Health ICT towards the millennium development goals

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THE CURRENT telecommunication technologies have an astonishing ability for transmitting information. The internet provides abundant database, reference materials, and online journals that all have given an enormous significance to connectivity in developing regions of the world. These resources have brought huge benefits to tertiary healthcare institutions not only in Pakistan but also other developing countries. The implementation of health ICTs in developing countries particularly Pakistan has been hampered by traditional obstacles like poor infrastructure, lack of resources, and insufficient political commitment and support. This can be appropriately summarized as follows, as the “Four Cs” – connectivity, cost, capacity, and culture.
Presently, the problem of improving health-care delivery in developing countries is more about the impartial distribution of available resources to all areas of the health system than about technology. Technologies exist that would help doctors working in isolated rural villages to access to up-to-date medical information and communicate with colleagues, and even to diagnose illnesses and treat patients. Yet, these health workers, who care 60 to 65 per cent of the population of Pakistan that still live in rural areas, have no meaningful access of internet. The rapid growth and extensive use of wireless technologies provides the best opportunity to reach these isolated health workers. There has also been increased global attention on the need to strengthen health systems in general and human resources in particular. There is growing recognition of the need for a paradigm shift to address the diverse needs of health-care providers, as follows: skills, equipment, information, structure support, medicines, incentives, and communication facilities.
Telemedicine covers various communication modalities and is not a single technology. This ranges from the use of sophisticated video conferencing and other conferencing modalities, through web-based provider patient communication systems, to the use of basic telephone service. It is defined as the delivery of health-care and the sharing of medical knowledge over a distance using telecommunications. In the developing countries, the promise of remote diagnosis and treatment heralded a new hope for health sector, particularly in Pakistan where communities live in rural areas and health-care is sparse. However, the persistence of poor infrastructure, poor investment, and lack of political support hampered its growth. There are, however, a few pilot projects and case studies have been reported from various parts of the country. This is the beginning of a learning curve for the health sector in Pakistan ultimately; success will not come from using expensive, high-end, cutting-edge technology, but from tools that are simple, appropriate, and adapted to local needs.
Ten years ago, Simon Forge of the World Bank had argued that telecommunications will soon become a routine rather than a luxury service. He further predicted that by the year 2005 telecommunications will have become so cheap that all charges, installation, and use will be perceived as free by all users, and considered a basic right even in the poorest countries. This predication is yet to be achieved globally and more visibly in the health sector in developing countries. Progress, however, has been made in tertiary care institutions with regard to electronic communications, access to health-care information, and stronger engagement of researchers with the international scientific community. The increasing use of wireless technologies has begun surmounting the persistent obstacles to the implementation of ICTs, but their capacity to carry information remains to be enhanced. To scale up these benefits will require a better understanding of local conditions, better training of health workers, and appropriate choice of ICT tools.


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