ICT4MOPWER- Supporting Healthcare in Uganda

April 2009- December 2012

Presenter: Cecilia Strand, project coordinator, SPIDER

Presentation done by Mr. Rustam Nabiev, Project Leader, Karolinska University hospital

Why ICT4MPOWER in Uganda?

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Health System Challenges – Human Resources

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• Shortage of health workers, Doctor: 18,000:1, Nurse: 3,065:1

• Isolation of the professional rural health workers

• Underutilization of the few specialist health workers

• Late referrals and emergency services are not well established

• Support Supervision of health care delivery is weak

• Absenteeism

Health System Challenges – Infrastructure

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• Inadequate road, transport and communication systems between healthcare levels, especially from rural areas.

• Many hospitals need rehabilitation, while others need upgrading to be able to deliver the expected services.

• Lack of basic medical equipment and poor routine maintenance and management.

• Shortage of trained biomedical and maintenance technicians and engineers and low user awareness and responsibility

• Non-functioning non-medical equipment and ICT, technical services, and including ambulances and utility vehicles.

• Limited and erratic power (energy) distribution.

Health System Challenges – Information Management

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• Mainly paper based and difficult to compile at a aggregated level

• Medical information inaccessible (drugs and diagnostics)

• Inadequate collection and utilization of collected data

• The feedback from the community on the services the hospitals provide is weak

• There is no structured way of providing the feedback from communities

Challenges in Uganda- Few healthcare services

available in rural areas- Shortage of health workers,

especially in rural areas (unattractive work place)

- Inadequate road and transport systems

- Poor data management- Poor communication links

between health units

The potential of ICT– Shrinks distances – Facilitates efficient use of

scarce resources (ex- drugs)– Makes available expert opinion

of the city doctors in the countryside.

– Enables continuous on-the-job training

– Makes medical information available

– Facilitates data collection for planning

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ICT4MPOWER - Objectives

– To establish a solid and secure information flow between the district and the regional level for improved healthcare delivery in Uganda using information and communication technology (ICT)

– Isingiro District is chosen as a proof of concept

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ICT4MPOWER – Project Implementation Area

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Isingiro District400 000population

ICT4MPOWER – Sub Goals

1. E-infrastructure Development with support from UCC

2. Electronic Health Record and Electronic Referrals

3. Unique Patient ID

4. Tele-consultation

5. Learning platforms for continuous Human Resource Development

6. (Drug decision and stock management system based on WHO developed algorithms )

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ICT4MPOWER – Supporting Health Care System

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- All health units connected to EHR

- Patient data follows the patient

- Second opinion via telecommunication links

- Effective referrals

- Continuous Professional Development

ICT4MPOWER -Empowering Communities in Uganda www.ict4mpower.org

Drug decision and stock

Tele-Consultation- Shrinking distacnes

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Human Resource Development Through E-learning

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Human Resource Development Through E-learning

Focus on Village Health Teams. VHT strategy, a relatively new phenomenon in Africa in general and Uganda in particular.

Existing training program for VHT– MODULE1: The village health team concept– MODULE 2: Communication– MODULE 3: Community Mobilization and empowerment– MODULE 4: Child growth and development– MODULE 5: Control of Communicable diseases– MODULE 6: Sexual and reproductive health– MODULE 7: Environmental health– MODULE 8: Common Non- communicable diseases– MODULE 9: Monitoring

The manual is designed to fit the Ugandan context and aims to equip VHTs and community members have adequate knowledge and skills to help them prevent suffering and deaths, identify common diseases, recommend appropriate treatment and give correct health messages.

Human Resource Development Through E-learning

Formal courses offered on Moodle or similar platform for all levels

Build on teleconsultatioin data

Focus on Village Health Teams (Community Mobilization and empowerment, Child growth and development, Control of Communicable diseases, Sexual and reproductive health, Common Non- communicable diseases)

Support to CHW by sending tailored health education messages

Software could ensure that appropriate health education messages are tailored in preparation of a round of home visits.

The e-learning platform can show pictures and animations to support health education.

Participatory approach- allow end user produce the material

Stakeholders in Sweden and Uganda

– SPIDER, Swedish Program for ICT Development

– Karolinska University Hospital, Sweden

– Karolinska Institutet, Sweden

– Royal Institute of Technology (KTH), Sweden

– Ericsson, Sweden– IICD, the Netherlands– Sida– DANIDA– USAID

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– Ministry of Health – Ministry of ICT– Uganda Communication

Comission– Makerere University, College of

health and sciencies, – Makerere University, Faculty of

ICT– ISINGIRO District Local

Govenment– District Health Officer, ISINGIRO– Millennium Villages Project– Mbarara University of Science

and Technology– Mbarara University Teaching

Hospital– Mulago Hospital– Makerere University, College of

Health Sciences, Medical Illustrations Department

– District Health Offices, – Mbarara District Hospital

Uganda – Structure of Health Delivery

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1) Disease Surveillance, 2) Collecting statistics and surveys, 3) Helping birth delivery, 4) helping injuries, 5) sharing health information, 6) ordering and distributing drugs to

communities

1000 populationVillage Health Team (VHT)

1) Help Community Workers, 2) Distribution of drugs to community, 3) 1st help to rural people, 4) assistance for giving birth, 5) referral to HC3

5000 population, 1 nurse usually

20000 population1 doctor, 1 nurse, 1 laboratory assistant

1) Diagnostics with limited equipment (Ultrasound, ECG, Blood Pressure), 2) Laboratory Analysis, 3) Referral to HC4, 4) Distribution of drugs to lower level

100000 population1) Emergency Surgery, 2) Blood Transfusion, 3) Laboratory and X-Ray Analysis, 4)

In-Service Training, 5) Support to Community Programs, 6) Referral to higher level

1) ENT, Pathology, Ophtalmology, Radiology, Psychiatry, Higher level surgical and Medical Services, Referrals to National Referral Hospital, Research and Training

1) Specialized Services, 2) Research and Training30.7 million population

Electronic Health Records and Electronic Referrals

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Unique Client ID – 3 Step Process

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