By Tseday Alehegn
Published: Monday, February 11, 2013
New York (TADIAS) – The first Global Education and Technology Health Summit was held at the United Nations in New York last week, which brought together academics, social entrepreneurs, distance learning experts, physicians, business leaders and ministers of health for a talk on the impact of mobile technologies to improve global health.
The summit was organized by Johns Hopkins Center for Clinical Global Health Education and Global Partnerships Forum and co-hosted by the International Telecommunication Union as well as the governments of Ethiopia, Rwanda, Uganda, and Norway.
Dr. Enawgaw Mehari, Neurologist and Founder of People to People (P2P) global network was a panelist discussing information and communications technologies, and the patient versus provider relationship. Citing his organization’s work, Mehari described the People to People as being founded on the principle of triangular partnership consisting of “the mother country (Africa), the Diaspora, and Western institutions.” The main effort is to “implement programs that contribute to closing the gap through education, training, and research,” Mehari told Tadias in a later interview. An example of such a program was an emergency medicine initiative coordinated by People to People, Black Lion Hospital in Addis Ababa, and Wisconsin University as well as a neurology program at Black Lion Hospital in collaboration with the Mayo Clinic.
Another panelist, Ms. Amy Lockwood, Deputy Director of the Center for Innovation in Global Health at Stanford University, supported Mehari and the role that individuals from the Diaspora can play by noting that pilots implemented by NGOs or student interns are short-term and don’t help to form the deeper, and more meaningful connections needed to scale and grow programs. “When you are a member of the Diaspora you have an umbilical cord” she said and urged practitioners to move towards implemented innovative projects with the support and collaboration of diaspora resources.
Dr. Seble Frehywot, Principal Investigator of the MEPI Coordinating Center at George Washington University also presented on the topic of creating centers of excellence for ICT in health education and research training that would likewise serve as hubs of innovation.
Ethiopian Diaspora physicians participating in the summit included Dr. Senait Fisseha from the University of Michigan who is both a doctor and lawyer by training and is involved in global health activities in collaboration with medical schools in Ethiopia. She felt the summit was “an interesting meeting looking at the impact of technology to improve health care services as well as global medical education,” but also pointed out that she “would like to see more healthcare providers and stakeholders at this meeting as well as diaspora from all African and Asian countries who really have a vested interest in addition to NGOs and funders.” She travels once a month to Ethiopia to oversee projects that are currently being developed on the ground.
On the topic of leveraging mobile technology to strengthen health systems, Dr. Ferew Lemma Feyissa, Senior Advisor at the Ministry of Health in Ethiopia, told Tadias that the summit has enabled them to network and meet with various technology company representatives including from Dell and Verizon who have shown interest in working with them as private sector partners. An area of health that Ethiopian Ministry of Health is primarily focused on is improving maternal and child health outcomes, and expanding emergency obstetric care at the district level. Dr. Feyissa notes that Ministry is also using mobile technology tools to “help us enhance the skills of health extension workers in the primary health care unit.” In the future, Ethiopia also hopes to use mobile health to address chronic care and to support the vastly expanded medical education system in Ethiopia.
During the ministerial addresses, Ethiopia’s Minister of Health, Dr. Kesetebirhan Admazu Birhane, described the three-tier health system, which is comprised of health centers and community health extension workers. “We consider our community health extension program as a pillar of our health system,” he said. “And through this program we have trained and deployed 38,000 health extension workers, with two workers per village.” Most of these professionals are women who have been “tasked to do health promotion, disease prevention, and provide basic curative services,” he added. The four areas of support for them include data exchange, improving supply chain so that workers are receiving supplies on a continuous basis, and using mobile technology to improve both communication between the community health extension workers and labs and hospitals. One outcome of this program is that “we have seen an increase in antenatal visits as well as an increase in institutional delivery rates,” Dr. Birhane said, citing the use of mobile technology to reduce maternal mortality in Ethiopia. “So the challenge is to have the same quality of success at scale.”
Similarly, the Director of e-health at the Rwandan Ministry of Health said his nation has three community health workers per 75,000 villagers, which exceeds the goal of the million community health worker campaign for Sub-Saharan Africa announced by President Paul Kagame, Novartis CEO Joseph Jiminez, and Columbia Professor Jeffrey Sachs this past January at the World Economic Forum.
In addressing some of the current challenges faced, Dr. Birhane noted the recent expansion of Ethiopia’s medical schools from just three to 25 new medical schools. Dr. Birhane spoke of the difficulty in retention of physicians who leave and practice in other countries, and mentioned the initiative to increase medical school enrollment capacity from “150 five years ago to 3,000 this year.” The challenge is that “we don’t have enough faculty,” he said, “and that’s where technology will definitely help.”
Dr. Wuleta Lemma, Director for the Center for Global Health Equity at Tulane University and Country Director for Tulane’s program in Ethiopia has been working for several years in Addis Ababa spearheading the development of a pre-service Master’s training program in health monitoring and evaluation, as well implementing an e-health and mobile health strategy called HealthNet in collaboration with the Ethiopian Ministry of Health.
Speaking of such efforts, Dr. Birhane said “we have tried to create a linkage between universities in Europe and the U.S. with our newer medical schools. And we have also created a network with the Ethiopian Diaspora.” He added, “I would like to call upon our partners here to work with us to really improve the quality of medical education in Ethiopia using information and communications technologies.”
State Minister for Primary Health Care in Uganda, Ms. Sarah Opendi cited similar hardship in the retention of trained doctors in her country, noting physician preferences to work for higher pay in the private sector or abroad. Yet, by using mobile technologies, Uganda has improved service delivery and monitoring of medicines, and has better quality of data from monthly reports, as well as improved anonymous consultation services for HIV/AIDS patients through the national, toll-free hotline. Uganda has also “connected regional referral hospitals with the national hospital so that doctors can easily consult with their colleagues.”
The Minister of State for Health in Nigeria, Dr. Alit Pate, shared with participants that his country has 65,000 registered health extension workers, but more initiative is needed, especially when it comes to evaluating the impact of using mobile technology to improve health outcomes. He mentioned an online portal for training midwives that initially received a lot of hits but then experienced a decline in submissions, and emphasized that incentives need to be put in place to encourage community health extension workers to continue submitting valuable data used for tracking progress.
Incentives such as providing promotion opportunities for community health workers to supervisory levels, and providing access to medical education via distance learning modules to increase medical student enrollment and retention are just a few ways that Dr. Feyissa at the Ethiopian Ministry of Health hopes to build and maintain a trained health workforce. Uganda’s integrated use of an innovative health system tracking service known as IHRIS is yet another avenue for better monitoring and evaluation of health outcomes.
The Summit also covered subjects such as health and media literacy, and leveraging social media to address issues including increasing organ donation. Sarah Wynn-Williams, Manager of Global Public Policy at Facebook informed the audience that the launch of Facebook organ donation profiles increased organ donation by 800% in California in the first week alone.
Lee Wells, Head of Health Programs (Africa) at Vodaphone Foundation looked forward to translating the success of mobile money such as the M-Pesa system in Kenya to the mobile health sector. He stated that “last year, 25% of Kenya’s GDP was transferred via M-Pesa mobile system.” He emphasized “It’s low-cost, let’s use what’s already available.”
Below are photos from the event: