensive Eye Care) in partnership with the Seva Foundation Blindness Prevention Action - an NGO - and Dutch Foundation Eye Care Himalaya

Source: The communication Initiative website

  ICTs for Participatory Health and Livelihood Skills Training for Mon Migrants – Dot.com Alliance

Success Strategy: In the Mon State of Myanmar, political differences between Mon and Burmese military authorities persist despite the 1995 cease-fire. More than 200,000 Mon fled the continuing instability there and now struggle to feed themselves and their families under trying conditions in border areas. Cross-border migrants like these typically live in fear, worried about being exposed to authorities and anxious about food security and income generation. Health issues including drainage of household water and the management of waste are overtaken by a preoccupation with survival.

ICTs for Participatory Health and Livelihood Skills Training is a pilot project designed to harness new digital camera technologies to help cross-border migrants learn basic health and livelihood skills that can improve their well-being even under the harsh realities stateless migrant experience. Community-based facilitators are taught how to lead interactive group discussions among marginally-literate neighbours and friends. Each target population learns how to critically assess local health and livelihood practices while collaboratively constructing their own models of best practices.

Using Participatory Video Editing, group facilitators capture raw digital video footage of poor health and livelihood practices to stimulate collaborative development of improved practices. Through an iterative process, poor practices are gradually edited out and improved practices edited in resulting in local models of best practices that incorporate the insights of the full range of stakeholders. The twelve video modules developed under the pilot will be produced and distributed as a set of Video CDs (VCDs) to facilitate the exchange of these best practice results across the participating target populations. In addition to the Mon and Karen migrants in the border areas of Kanchanaburi and Ratchaburi provinces, the target populations include Burmese migrants working in the seafood plants of Mahachai in Samut Sakhon province, Laotian migrants crossing the Mekong at Khong Jiam in Ubon Ratchanthani province, and crossborder Khmu and Hmong along the border between Laos and the Han province of Thailand. This one-year activity is funded by USAID under the dot-EDU cooperative agreement that seeks to strengthen education and learning systems through the use of information and communication technologies (ICTs).

The project is being implemented with collaboration from a network of local NGOs that includes the Pattanarak Foundation, the Raks Thai Foundation, the Mon Relief and Development Committee. Hands on activities related to specific health and livelihood themes are being carried out by these local implementing partners with support from other donors. Education Development Centre and Academy for Education Development are jointly administering the activity.

Partners: dot.com Alliance

Source: dot.com Alliance website

  Give 1 Minute of Your Life To Stop AIDS - South Africa

Success Strategy: This Nelson Mandela Foundation initiative brings together leading music icons to create a new way of donating funds toward, and raising awareness about, HIV/AIDS. The campaign uses former South African president Nelson Mandela's prison number, 46664, as a telephone number and website address in a campaign that seeks to support the fight of AIDS in South Africa.  

"Give 1 Minute of Your Life To Stop AIDS" is an effort to draw on global musical talent, and people's love of music, to inspire increased awareness, discussion, and action related to HIV/AIDS. The campaign is multi-faceted, combining a music concert launch with worldwide broadcast, a website, telephone service, and a CD and DVD. For instance, at the launch of the 'Give 1 Minute of Your Life To Stop AIDS' campaign, songs heard included "46664 (Long Walk to Freedom)" written by Joe Strummer, Bono, and Dave Stewart, and performed by Bono, Youssou N'Dour, and Abdel Wright, and "People", written by Dave Stewart and Jimmy Cliff, and performed by Sting and Jimmy Cliff. This performance was followed by a series of further ensemble and solo tracks written variously and collectively by Bono and Dave Stewart, Queen, Mick Jones, Anastacia, The Neptunes, Johnny Clegg, and many more well known artists. The music is available throughout the world via telephone lines and the website. In the UK, all telephone users call a premium line using the number 09060 1 46664.

Partners: Tiscali, MTV's Staying Alive, Coca-Cola, BBC World Service, FedEx, Virgin Atlantic, SABC, The Fleming Media Group, BMW, Arabella Sheraton Grand Hotel, Nissan.

Source:  The Communication Initiative websiteand 46664 website

 Staying Alive - Global

Success Strategy: The Staying Alive partners have developed an AIDS media campaign to raise awareness and promote prevention of HIV/AIDS in the international youth community. While the internet is used to facilitate exchange and information gathering year-round, the multi-tiered, multi-media campaign is launched as a new installment each year around World AIDS Day (December 1). These campaigns include celebrity involvement, public service announcements (PSAs), and on-air and on-line products created rights-free for distribution to other TV/radio partners. The Staying Alive campaign seeks to help prevent HIV/AIDS by empowering individuals to protect themselves, fight stigma and discrimination, and engage media and other organisations to form their own response to HIV/AIDS.

In brief, the Staying Alive campaign includes long-form programming (such as documentaries, concert events, news specials, and discussion programmes), public service announcements, sexual behaviour polls, a web site in 10 languages, and off-air marketing and grassroots promotions. A key strategy underlying the development of these media tools is celebrity involvement. In an effort to reach the broadest global audience possible, all Staying Alive programming is available free of charge and rights-free to all broadcasters. Visitors to the website, which may be accessed in Chinese, Dutch, English, French, German, Italian, Portuguese, Spanish, are invited to share their personal experiences with, or other stories about, HIV/AIDS. Other features of the site include facts and figures about HIV/AIDS, a survey, a form to submit digital artwork to be included in on-air programming, and Staying Alive screensavers. Youth participation in the yearly campaigns is encouraged through such features as the yearly PSA competition.

Partners: Viacom, Inc. and the Henry J. Kaiser Family Foundation, other partners including CNN, UNAIDS, the World Bank, the Kaiser Family Foundation, Family Health International, UNFPA, and Sida.

Source: The Communication Initiative website and Staying Alive website

  Saadhan HIV/AIDS Helpline - Mumbai, India

Success Strategy: As part of its Operation Lighthouse Project, Population Services International (PSI) India runs a Saadhan Helpline for HIV/AIDS prevention in Mumbai, India. In operation since December 2002, the helpline employs counselors who provide information, support, and referrals. It also features customised software designed to improve the communication with callers. Communication campaigns have been developed to promote awareness of risk behaviours and its multiple consequences.

PSI selected a helpline as a tool to exchange information about HIV/AIDS because they say it is a low-cost, anonymous, and confidential channel that offers personalised interaction with a professional. This medium is especially helpful, they say, in that the concept of talking freely to a doctor is not common in Mumbai, especially about sex and HIV/AIDS. To compound information barriers, people do not wish to be seen at places associated with HIV/AIDS due to associated stigma. Telephones are widely accessible in Mumbai; in addition to cellular phones and landlines, public phones are available nearly every 100 meters. From January through May 2003, 5066 clients used the helpline, with an average of 1000 callers per month. The majority of these callers were single males between the ages of 21-30 years old, who often called to request information about modes of HIV/AIDS transmission. The majority said that one of the campaigns first alerted them to the existence of the helpline.

Partners: PSI, Naz Foundation, Elton John AIDS Foundation, USAID

Source: The Communication Initiative website

For more information: "The Saadhan Helpline: HIV/AIDS Information and Counseling in Mumbai (A Case Study)" [PDF]

  Mapping Malaria Risk in Africa (MARA/ARMA)

Success Strategy: Sub-Saharan Africa carries the highest per capita burden of disease in the world of which malaria is the single most important cause. Of global deaths attributed to malaria 90% now occur in sub-Saharan Africa. Detailed mapping of malaria risk and endemicity has never been done in Africa. Accurate estimates of the burden of malaria at regional or district level remain largely unknown. In the absence of such data it is impossible to rationalize allocation of limited resources for malaria control. The heart of the MARA programme is a massive information collection and data-basing project that has to date over 10 000 data points that have been collected from published and unpublished sources, through literature searches and country visits. The intellectual and monetary value of the collated database alone is hard to appreciate. It represents decades of malaria research in Africa, much of which was on the verge of being lost and forgotten, and certainly not being used. MARA/ARMA has provided the first continental maps of malaria distribution and the first evidence-base burden of disease estimates. There is currently hardly any major document on malaria in Africa that does not make use of MARA maps and the BOD figures produced by MARA/ARMA are now universally used.

MARA/ARMA is at the cutting edge of, and has made significant steps forward in, the geographical modelling of malaria using eco-physiological / climate / GIS (geographical information systems), as well as spatial statistical approaches. Highly original spatial statistical methods are being developed currently to strengthen the analysis of the MARA/ARMA data. MARA has made its results widely available through the regular publishing of technical reports in English and French which are available on their website. They also publish and regular update a large collection of maps demonstrating the endemicity, density and seasonality of Malarial infections. Some 3000 poster sized maps of malaria models and population distribution were produced and sent to malaria control programmes, departments of health, and research institutions in all endemic African countries. All the maps are readily available by downloading them from the website and can act as invaluable resource tools. It has also developed an innovative CD-ROM – the MARA LITe CD – which is a user-friendly tool designed to access products of the MARA project. The tool was developed and produced within the Malaria Research Programme of the South African Medical Research Council, which operates as the main MARA/ARMA investigating centre. Finally it is hoped that this collaboration serves as a model for other large-scale disease information systems in Africa and in other developing countries.

Partners: International Development Research Centre of Canada (IRDC), South African medical Research Council, The Wellcome Trust – UK, Swiss Tropical Institute, WHO, Multilateral initiative on Malaria, Roll Back Malaria

Source: The Communication Initiative website and MARA website

 Hume Regional Broadband Digital Imaging Project

In 2002 Wodonga Regional Health Service (WRHS) implemented a Picture Archival Communication System (PACS) to reduce the recurrent cost of film in providing medical imaging (X-ray) services and to increase productivity of human (i.e. radiologist and medical imaging technologist) and new digital imaging (General X-ray) equipment.The successful implementation reduced recurrent operating costs by 5% and increased productivity by around 20%- 30% - the self-funded capital equipment payback time being six years.  

Success Strategy: The HRBDIProject is the third implementation of a rural multi-site, integrated PACS/RIS platform in the world – the other two being based in rural Finland and Norway.As such it is innovative for Victoria and reflective of the enabling reach that broadband technology can have for rural communities. The project is aiming to establish a regional broadband telecommunications network and to deliver integrated digital imaging and radiology information systems across that broadband platform. The regional Picture Archival Communication System (PACS) solution will manage digital images so that those images are available to clinicians when and where they are required and stored to ensure completeness of the patient’s image record.  The solution will substantially improve the speed of reporting, the throughput of the imaging departments and reduce costs of film and associated chemicals.  The PACS will be managed through a series of binding Service Level Agreements between key stakeholders. The regional Radiology Information System (RIS) solution will provide the operational support to the three major public imaging services in North East Victoria and performs the key functions of maintaining client data, scheduling patient services, clinician reports, calling up the relevant digital image matched to the patients’ image history (integration with PACS).  The RIS will be delivered from one site versus the current nine sites.

Partners: Wodonga Regional Health Service (WRHS), The Victorian Government, Hume region public hospital medical imaging providers, other rural Health ICT Alliances

Source: http://www.wrhs.org.au/cms/printthispage.asp?ArticleFileName=20044263146.htm and HumeNet website

  Impact Data - Radio Barkeol - Mauritania

Success Strategy: A radio station was established in Mauritania to promote and support action on health and development issues. The radio programmes was specially designed to address Guinea Worm, which has a devastating impact on the economy of communities. The station covers 3,000 square kilometers and targets 70,000 people. Half of the programmes are devoted to community issues such as health, literacy, environment and economy. The remainder of the programmes provide local music, news, radio games and religious shows. An innovative feature is that the station runs from solar energy. According to an independent evaluation in 1993, a long-term consequence of the campaign is the significant reduction in number of cases of Guinea Worm as well as an exponential increase in number of children fully immunized - five times more immunizations. The programme contributed also to a better understanding of how to prevent guinea worm (estimated at about 80% following the campaign).

Source: The communication Initiative website

 Children's Health in Ghana's North

Success Strategy: Since 1989 Dr. Fred Binka and his staff have been conducting a project named “Health Net Project”. It aims to improve the quality of life in Northern Ghana. The Guinea Savannah of Northern Ghana is possibly the most risky place to live during infancy. For every 1,000 children born, 222 die before age 5. The most common causes of death are malnutrition, measles, lung infection and malaria.

Dr. Binka is an Associate Professor of Epidemiology in the School of Public Health at the University of Ghana, and a volunteer on this assignment. His Research Center is located in Navrongo, a 12-hour drive from the capital Accra, linked only by unreliable telephone lines. However, with funding provided by several organizations, the Center is well equipped with radio modem, computers and a satellite ground station that permit communications and information exchange through the Health Net Project. Dr. Binka explains, “We are building a large database containing the names, ages, pregnancies, births, illness, recoveries and deaths” of the populations there.

To educate the population and know where to send this information, the Center uses Digital Mapping. A device the size of a calculator uses satellites to isolate landmarks such as family compounds. With a computer map that shows where planning is being practiced, the areas that require attention become obvious. Information on screen reveals discrepancies better than numbers on charts. For instance, half of the population not protected by bed-nets treated with biodegradable insecticide are now buying their own. As a result, malaria deaths in children under 5 were reduced one-sixth in Ghana.

For Dr. Binka, the trial has been a huge success. “They know they sleep better at night, they are stronger on the farm and they get sick less often. What further proof does a working man or woman need?”

For in-depth information: see http://www.unites.org/cfapps/WSIS/wsis.cfm

 MobiHealth – Europian Union

Success Strategy: MobiHealth is a mobile healthcare project funded by the European Commission. The MobiHealth consortium unites partners from five European countries and represents all the relevant disciplines. Partners include hospitals and medical service providers, universities, mobile network operators, mobile application service providers and mobile infrastructure and hardware suppliers. The MobiHealth system allows patients to be fully mobile whilst undergoing health monitoring. The patients wear a lightweight monitoring system - the MobiHealth BAN (Body Area Network), which is customised to their individual health needs. Therefore, a patient who requires monitoring for short or long periods of time doesn't have to stay in hospital for monitoring. With the MobiHealth BAN the patient can be free to pursue daily life activities.

MobiHealth targets the introduction of new mobile value added services in the area of health, based on 2.5 and 3G technologies. This will be done with the integration of sensors and actuators, to a wireless Body Area Network. These sensors and actuators will continuously measure and transmit vital constants along with audio and video to health service providers and brokers, improving from one side the quality of life of patients and allowing, from the other side, the introduction of new value added services in the areas of disease prevention, disease diagnosis, remote assistance, clinical research, para-health services, physical state monitoring (sports) and even clinical research.

The Mobihealth Services are based on GPRS and UMTS technologies for wireless broadband data transfer. The introduction of these services is achieved by the integration of sensors and actuators to a wireless Body Area Network (BAN). Vital signals are measured and transmitted along with audio and video to healthcare service providers.

A full-cycle monitoring is enabled by the MobiHealth system allowing patients to move and live freely minimizing the handicap of chronic diseases and aging. An additional advantage of the services being its increased efficiency due to the early alarm in case of need.

Partners: European Commission (funding), Ericsson Gmbh, University of Twente, TMS Internationa BV, Medish Spectrum Twente, CMG Wireless Data Solutions BV, Lulea Teksinska Universitet, Telia Mobile AB, GesundheitScout24 GmbH, YUCAT Mobile, HP Nederland, PHILIPS Research Laboratories, Corporacio Sanitaria Clinic, Universitat Pompeu Fabra, Telefonica Moviles Espana, etc.

Source: WSIS Stocktaking Database and the website of the activity

 WorldSpace Project

Success Strategy: Pervasive poverty and a lack of medical facilities in developing countries render large portions of Africa and Asia exposed to diseases like malaria, influenza and severe diarrhoea that disproportionately kill the youngest and most vulnerable.

WorldSpace thought to employ bold new methods to face an enormous challenge. Imagine hundreds of physicians in remote settlements across Africa getting medical advisories via a compact receiver that gets programs directly from a satellite in space. Picture daily bulletins on diagnostic techniques going to clinics throughout India and Pakistan, even in areas where internet service is sporadic or nonexistent. The far-flung clinics use a small, inexpensive device that gets satellite transmissions and downloads the information to a personal computer. Finally, imagine millions of people across Africa and Asia using satellite radio to get information about nutrition, hygiene and practices to stop the spread of HIV/AIDS. Receivers for this system - identical those used by the physician in the Serengeti and clinics in India and Pakistan - would be inexpensive, easy to operate and would run off mains power, batteries or even solar cells. CLASS - Combined Live Audio and Slide Show CLASS is an innovative solution developed to leverage the capabilities of the WorldSpace system for distance education in developing countries. The CLASS service from WorldSpace is unique in its ability to economically merge content creation and delivery to vast territories. It uses the WorldSpace system to provide error-free digital transmission of presentations, lesson plans and other multimedia material.  

CLASS technology facilitates a smooth integration of media to support education across vast territories. The result is an array of valuable capabilities:

• Delivering the lectures with accompanying PowerPoint presentations directly so students' PCs (direct-to-home, or schools) at a scheduled time

• Enabling students to hear live commentary from the best  teachers while following associated presentations and getting real-time updates as the teacher works through the material

• Enabling students with internet access to ask questions via text chat or VoIP

• Delivering presentations, lessons plans and other multimedia materials to students, thus complementing and expanding the classtoom lecture

Besides CLASS delivery, the WorldSpace system, of course, provides digital audio with fade-free, crystal-clear reception across vast territories. Reception requires a WorldSpace radio. These units are reasonably priced and available from vendors throughout Africa and Asia.

Partners: WorldSpace Corporation

Source: Bytes for all website and the website of the activity

  Healthy Russia 2020

Success Strategy: In 2002, the stakeholders launched Healthy Russia 2020, a five-year programme using networking and web-based efforts to help Russian institutions improve the health of their people. Health indices for Russia have declined sharply over the last decade in large part due to unhealthy lifestyle behaviours.  

ASI will support JHU/CCP on "Healthy Russia 2020" by designing an internet Web portal to promote healthy behaviors across the Eurasian country. ASI will design, deploy and assist in maintaining the internet-based portal, which will be built in the first year for use by citizens, policy makers, health-care administrators, health professionals and other stakeholders. The portal will give users an online platform in which they can obtain information and collaborate on solutions to numerous health issues. It will be created in English and Russian and will also allow users to exchange ideas on a variety of health-related topics.

Goals of the project include promoting healthier lifestyles for young Russians, reducing HIV/AIDS and sexually transmitted infections (STIs), controlling the spread of tuberculosis (TB), and improving the health of women and infants. One of the main tools is a dynamic Web Portal that uses proven techniques to serve a wide range of interactive users. The web portal will facilitate and reinforce behavioural changes (for instance various drug and alcohol prevention programs) as well as URGE peers to access and share health information and advocacy tools; serve as a locus for distance education; attract members; and mobilize collective action.

Target group:  Direct beneficiaries include Russian youth, women of reproductive age, infants, children, and the public. Indirect beneficiaries include the Federal and regional administrations, health policy-makers, health care administrators and providers, secondary school teachers, advocacy groups and NGOs.

Partners: JHU/CCP, the Futures Group International, ASI, Deloitte Touche Tohmatsu, Project HOPE, International Research & Exchanges Board (IREX), the Centre for Association Leadership, the American Red Cross, the Public Health Foundation, and the National Association of Chain Drug Stores (NACDS). The U.S. Agency for International Development (USAID) is funding the project.

Awards: ASI won a $8 Million award as Global Leader in Application of Technology for Health Communications by The Johns Hopkins University Centre for Communications Programs (JHU/CCP) for implementing Healthy Russia 2020 and create web portal for INFO Project.

Source: The Communication initiative website and the ASI website

 Internet-Based Tobacco Control Network - Czech Republic

Success Strategy: Initially the goal was to build up a media advocacy program forming an internet-based network comprising health professionals from Czech DITs, heart disease-prevention NGOs other professionals concerned with tobacco-control. Finally the outcome of the different activities was even more comprehensive:  

• A self-sustaining Tobacco-Control Training and Communications Program promoting excellence in communications technology, and regional, national and international linkage and outreach

• Targeted information technology and skills transfer workshops and a Tobacco-Control Conference conducted at the project hub and in various districts of the Czech Republic

• A demand-based resource service on tobacco control equipped with high-quality resource materials for the internet and computerized database and research capabilities that cater to requests

• The development of a comprehensive data collection system to support program operations and pre- and post-surveys of knowledge, skills and applications among the participating organizations to assess program impact

• Continuous electronic-media tobacco-control campaigns, which increasingly engage more groups in Czech society in tobacco control.

• A website with an electronic bulletin board, resource directory, and "What's New" listing. See the homepage at Czech Ministry's National Institute of Public Health's website for up-to-date reports on current events

• Monthly electronic bulletins with nationwide and international circulation

• The establishment of an advocacy NGO dedicated to reducing tobacco use and the prevention of cardiovascular disease - the Czech Heart Association (CHA)

Target group: Health professionals, broader audience

Partners: The World Bank, Centre for Communications, Health & Environment (CECHE) - USA, Institute for Clinical & Experimental Medicine (IKEM) - Czech, National Institute of Public Health (NIPH) - Czech, UICC-GLOBALink - Geneva, the National Centre for Tobacco-Free Kids & the Advocacy Institute, Financed by the International Bank for Reconstruction & Development-infoDev Trust Grant.

Source: The Communication Initiative website and the CECHE Website

US group launches online medical record program

Success strategy: The Initiative launched in 2005 is a health information resource with a great potential in terms of efficiency, in case of emergency or just when changing the GP. The new system allows patients to see, change and share medical records on the internet with a service launched today by a company set up by a coalition of professional medical groups. The service, called iHealthRecord, will let patients control their own records, while allowing doctors vital access when they need it, eventually reducing the risks of mistakes such as prescribing errors. They also hope it could provide a way for doctors and patients to replace thick medical charts and swap information without the need for costly and time-consuming office visits. The system is being provided by Medem Inc, an online medical services company set up in 1999 by medical societies such as the American Medical Association, American Psychiatric Association and American Academy of Pediatrics.

"We believe that electronic personal health records are an important service for physicians and patients, and a key element of the national information technology infrastructure," said Dr James Rohack, chairman of the American Medical Association. The medical groups backing the iHealthRecord, which include the American Heart Association and American Cancer Society, said it could be a first step to transforming the ponderous and mistake-prone paper-based US medical records system into an efficient, digital structure.

"Ultimately, we know these systems will reduce medical errors and save lives," Rohack asserted. "It doesn't matter whether (patients) move, switch health plans or switch doctors." At present, vital medical information is now not available to emergency workers leading to a number of complications, constraints or delays. The online service is free to patients who access it directly via the internet at www.ihealthrecord.org. Doctors, hospitals and medical groups will pay for the system, with a maximum charge of $US25 per month per patient, plus a charge for each email consultation made using the system. The password-protected service prompts a patient to enter medical details in a "check-the-box" format similar to the clipboards used now in doctors and dentists' offices. Patients can also record details of their prescriptions, health insurance and physicians.

Medem hopes to lure doctors to join by providing a way to offer extra services to patients with little effort. Patients can choose to manage their own records. And the system is designed to minimize the risks that hackers could view patient records. "Patients control the record. They decide who can see it and who cannot," Fotsch said. To remind, there have been several cases of hackers getting into computer-based medical records – for instance at the University of Washington Medical Centre in 2001. However, the new system is encrypted and said anyone who opens a file leaves electronic "fingerprints" that the patient can see. Nonetheless, there is a tiny probability that patients could falsify online records if they wish, or create phony profiles, even if the real risk is being very law.

Partners: Medem Inc

Source: Reuters

For more detailed information: see iHealthRecord website

 Community Radio: The Next Step

Success strategy: Having survived the arrival of newer media, it is evident that radio will always be one of the cheapest and most effective ways to dispense information widely. Information exchange between radio stations takes it one step further.

In December 2002, grassroots communities in Africa had the opportunity to share stories on the communities coping with HIV-AIDS through an internet-based programme swap. The story swap was one of the World Association of Community Broadcasters’ (AMARC) exchange projects set up to enable community radio stations to share experiences and learn from each other. Information exchange—though basic—has a deep impact on society. Isolated Maasai communities in Northern Tanzania had an opportunity to talk openly about the stigma and discrimination against HIV-AIDS-infected people. The discussion was significant for a community whose knowledge about the disease is largely based on hearsay and has led to the alienation of HIV positive people. The broadcast of a Ugandan businessman whose life was changed by the disease puts a human face to the disease, helping to raise awareness among others. Discussions such as the one on HIV-AIDS open up the communities’ thinking and facilitate social change.

AMARC is an international non-profit organization, born as a movement in 1983 and formalized in 1988, which supports and serves community radio broadcasters around the world. There are more than 2000 AMARC members across all five continents.

For more detailed information: see http://africa.amarc.org

  Satellife PDA Project - Uganda

Succes Strategy: The goal of the SATELLIFE PDA Project was to demonstrate the viability of handheld computers -- also called Personal Digital Assistants or PDAs -- for addressing the digital divide among health professionals working in Africa. Started for the first time at the end of 2001, the project uses affordable technologies to link health professionals in developing countries to each other and to reliable sources of information, including modem-to-modem telephone links and the internet by using geostationary satellites.

The organisers believe Information and communications technology (ICT) can play an important role in combating disease and improving healthcare. The project used ICT as a tool to collect community health information to support decision-making; improving doctors' access to current medical information; linking healthcare professionals so they could share information and knowledge; and enhancing health administration, remote diagnostics, and distribution of medical supplies.

The project-explored questions related to the selection and design of appropriate, affordable technology and locally relevant content for use in African healthcare environment, specifically targeted at assessing the usefulness of the PDA for data collection and information dissemination. Physicians, medical officers, and medical students tested the PDA in the context of their daily work environments in order to gain a perspective on the real issues that affect the adoption of technology.

The PDA used was the Handspring Visor Neo, with a 33 MHz DragonBall VZ microprocessor from Motorola, a Palm operating system (Palm OS), and 8 MB of main memory. Pendragon Forms v3.1 was the software programme used to create the survey forms. Country-specific drug lists and treatment guidelines were obtained by Satellife in hard copy or electronic formats and adapted to a PDA-accessible format. Medical texts were obtained from Skyscape.

The Project was conducted in three phases. Satellife first put the handheld computers to use for field surveys, by linking this project to a widespread measles immunisation campaign being conducted in Ghana by the American Red Cross (ARC) in December 2001. The Satellife-Arc joint effort used 30 PDAs in a short-term survey intended to determine the efficacy of the measles immunisation campaign outreach efforts and collect some baseline health information. The Uganda phase tested the use and usefulness of 40 PDAs by medical practitioners to conduct an epidemiological survey on malaria, and to access and use medical reference tools and texts. The Kenya phase tested the use and usefulness of 40 PDAs by students to collect field survey information, and to access and use medical reference tools and texts as part of their studies.

This project was inspired and led by SATELLIFE, a non-profit 501(c)(3) organisation based in Massachusetts, USA. SATELLIFE's mission is to improve health in the world's poorest nations through the innovative use of ICT.

Target groups:  Health professionals in Ghana, Uganda and Kenya Partners: SATELLIFE, the American Red Cross; Makerere University Medical School in Kampala, Uganda; HealthNet Uganda; Moi University Faculty of Health Sciences in Eldoret, Kenya; and the Indiana University Kenya Program, Acumen Fund

Awards:

• Tech Museum Laureate 2004

• The Stockholm Challenge Winner 2002

Source: Briges.org and http://www.healthnet.org

  Sexual Abuse Centre in Christchurch – New Zealand

Success Strategy: The Sexual Abuse Centre is a Not-for-Profit organisation supporting Rape and Incest survivors, both female and male, throughout the Canterbury, New Zealand region. It is an established entity of the not-for-profit sector since 1991. Developing a website has brought many unexpected benefits for the Sexual Abuse Centre in Christchurch and has made them part of a global network of service providers to survivors of sexual abuse. The Sexual Abuse Centre is a place of counseling and support with a focus on healing and thriving and the website reflects this vocation. It reveals as a mainstream tool to access information by people and for the centre as a quick, efficient and effective tool with important potential to disseminate written material quickly and to a wider audience.

The website has a feedback page to ascertain that provided information is useful or not to people. It showed that it has been well utilized, not only by New Zealanders but by survivors and other allied professionals throughout the world. Throughout the working process, a need occurred to establish relationships with other professionals in other parts of the world. The Centre is involved closely with the FBI around child protection and child abuse issues and have had a number of US survivor’s cases resolved by the FBI’s intervention. The competent staff has worked with a number of people around legal issues pertinent to their country, particularly in the UK, and has contacts to help them do that. The website has also helped and assisted allied professionals with information and support in setting up survivor based programmes & groups in such areas of the world as Indonesia, Africa and Europe. The website has been assessed by the centre people as an incredibly useful tool for their work. “ … it has made our small world here in Christchurch truly part of a global community providing the highest quality services to survivors of sexual abuse and rape no matter what part of the world they are in.”, ascertain the centre staff.

Target group: Victims of sexual abuse

Partners: Sexual Abuse Centre

Source: the website of the activity and CommunityNet Aotearoa website

 Calculating Risk

Success strategy: The constant flow of information throughout the world has made it easier for physicians to diagnose a variety of illnesses and identify new treatments for a multitude of diseases.  This information, which is collected in massive databases, has given both physicians and patients access to more information about health improvement and risk assessment.  The Bolivian Familial Cancer Database is one such international database that allows physicians to compare and contrast tumor and non-tumor features of a person’s genetic makeup with existing database entries.  This interactive database already contains over 300 entries and is updated regularly.  Another similar site administered by Harvard University allows users to calculate their risk of getting cancer free of charge.  Overall, ICTs and access to the global information network are allowing citizens around the world better prepare for and treat cancer and other illnesses.  

For in-depth information: see http://www.itu.int/ITU-D/ict/cs/bolivia/bolivia.html

 AIDS Prevention Information Centre Programme (API-net) - Japan

Success Strategy: This Programme was established in 1999 in order to provide various information about HIV/AIDS such as prevention, VCT, treatment, new drug, event activities, guideline set by government for HIV/AIDS patients, their family members, general population and medial suppliers. Japanese Foundation for AIDS prevention has executed this programme committed by Ministry of Health, Labour and Welfare, Japanese Government. It includes the plan for setting up information providing system and the collection, organization and announcement of various information for HIV/AIDS via internet service. The information provided by this programme are general knowledge for HIV/AIDS, up-to-date reports of HIV/AIDS research, guidance and addresses of AIDS treatment designated hospitals, guidance for government or non-government services for HIV/AIDS.

Target group :AIDS Victims and vulnerable & high-risk categories of people

Partners: Japanese Government

Source: WSIS Stocktaking Database and the website of the activity

  Leprosy Awareness Campaign – Brazil

Success Strategy: Brazil has the second highest number of cases of leprosy in the world. In 2003, the WorldHealth Organization (WHO) commissioned the BBC World Service Trust to conduct a national radio andtelevision hanseniase (leprosy) awareness campaign in Brazil. Three TV spots and 10radio spots were broadcast during the month-long campaign, which ran in February 2003. The campaign, which urged people to seek free treatment at public health centres, was backed by Brazil's Minister of Health, who has pledged to reduce leprosy inBrazil by 2005.  

The campaign, which was carried by all 13 major TV networks and some 2300 radio stations, emphasised three key messages: leprosy symptoms can be recognised; leprosy can be treated and cured; and a person undergoing treatment can continue to have a normal life while being treated (he or she is not contagious). A survey of 1000 people was conducted to evaluate the campaign during March 2003. Five sites - across all Brazilian regions - were selected from the Brazilian Ministry of Health’s list of priority areas for leprosy control. Globo, SBT, Bandeirantes and Rede TV!, reported broadcasting the campaign TV spots more than 7000 times nationally. In addition, over 2300 radio stations across Brazil were given the campaign spots. TV campaign was more effective than radio reaching 60% of respondents, radio reached just 4%. During the one-month campaign, the Telehansen information hotline offered by Reintegration Movement of People Affected by Leprosy (MORHAN, or Movimento de Reintegração das Pessoas Atingidas pela Hanseníase) received more than 10,000 calls. This was an average of 387 calls per day during the campaign, an increase from an average 14 calls per day in January prior to the campaign.

Partners: BBC World Service Trust, Brazil's Ministry of Health, Reintegration Movement of People Affected by Leprosy (MORHAN, or Movimento de Reintegração das Pessoas Atingidas pela Hanseníase), Pastoral da Crianca, and major broadcasters including Globo, SBT, Rede TV!, and Bandeirantes, funding by WHO

Source: BBC World Service Trust website and The Communication Initiative website For more information: see Executive Summary of Brazil Leprosy Campaign Evaluation, 2003 [PDF] 

  Twende na Wakati, Radio Drama on Health and Family Planning Issues – Tanzania

Success strategy: Family planning is an innovation that many individuals in Tanzania consider highly sensitive, and something which involves preventative behaviour. This results in family planning motivation are generally weak. The introduction of an entertainment-education radio soap opera in Tanzania attempted to change attitudes and behaviour in a positive direction while providing health information on other issues such as HIV/AIDS. Serialised radio drama which began in July 1993, and was broadcast twice weekly slmost nationwide. The soap opera rewarded positive behaviours and punished negative behaviour consistently, but also kept the drama highly entertaining and emotional to keep listenership high. Epilogues summarized each episode to reinforce educational messages. An evaluation led in 1995 showed that:

• 88 percent of people listening reported that they learned about family planning; 86 percent said they learned about HIV/AIDS prevention; and 76 per cent said they learned about spousal communication.

• Favorable attitudes to family planning increased by 5 per cent from 1993 to 1995 [69 per cent to 74 per cent] in the treatment area and decreased by 6 per cent (1993:82 per cent; 1995:76 per cent) in the control area.

• 23 per cent of the listeners said they adopted family planning as the result of listening to "Twende na Wakati" 

• Married female respondents in the treatment area reporting use of a family planning method increased from 25 per cent (1993) to 33 per cent (1995); compared with a decrease in the control area from 51 per cent (1993) to 46 percent (1995)

• 82% of listeners in 1995 said that they adopted an HIV/AIDS prevention behaviour because of; listening to "Twende". This was a 10 point rise from 72% in 1994

• 77 per cent of those who adopted safer sex reduced their number of sexual partners; 16 per cent began using condoms; 6 per cent stopped sharing razors and/or needles. 61% of listeners reported discussing HIV/AIDS issues raised in 'Twende' with friends (55 %); spouse (37%); other individuals (8%)

Partners: Population, Family Life Education Programme of the Ministry of Community Development, Women Affairs and Children, Ministry of Health, Population Communication International; UNFPA; Department of Communication and Journalism at University of New Mexico

Source: The Communication Initiative website

Background materials: "Effects of an Entertainment-Education Radio Soap Opera on Family Planning and HIV/AIDS Prevention Behaviour in Tanzania" by Rogers, Vaughan, Swalehe, Rao, Svenkerud, Sood and Alford

 Telemedicine in LDCs

Success strategy: From virtual doctors to videoconference consultations and digitized medical records, telemedicine is a relatively inexpensive and hugely beneficial option for the developing world.  By bringing together global health care and telecommunications experts, less developed countries are now capable of providing 21^st century medical care to their marginalized communities.  In Mozambique, for instance, ITU helped the government establish a network between central hospitals in two of the country’s biggest cities, Maputo (the national capital) and Beira.  This link allows doctors in each city to confer with each other and share medical records to ensure that patients in their respective cities get the best possible care.  The hospital in Beira now has instant access to radiologists located in the capital city, which has significantly improved patient care.  Similar telemedicine projects with which ITU is involved are currently under way, inter alia, in Senegal, Uganda and Ukraine. 

For in-depth information: see http://www.itu.int/newsarchive/wtdc2002/internet_Health.html

AIDSWEB Project - Africa

Success Strategy: Launched in 1998, the AIDSWEB project is an effort to offer secondary-school students training and access to technology as well as accurate information about HIV/AIDS. The project provide also guidance in initiating and sustaining action to combat the disease through national and cross-national partnerships. The project, which addresses 13- to 18-year olds in Botswana, Ghana, Kenya, South Africa, Uganda, the USA, Zambia, and Zimbabwe, is designed to complement existing Ministry of Education and NGO HIV/AIDS education prevention campaigns. The project also works to increase the quantity and quality of HIV/AIDS educational materials in schools. A CD-ROM with HIV/AIDS-related information drawn from existing online material was produced for schools with slow or no internet connections. In addition, efforts have been made to help adapt locally produced print-based HIV/AIDS educational material for electronic dissemination via CD-ROM and the AIDSWEB site. Training materials designed to integrate computer and internet literacy training material with HIV/AIDS examples were delivered by ICT for Education-trained teachers to HIV/AIDS-oriented NGOs and peer educators accessing the school-based telecentres in the after-school hours.

Impact Data about the project was collected in 2002 showed that AIDSWEB currently serves approximately 500 youth in 70 schools in 8 African countries. Students who were not in the programme were almost 6 times more likely to have less than 1 hour of computer access in the previous month. In the intervention group, 51% reported having more than 4 hours of computer access in the previous month compared to 23% in the control group. In the previous month, 35% of control respondents reported no computer access; 6% in the intervention group reported no access. AIDSWEB students were almost twice as likely to correctly identify all 4 methods of AIDS prevention and transmission. These results were consistent across countries, except for Uganda (a country that, according to evaluators, has well-established programmes in HIV/AIDS education and youth development). 63% in the control group and 85% of the intervention group responded that they helped their communities by sharing information about HIV/AIDS with family, friends, and/or health workers about HIV/AIDS; volunteering with local organisations or health clinics/hospitals; or developing a social action plan. AIDSWEB students were similar to students outside the programme in their choices of social action, but AIDSWEB students were more than twice as likely to develop social action plans.

Partners: ICT for Education (part of the World Bank Institute), World Links, iEARN, Schools Online, Education Development Center, Knowledge Economy (part of the World Bank), SchoolNet Uganda, The United Negro College Fund's Specials Projects programme, US Department of State's Bureau of Educational Cultural Affairs and Microsoft. AIDSWEB involves schools in Ghana, South Africa, Uganda, Zimbabwe; Botswana, Kenya, Nigeria, the US, and Zambia.

Source: The Communication Initiative website For more information: see the AIDSWEB site

Background materials: "Evaluation Report of WBIHD's ICT for Education AIDSWEB Project" (prepared by ENCOMPASS LLC, November 23, 2002)

  Fighting HIV with Anti-Spam Tools

Success Strategy: The great similarity between how spam works and how HIV cells mutate in the human body has allowed researchers to use Microsoft's machine learning and data mining algorithms to analyze the virus's genetic sequences.

Spam-filtering technology may soon save millions of lives, thanks to the technology’s potential use in developing a vaccine to fight the deadly human immunodeficiency virus (HIV).  Researchers are at present conducting in vitro tests of HIV vaccine models developed using Microsoft's anti-spam software, according to Kevin Schofield, general manager, Microsoft Research in Redmond, Washington.

The great similarity between how spam works and how HIV cells mutate in the human body has allowed researchers to use Microsoft's machine learning and data mining algorithms to analyze the virus's genetic sequences. The purpose was to identify patterns within the genetic mutations of the virus and the patient's immune system, according to Schofield.

These patterns are then used to create vaccine designs that have more HIV-fighting genetic markers. In a very similar way, anti-spam software detects patterns, such as common words or phrases, enabling it to identify legitimate e-mails and prevent spam from getting into the system, said Schofield.

Using Microsoft's data mining technology, researchers were able to search through millions of HIV strains and find genetic patterns more efficiently than previous methods, according to documents obtained from Microsoft Research.

Aside from anti-spam technology, the researchers also relied on other software algorithms used for database management and compressing digital files.

"These Microsoft Research technologies weren't initially conceived as medical research tools, but they may prove critical to the ongoing battle to slow down or halt HIV and other deadly viruses," said Dr. James Mullins, professor at UW's department of microbiology.

The World Health Organization has reported that AIDS has claimed the lives of nearly 30 million people worldwide. Forty million people today have HIV and close to five million are infected each year.

Partners: joint initiative between Microsoft Research, the University of Washington (UW) in Seattle, and the Royal Perth Hospital in Australia; since other partners have adhered, including Massachusetts General Hospital and the University of Toronto

Source: IT World Canada (26 May 2005)

  AIC Rural Communication Project in Kenya - Radio Drama and Radio Magazines on Economic and Social Development Issues

Success Strategy: A highly successful and impactive radio project which used two radio soap operas and two radio magazines to broadcast information on a range of important issues. There was a focus on reaching rural areas. The soap operas used entertainment to reach audiences, and the magazines were primarily focussed on information. Inventive and professional programming based on extensive and careful Participatory Rural Appraisal research resulted in a very effective campaign. Radio broadcasts of radio soap operas took place in Ndinga Nacio (in Kimeru), and Tembea Na Majira (in Kiswahili), and radio magazines: Mugi Ni Mwere (in Kimeru) and Sikizia Uerevuke (in Kiswahili).

Among listeners in 1996, almost 25% claimed to have applied the information gained from the programmes including, relating harmoniously with other family members (23% male and 25% female), use of better farming methods (22% male and 19% female) and keeping surroundings clean (15% male and 11% female). 47% of listeners said that they had put some knowledge gained from the soap opera into practice, i.e. 1/5 of the population. 28% of magazine listeners claimed to have put some of its information into practice. The two most commonly claimed applications were horticultural techniques and moral advice.

Partners: Agriculture Information Center (AIC) is part of the Ministry of Agriculture of Kenya. Kenya Broadcasting Centre, Air-time sponsored by commercial companies, The Media Trust, UK government, East Africa Industries

Source: The communication Initiative website