public ehealth in the caribbean nancy muturi kansas state university public ehealth innovation and...
TRANSCRIPT
Public eHealth in the Caribbean
Nancy MuturiKansas State University
Public eHealth Innovation and Equity in Latin America and the Caribbean
eSAC Caribbean Webinar SeriesPublic eHealth and Equity: Media Focused
OutlineDefining eHealthConcept of mHealtheHealth in the CaribbeanGender and healthGender and ICTsConsiderations for women in
eHealth
eHealth Defined
The combined utilization of Information Communication Technologies (ICTs) and networked data processing to transmit, store and retrieve digital data for clinical, educational and administrative purposes by the health sector
(Rodriguez, 2003)
ICTs refers to: Innovations in microelectronics, computing
(hardware and software), telecommunications and opto-electronics—micro-processors, semiconductors and fibre optics.
(UNDP, 2001)
In other words, innovations that are used to handle:◦ Telecommunications◦ Broadcast media◦ Information management systems◦ Audiovisual processing transmission systems◦ Network-based control and monitoring functions
Includes: Radio, Television, Internet, Telephones, Computers, Hand-held computing and telecommunications devices etc.
Global Recognition of eHealth
Healthy people 2020 recognizes the role of Information Technology (IT) to improve population health outcomes and health care quality, and to achieve health equity.
Millennium Development goals underscored the benefits of ICTs in achieving gender equity and equality
Health Information Technologies
Health Information Technologies (HITs) have tremendous promise for delivery of health care and health promotion esp. in less developed nations
Use of HITs
Cost effective and secure use of ICTs in ◦Health-care services – diagnosis and
treatment◦Health surveillance◦Healthcare policy and decision-making◦Health literature◦Healthcare marketing◦Health education, knowledge and
research◦Health communication
HITs Usage in the Caribbean
Mainly used for:
◦ Surveillance
◦ Management information systems/ Patient information systems
◦ Information dissemination
◦ Not much for communication and behavior change
◦ Limited interaction with the audience
◦ Limited audience participation
eHealth ApplicationsWebsites
(e.g. Medline Plus, Healthfinder, and Web MD)E-mail, message boards, chat rooms,
interactive websites, Voice recognition, etc.)
Online social support networks and communities,
Interactive electronic health recordsHealth decision support systemsTailored health education programsHealth care system web portalsMobile health communication devicesAdvanced telehealth applicationsOnline gaming for health promotion
If used correctly HITs can:Increase patient and provider access to
relevant health informationEnhance the quality of careReduce health care errorsIncrease collaboration among providersEnhance doctor/patient interactionsImprove patients’ knowledge and
confidenceEmpower patients in health decision-
makingEncourage the adoption of healthy
behaviors
mHealth Defined The mobile computing, medical sensor,
and communications technologies for health care.
Wireless connection of personal server to the telemedical server
Through personal computer, cell phone, other telecommunication devices
This developments is driven by the evolving mass markets for cell phones and portable computing devices
mHealth in the CaribbeanMobile technology expanding rapidly in
the Caribbean
Pervasive access to mobile telephony, with some countries having over 100% penetration
By Dec. 2011, there are approximately 2,945, 395 cell phones in Jamaica
Mobile penetration rates of 109%Internet penetration
118, 259 subscribers – 4% Internet Users – 1,581,000.
Other Examples
Computer penetration ◦ Suriname -- 14% ◦ Antigua and Barbuda --
47% ◦ Trinidad and Tobago –
25%◦ Barbados – 39.6%
Internet access:◦ 36% in Antigua and
Barbuda ◦ 34% in Barbados
Access at home:◦ 68.9% in Barbados◦ 59% in Antigua and
Barbuda
Mobile phones Barbados – 61.2% Belize – 50%
Source – Lawton, 2010
Technological Divide
Based on: ◦Age◦Gender◦Income◦Disability access◦Literacy/illiteracy levels◦Computer/digital literacy◦Geographical location
ICT Usage in the Caribbean
Infrastructure and access mobile strong, other areas some progress
Education some progress
Public management some progress
Production sector some progress
Policy instruments and strategies progress
Health limited progress
Challenges for eHealthCost Concerns
For organizations to operate inexpensively Lack of adequate funding for healthcare For consumers/women to participate
affordably
Standardization To enable different systems to
communicateSecurity and Privacy
Data security and privacy of personal health data
Quality of Publicly Available Information
Timeliness, accuracy, depth, and diversity
eHealth ImperativeeHealth is imperative for Caribbean due
to:
◦ Changing demographics – age and population structure
◦ Increase in digital natives (young adults who grew up in the digital age)
◦ Lifestyles changes due to urbanization, immigration and industrialization
◦ Global advancement in technological development
◦ Global advancement in medical fields
A dynamic model of healthcare is required to match these changes
Gender and Health
Women are more likely to suffer from lifestyle-related illnesses
e.g. diabetes, cardiovascular disease, HIV/AIDS and other sexual and reproductive health infections
Caribbean women between the ages of 24-44 years old are more likely to get be infected by HIV than men
Due to gender inequity and inequality
Women are less likely to have access to preventive healthcare
Lack of adequate health insurance/coverage Low or no income Stigma and Discrimination
Gender and ICT
ICTs are not gender neutral Access and use of ICTs differ by gender Digital divide based on gender
Previous Studies show that: Women are more likely to search for health
information online Women are more likely to use ICTs for social
networking Women living in developing countries are 21%
less likely to own a cell phone than men Women are more likely to feel connected and
empowered to connect with the healthcare professionals if they own a cell phone
Women’s Access to ICTsMore likely to have access to internet at
workMore women with low-paying jobs –
limited access More women working at call centers Mostly using computers for word processing,
typists, data entry clerks
Women have limited IT training Limited understanding of ICTs and HIT
applications Low computer literacy Men have more skilled IT-related jobs
Gender ConsiderationsGender component in the IT policyOwnership – hardware/softwareTraining and capacity building Access points – public/privateCost and capabilityLiteracy/computer skills/technophobiaParticipation Confidentiality/privacy issues especially
in dealing with stigmatized diseases Ethical issues in health careSecurity issues in regard to ICT access
and use
Effective eHealth among women
Key questions to ask :◦ How easy are ICTs for women to understand and
use?
◦ How comfortably do ICTs fit within the policies, practices, and technical infrastructure that are built into existing health and social systems?
◦ How affordable are they for the women and other intended audience?
◦ Are the messages delivered on eHealth programs easy enough for women to understand and apply the health information provided?
◦ Are the information systems adaptive, interactive, and self-correcting?
◦ Do ICTs provide interesting, relevant, and engaging information for the women?
References Blaya, J. A., Fraser, H. S., & Holt, B. (2010). E-health technologies show promise in developing countries.
Health Affairs (Project Hope), 29(2), 244-251. doi:10.1377/hlthaff.2009.0894; 10.1377/hlthaff.2009.0894
Dunton GF, Robertson TP. A tailored Internet-plus-email intervention for increasing physical activity among ethnically-diverse women. Prevent Med 2008;47:605–11.
Healthy People 2020. Health Communication and Health Information Technology. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=18
ICA World Factbook
Jansen C. (nd). Information, Communication Technologies (ICTs). Technopedia. Accessed from http://www.techopedia.com/definition/24152/information-and-communications-technology-ict
Kreps G. L., & Neuhauser L. (2010). New directions in eHealth communication: Opportunities and challenges. Patient Education and Counseling 78: 329–336
Lawton, O. (2010). Monitoring Caribbean Information Societies. IDRC, Canada, Project Document. Retrieved from http://www.cepal.org/publicaciones/xml/9/38899/W315.pdf
Lindsay S, Smith S, Bellaby P, Baker R. The health impact of an online heart disease support group: a comparison of moderated versus unmoderated support. Health Educ Res 2009;24:646–54.
Marsh, W. (2012). Why are businesses ignoring the mobile opportunity? Jamaican Observer, July 15. Retrieved from http://m.jamaicaobserver.com/mobile/business/Why-are-businesses-ignoring-the-mobile-opportunity-_11949851
Muturi, Nancy (2005). Gender, ICTs and Health in the Caribbean. In Cummings, Sarah, Henk van Dam, and Minke Valk, (Eds.) Gender and ICTs in Rural Development. A Global Source Book, Gender, Society & Development series, no. 8. (pp.61-74), Oxfam, UK.
Muturi, Nancy (2006). Access and Use of ICTs among Women in Jamaica. In Tauth Eileen M. (Ed). Encyclopedia of Gender and Information Technology. (pp.1-6), Hershey, Idea Group Inc. (Peer reviewed)
Rodrigues, R. J., & Risk, A. (2003). eHealth in Latin America and the Caribbean: Development and policy issues. Journal of Medical Internet Research, 5(1), e4. doi:10.2196/jmir.5.1.e4