January 2007

e-Health in Developing Countries

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One of the most significant impacts of the ongoing information  revolution has been in the health sector. In the field of health care, ICTs have emerged as key instruments in solving many of the most pressing problems. ICT has helped to bridge the gap between the provider and seeker through telemedicine and remote consultations, enabled health knowledge management by institutions and agencies, and facilitated in the creation of networks between providers for exchange of information and experiences.

In fact, globally, the e-Health or health telematics sector is fast emerging as the third industrial pillar of the health sector after the pharmaceutical and the medical (imaging) devices industries. From a development perspective, ICTs are key instruments towards meeting the Millennium Development Goals (MDGs) related to health. In this respect, the increasing adoption of ICT in health care services of developing countries, by both public and private sectors, has been a welcome trend. All across the world, governments are pledging and pooling more and more of their resources towards developing ICT tools and systems with the ultimate aim of facilitating management, streamlining surveillance and improving health care through better delivery of preventive and curative services.

e-Health scenario in developing countries

Developing countries suffer from an extremely high incidence of virulent diseases, which comprises not only the prevalent contagious and communicable diseases, but also an increasing number of chronic diseases related to changes in lifestyle and consumption patterns. Much of the disease burden of low-income countries stems from a number of interrelated factors such as poverty, malnutrition, poor hygiene and living environment, along with gender and caste-based discrimination. Overall, health budgets are extremely low in developing economies, though in terms of disease burden, some 93 percent is borne by them.

The growing popularity of e-Health in India is a healthy indication that the country's development sector has the potential and the necessary technical expertise to set in place such initiatives. India is among the top global exporters of IT products. In that sense, it is much better placed than other developing nations in the world, where the digital divide translates into technological as well as infrastructure divide.

According to the World Bank figures, expenditure on health in developed countries is 11 percent of their GDP, as compared to just 6 percent on an average for developing countries. Given this depressing scenario, it is no surprise that the developing countries are woefully off-target in meeting the MDGs pertaining to reduction in child and maternal mortality and in control of major communicable diseases like malaria and HIV/AIDS. In this context, ICT is playing a crucial role. ICTs are increasingly playing an important role in improving the performance of health care system in developing countries, specially in enabling equitable access to health services delivery, besides networking, coordinating research and knowledge management. A number of successful initiatives have been reported regarding innovative use of ICT in health.

Some of the major fields include internet based disease surveillance and monitoring systems, information exchange and capacity building of remote health workers at all levels, better programme implementation and supply management, disease prevention and emergency response facilitation, management of health institutions, capacity building of health functionaries and platforms for information dissemination and exchange. In India, as in other developing countries – initiatives such as Voxiva's disease surveillance and reporting systems for state governments, Jiva's teledoc initiative, the use of PDAs by ANMs in Nalgonda (sponsored by World Bank), and the Electronic Resource Centre for capacity building in HIV/AIDS set up by SAATHI

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