Information Communication Technology (ICT) supports medical workers when physicians are absent. They manage patient records and keep accurate accounts in medical supplies and medication inventory. ICTs increase lab information management and create algorithms for effective treatment plans including the distribution of medications and immunizations. As a laundry list of medical conveniences, ICT in eHealth has a lot of advantages. Yet, the concept of eHealth in developing countries is more about connecting rural and resource-poor communities with specialists. So, how does ICT and eHealth in developing countries work?

Asynchronous Medical Exchanges

The obvious advantage is that health information is easily accessible, regardless of time, location or occupation. Asynchronous medical exchanges bridge physical and time-complying barriers between multiple personnel. This could be between a doctor and patient or doctor and specialists or all three. There are various forms of ICT (email, video conference and audio), all of which offer an array of services including teledermatology, telepathology and teleradiology, to name a few.

Maternal and child health care is of primary concern in many countries, and India has shown particular promise in women and children eHealth platforms.

Successful ICT Programs in India’s Mobile Health Initiative

The use of cell phones, home patient monitoring devices and other wireless devices closed the gap between India’s poorest communities and health care. The National Informatics Centre developed MCTS (Mother and Child Tracking System), which utilizes information technology (IT or ICT) to access a full spectrum of health services for pregnant women and children. MCTS operates on an alert-notification platform for medical workers. Services include antenatal, post-op and post-natal care for mom as well as guaranteed immunizations and check-ups for the first five years.

At the state level, eHealth programs like PICME (Pregnancy Infant Cohort Monitoring Evaluation) in Tamil Nadu, Arogyam in Uttar Pradesh and the 2018 Digital LifeCare initiative all provide working platforms for physicians to screen, manage and care for patients in resource-poor areas on or off-site.

The use of ICT in eHealth has impacted developing countries and progress, as illustrated in India, has occurred. However, reliable internet access is necessary for the successful implementation of ICT in eHealth. In addition, eHealth development varies by country and has unequal distribution among the poorest of countries.

Serbia has a population of 7 million with about 37 percent seeking health information online; only 33 percent have access to reliable internet. Similarly, Turkey has a population of 80.3 million with reliable internet access for more than half. Algeria, Guatemala and Zambia’s populations have less than 20 percent internet access respectively and Afghanistan only 5 percent. Many challenges threaten the successful implementation of eHealth, chief among them access to reliable internet.

A Digital Divide

If global society continues daily reliance on digital technology and services, resource-poor countries will be in the wake of information communication technology. Gaps in supportive infrastructure cripple developing countries’ chances of successful eHealth platforms.

Rapid technological advances over the last decade impede resource-poor locations’ ability to remain up-to-date with medical equipment and treatment plans, disallowing use of the technology. Likewise, unstable power supplies and insufficient or unreliable communication networks fundamentally limit the potential of eHealth integration.

A cross-sectional survey conducted in Brazil reported 81.4 percent of medical physicians believed EHR (electronic health records) response time was unsatisfactory. Eighty-six percent complained of technical difficulties and 35 percent had an insufficient supply of equipment in clinics—a direct result of insufficient funding.

Information Communication Technology is expensive and insurance packages, private party investments and individual donors or clients provide the majority of funding.

Deputy Director of the Digital Health Solutions Programme Skye Gilbert speaks caution and vigilance to collaborators when considering solutions for the digital divide, stating that “Being excluded from the digital domain will have more and more implications for someone’s health status…So the digital divide will become more and more tied to health equity over time.”

A Symbiotic Relationship

Overall, health improvement for resource-poor settings will not improve unless health technologies are accessible to all. The way in which ICT impacts eHealth in developing countries is quantifiable in that the countries with proper resources and pre-existing conducive technological platforms have measurable success in the implementation of eHealth programs. But for those countries struggling to fill in a widening digital gap, eHealth and, by consequence, people will always underrepresent and neglect public health.

Countries like Bangladesh, Paraguay, Qatar and Rwanda officially adopted eHealth strategies—four of 73 with eHealth initiative plans. Until medical information communication technology is accessible to everyone, health will only ever be a privilege for those able to afford it.

– Marissa Taylor
Photo: Flickr