health sector communication
Communication is key when it comes to developing a well-performing healthcare system. Ineffective communication within healthcare systems “increases the likelihood of negative patient outcomes,” overall costs for healthcare systems, and “patient utilization of inpatient and emergency care.” Meanwhile, sound health sector communication ensures the maintenance of overall health and helps prevent diseases and premature death. Thus, it is important to ensure that healthcare systems across the globe are well equipped and supported. Recent developments in mobile technologies have made it easier to do so and transformed health-sector communication in several countries.

mHERO

A recently developed mobile application, called mHERO, has become one of the latest mobile applications to demonstrate the powerful and wide-reaching role that technology plays in health-sector communication. Created in 2014 by IntraHelath International and UNICEF, mHERO is a mobile-based application used by healthcare workers and ministries of health in order to communicate and coordinate effectively and efficiently. The application was developed during the 2014 Liberian Ebola outbreak after recognizing the need for a way to communicate urgent messages to frontline healthcare workers, to collect data concerning outbreaks development, and to provide support and training.

Messages sent through the application are transmitted through basic text or SMS. The app is compatible with most cellular devices. By merging existing health information systems, such as Integrated Human Resources Information System (iHRIS) and Fast Healthcare Interoperability Resources (FHIR), with popular communication platforms, such as RapidPro, Facebook Messenger and WhatsApp, mHERO acts as a cost-efficient, accessible and sustainable resource for many healthcare systems.

Implementation in Liberia 2014

The 2014 West African Ebola outbreak overwhelmed the Liberian healthcare sector. The absence of effective communication channels blocked the supply of vital information from health officials to health workers. UNICEF and IntraHealth International created mHERO to address the communication challenge. The application was initially designed to suit the needs of the Liberian healthcare system, utilizing the technology that was already available in the country. It then became the responsibility of the ministry of health to effectively manage and maintain the application’s implementation and its continued use.

Liberia utilized mHERO to validate healthcare facility data, to update health workers and to track which facilities need additional resources. Today, health officials use mHero to coordinate the country’s response to COVID-19. mHERO has become an integral part of the Liberian healthcare system, maintaining a vital role in health-sector communication.

Development and Reach

Guinea, Mali and Sierra Leone followed Liberia’s lead with the mHero integration process. The implementation guidelines and intent of use in these countries have generally remained the same as Liberia’s. Mali, however, has implemented the application with a need to train and develop the skills of healthcare workers.

Uganda, as of 2020, has also incorporated mHERO into its healthcare system with the intent of reducing the spread of COVID-19. The application has allowed for easier COVID-19-related communication between ministries of health, health officials and healthcare workers.

Uganda employes a developed form of the application with an extension called FamilyConnect. The extension sends “targeted lifecycle messages via SMS to pregnant mothers, new mothers, heads of household and caregivers about what they need to do to keep babies and mothers safe in the critical first 1,000 days of life” as long as they have been registered with the Ministry of Health’s Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH). Mothers can register themselves or can choose to have registration done by a community health worker.

Future Plans

UNICEF and IntraHealth International want to expand access to mHERO. Counties in East and West Africa have indicated an interest in implementing the application. UNICEF and IntraHealth International intend to continue to support the ministries of health and healthcare systems in which mHERO has already been implemented. They also hope to find new ways to encourage ministries of health “to understand the interoperability of the technology, the processes for implementation and best practices to using mHero data.”

Overall, mHERO has substantially improved health-sector communication within several countries, proving the application’s potential for revolutionizing health-sector communication throughout the world. Developments can be made to expand the application’s capabilities and reach, as proven in Uganda. The application is a sustainable and cost-efficient resource for healthcare systems and helps reduce the chances of premature death along with the spread of diseases and misinformation. It provides crucial support to healthcare workers, especially during times of epidemics, increasing the overall quality of healthcare and life.

Stacy Moses
Photo: Flickr

Healthcare in UzbekistanUzbekistan is a former Soviet country and many consider it to be the population center of Asia with a young population. Since its independence in 1991, the country has diversified its agriculture, while keeping a significant agricultural base to its economy. The quality of healthcare in Uzbekistan endured a drop after its independence from the USSR but now is on the upward trend, even though it remains low in global rankings. Here are seven facts about healthcare in Uzbekistan.

7 Facts About Healthcare in Uzbekistan

  1. Under Soviet control, all healthcare in Uzbekistan was free. However, the government focused on access and less on outcome, leading to weaknesses when dealing with sickness and disease, especially in rural communities. Meanwhile, about 27% of hospitals in rural areas had no sewage and 17% had no access to running water, while doctors received 70% of the salary of a farmer, a common Uzbek job. Now, reforms focused on rural areas have improved conditions in all hospitals, and doctors now make 26 times the amount of a rural farmer.
  2. In Uzbekistan, most people rely on public healthcare providers, organized in three layers: national, regional and city. Private healthcare is minimal due to unsafe practices in treatment and surgery. As a result, the government is the principal employer of health workers, as well as the primary purchaser and provider of health-related goods and services.
  3. Spending on healthcare in Uzbekistan has increased from the country’s independence in 1991, as the country aimed to westernize and reform. Uzbekistan’s current health expenditure is 6.4%. The government health spending increased from $36 to $85 per person; out of pocket spending almost doubled from $37 to $69 per person, and developmental assistance doubled from $3 to $7 per person in the 30 years from its independence. The increased funding led to higher availability in healthcare, especially in rural areas, and better quality of care.
  4. In the past 30 years, Uzbekistan has implemented healthcare reforms in rural areas. Some improvements include increasing sanitation levels in hospitals and healthcare availability, allowing for all patients to get better care. Overall, the under-5 mortality rate has decreased by 50%, and healthcare access and quality (HAQ) grew from 50.3 to 62.9 from 1990 to now.
  5. The physician’s density is low, at 2.37/1000 people, mostly due to the emigration of skilled professionals, even though the median pay for physicians has sharply increased to about $13,000 a year. On the other hand, the hospital bed density is higher than in some highly developed countries, such as the United States, at four for every 1,000 people.
  6. Uzbekistan ranks low in maternal and infant mortality. At 29 deaths out of 100,000, it ranks 114 in maternal mortality. At 16.3 deaths out of 1,000, it ranks 93 in infant mortality. Although its healthcare system has gotten better with reforms in sanitation and access to healthcare, Uzbekistan still needs to create more improvements, as the mortality rate is still high.
  7. Uzbekistan is also low-ranking in adult health. The country holds the rank of 125 in life expectancy, with an average lifespan of 74.8 years. As for the quality of health, Uzbekistan ranks 115 in HIV/AIDS, with a prevalence of 0.2% and ranks 123 in obesity, with a prevalence of 16.6%.

Project Hope

Uzbekistan has not accomplished everything on its own. Many charities have worked with Uzbekistan, such as Project Hope. In 1999, Project Hope established its first office in Uzbekistan, with a focus on reducing child and maternal mortality rates, through the Child Survival Program and Healthy Family Program. It created initiatives, as well as opportunities for sexual education for the new mothers. Since then, under the Global Fund to Fight AIDS, Project Hope has focused on creating opportunities for AIDS-focused healthcare and education.

Uzbekistan has made progress in healthcare from the time of its independence, but it still has a long way to go. As Uzbekistan’s government continues to implement reforms heavily focusing on rural areas, it will most likely continue on its upward trajectory and create a health system that is beneficial to all of its citizens. As healthcare grows, poverty will decrease. Currently, Uzbekistan’s most poor are in rural areas, the areas with the least access to healthcare, as well as the lowest levels of sanitation. If Uzbekistan continues making reforms, rural areas will receive more healthcare, decreasing the disadvantage of living there, and therefore increasing the quality of life for Uzbekistan’s poor.

Seona Maskara
Photo: Flickr

Apps that aid in healthcare in developing countries It can sometimes be difficult for people in developing countries to access healthcare, specifically those living in poverty. In order to address this problem, healthcare apps are being used to provide greater access. Here are 10 healthcare aid apps that are impacting access in developing countries.

10 Apps That Aid Healthcare in Developing Countries

  1. Peek has its sights set on helping people with vision impairment issues and blindness, a problem exacerbated in developing countries by a lack of resources. Peek can identify people with vision problems. The app then works with healthcare providers to pinpoint an economically feasible way to supply the treatment they need, before allocating the appropriate resources. Currently, Peek is being used by the International Centre for Eye Health at the London School of Hygiene and Tropical Medicine, which is administering a population-based survey of blindness and visual impairments in Cambodia.
  2. SASAdoctor focuses on making healthcare consultations more accessible in Kenya. In the country, only 12% of people are insured. About 8 million are reliant on the National Hospital Insurance Fund, leaving 35 million Kenyans uninsured. Available to all Kenyans with an Android smartphone or tablet (65% of Kenyans have one), SASAdoctor decreases the cost of an in-person consultation for the uninsured and makes it free for those with insurance. Patients will have their medical history, list of medications and other such medical notes in their ‘file’ on the app, so that whoever tele-consults with them will have the information they need to create an informed medical opinion. SASAdoctor can decrease the cost of uninsured visits with a doctor to Kes 495 (the equivalent of $4.66) for a projected 80% of Kenyans who are predicted to have smartphones in the next few years.
  3. iWander allows people to keep track of Alzheimer’s patients. Set with tracking technology that can be discretely worn by the patient, it offers whoever uses the app several options on how to deal with situations involving the patient. Solutions can range from a group calling session to making an emergency medical call or summoning a caregiver. iWander gives families more control over the care of a loved one, which can have a positive impact in countries where healthcare may be less accessible. In the US, the average cost of care for a single person is $174,000 annually. About 7 out of 10 individuals with dementia remain at home to receive care, where 75% of the costs fall to the family to pay. In helping families be proactive instead of reactive to crises, iWander can help in cutting these costs, especially in poorer countries, where many families are struggling to keep up with the high costs of at-home care.
  4. Kenek O2 allows the user to monitor their oxygen and heart rate while they sleep. Kenek O2, built for the iPhone, also requires a pulse oximeter which connects to the phone and retrieves the data to be stored in the app. Together, the cost for these two items is around $100, compared to the price of a regular hospital oximeter and other similar products, which could easily cost more than $500. Having effectively been used in North America, South America, Asia and Africa, Kenek O2 is currently working on developing a special COVID-19 device to watch for early signs of hypoxia, or the deficiency of oxygen reaching tissues.
  5. First Derm is an app that requires a smartphone-connected device, called a dermatoscope. This allows detailed pictures to be taken of skin conditions and lesions to better allow for remote, teleconsultations. In places where doctors are few and far between, and public transport is less reliable, this can make getting a second medical opinion much easier. So far, First Derm has helped in more than 15,000 cases from Sweden, Chile, China, Australia and Ghana, ranging from ages of just 3 days old to 98 years. Of these cases, 70% could be treated without a doctor, most often by over-the-counter treatments available at local pharmacies.
  6. Ada takes user-input symptoms and provides appropriate measures to take as a result, like a personal health assistant. It’s intended to assist those who don’t have the means to seek an in-person consultation right away. The app has been released in several languages, which makes it more accessible. Currently, 10 million people around the world are using Ada for symptom evaluation.
  7. Babylon is intended to mitigate the obstacle of going to see a doctor in person by allowing users to input symptoms or solve common health problems via teleconsultation with a doctor. Babylon specializes in non-emergent medicine, allowing patients to skip a trip to the doctor’s office entirely if their condition allows it. This is beneficial in places where doctors are sparse, or the patient lacks the financial means or a method of transportation in getting to the hospital. Babylon caters to users across the U.S., U.K., Canada, Rwanda and several countries across Asia-Pacific and the Middle East. The app aims to expand to more countries in the upcoming years.
  8. MobiSante, through its ultrasound device, allows versatility in diagnostic imaging by bringing the ultrasound to the patient. This allows quality, diagnostic imaging to be done outside the confines of a hospital or clinic. As a result, it provides more holistic and informed treatment where people may need it most but have previously struggled in accessing a healthcare center with the necessary technology. While having a computer at home with a desk is much less common in developing countries, the world’s increasing reliance on the internet is shifting the status of internet technology from a luxury to a basic necessity. This means that technology such as smartphones are becoming somewhat of a necessity in impoverished countries, making an app like MobiSante effective in using smartphones to make diagnostic imaging more accessible.
  9. Go.Data is a tool released by the WHO. It is specifically for collecting data during global health emergencies. During the Ebola outbreak in Africa, Go.Data was praised for tracing points of contact. The app also tracked infection trends and helped in arranging post-contact follow up.
  10. Mobile Midwife is a digital charting app that stores information in a cloud so that healthcare workers have access to all pertinent patient information. It works even in cases of power outages, or home births where internet connection may be less reliable. This app can help in areas where mother and infant mortality is higher, ensuring that healthcare providers can efficiently access patient information to ensure the best care. It can also cut the extra time it takes to find records that could otherwise make procedures more dangerous for both mother and child.

Bridging healthcare accessibility with smartphone apps isn’t a perfect solution, as it comes with accessibility issues of its own. However, these healthcare aid apps can help people without insurance, or who are physically unable to visit a physician, access health consultations. As a result, more people are provided access to healthcare, empowering a healthier (and more health-conscious) population.

– Catherine Lin
Photo: Flickr

Health Care in SwedenSweden has the highest income tax rate in the world. More than 57% is annually deducted from people’s incomes. However, Sweden placed seventh out of 156 countries in the World Happiness Report 2019, and its healthcare system is one of the best in the world.

In 1995, Sweden joined the European Union and its population recently reached over 10 million people. Healthcare is financed through taxes and most health fees are very low. Sweden operates on the principle that those who need medical care most urgently are treated first. Higher education is also free, not only to Swedes, but also to those who reside in the rest of the European Union, the European Economic Area, and Switzerland. Like healthcare, it is largely financed by tax revenue. Here are 10 facts about healthcare in Sweden.

 10 Facts About Healthcare in Sweden

  1. Sweden has a decentralized universal healthcare system for everyone. The Ministry of Health and Social Affairs dictates health policy and budgets, but the 21 regional councils finance health expenditures through tax funding; an additional 290 municipalities take care of individuals who are disabled or elderly. To service 10.23 million people, Sweden has 70 regionally-owned public hospitals, seven university hospitals, and six private hospitals.

  2. Most medical fees are capped and have a high-cost ceiling. According to the Swedish law, hospitalization fees are not allowed to surpass 100 kr (Swedish Krona), which is equivalent to $10.88, a day and, in most regions, the charge for ambulance or helicopter service is capped at 1,100 kr ($120). Prescription drugs have a fee cap and patients never pay more than 2,350 kr ($255) in a one-year period. In the course of one year, the maximum out-of-pocket cost is 1,150 kr ($125) for all medical consultations. If the person exceeds the cap, all other consultations will be free. Additionally, medical services are free for all people under the age of 18.

  3. The cost for medical consultations not only has a price cap, but is generally low. The average cost of a primary care visit is 150 kr-300 kr ($16-$33) and the cost of a specialist consultation, including mental health services, ranges from 200 kr-400 kr ($22-$42). The cost of hospitalization, including pharmaceuticals, does not exceed 100 kr ($11) per day and people under the age of 20 are exempt from all co-payments. Healthcare services, such as immunizations, cancer screenings, and maternity care, are also free and have no co-payments.

  4. All dental care for people under the age of 23 is free. When a person turns 23, they no longer qualify for free dental health care in Sweden and must pay out of pocket. However, the government pays them annual subsidies, or an allowance, of 600 kr ($65) to pay for dental expenses. In Sweden, the cost of a tooth extraction is 950 kr ($103) and the cleaning and root filling for a single root canal costs 3,150 kr ($342). If dental care costs total anywhere between 3,000 kr-15,000 kr ($326-$1,632), the patient is reimbursed 50% of the cost. If it exceeds 15,000 kr, 85% of the cost is reimbursed.

  5. To battle its large medical waiting lists, Sweden has implemented a 0-30-90-90 rule. The wait-time guarantee, or the 0-30-90-90 rule, ensures that there will be zero delays, meaning patients will receive immediate access to health care advice and a seven-day waiting period to see a general practitioner. The rule also guarantees that a patient will not wait more than 90 days to see a specialist and will receive surgical treatment, like cataract removal or hip-replacement surgery, a maximum of 90 days after diagnosis. Sweden’s government also committed 500 kr million ($55 million) to significantly decrease wait time for all cancer treatments. In 2016, Sweden developed a plan to further improve its health services by 2025 through the adoption of e-health.

  6. In 2010, Sweden made private healthcare insurance available. The use of private health insurance has been increasing due to the low number of hospitals, long waiting times to receive healthcare, and Sweden’s priority treatment of emergency cases first. In Sweden, one in 10 people do not rely on Sweden’s universal healthcare but instead purchase private health insurance. While the costs for private plans vary, one can expect to pay 4,000 kr ($435) annually for one person, on average.

  7. Sweden’s life expectancy is 82.40 years old. This surpasses the life expectancies in Germany, the UK, and the United States. Maternal healthcare in Sweden is particularly strong because both parents are entitled to a 480-day leave at 80% salary and their job is guaranteed when they come back. Sweden also has one of the lowest maternal and child mortality rates in the world. Four in 100,000 women die during childbirth and there are 2.6 deaths per 1,000 live births. There are 5.4 physicians per 1,000 people, which is twice as great as in the U.S and the U.K, and 100% of births are assisted by medical personnel.

  8. The leading causes of death are Ischemic heart disease, Alzheimer’s disease, stroke, lung cancer, chronic obstructive pulmonary disease and colorectal cancer. While the biggest risk factors that drive most deaths are tobacco, dietary risks, high blood pressure and high body-mass index, only 20.6% of the Swedish population is obese and 85% of Swedes do not smoke. The Healthcare Access and Quality Index (HAQ Index) also estimates that, in 2016, the rate of amenable mortality, or people with potentially preventable diseases, were saved at a rate of 95.5% in Sweden. The HAQ Index estimates how well healthcare in Sweden functions; the index shows that it is one of the best in the world.

  9. Sweden’s health expenditure represents a little over 11% of its GDP, most of which is funded by municipal and regional taxes. Additionally, in Sweden, all higher education is free, including medical schools. There are no tuition fees and a physician can expect to have an average monthly salary of 77,900 kr ($8,500).

  10. In Sweden, 1 in 5 people is 65 or older, but the birth rate and population size are still growing. Because Sweden has one of the best social welfare and healthcare systems in the world, people live longer and therefore 20% of the population does not generate income or pay taxes from their salary. This dynamic stagnates social welfare benefits and slows down the economy. Increasing immigration and a rise in births are the two solutions to ensure that the younger generations will receive the same benefits. Swedish-born women have an average of 1.7 children and foreign-born women have an average of 2.1 children. In 1990, Sweden broke the 2.1 children fertility rate but quickly dropped below 2.0 in 2010. Since 2010, Sweden has seen an increase of 100,000-150,000 immigrants and has seen 45,000 citizens emigrate.

In 2018, Sweden reached its record highest GDP (PPP) per capita of almost $50,000. Despite having the highest taxes in the world, the living conditions and healthcare in Sweden are some of the best. With time, its population will continue to grow and the healthcare system will continue to advance.

Anna Sharudenko
Photo: Flickr