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? ICT4MPOWER -Empowering Communities in Uganda

Health System Challenges – Human Resources 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 ICT4MPOWER -Empowering Communities in Uganda

Health System Challenges – Infrastructure 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. ICT4MPOWER -Empowering Communities in Uganda

Health System Challenges – Information Management 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 Workshop “ICT4MPOWER, Rustam Nabiev, 2009-09-10

Challenges in Uganda The potential of ICT 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 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

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 Workshop “ICT4MPOWER, Rustam Nabiev, 2009-09-10

ICT4MPOWER – Project Implementation Area Isingiro District 400 000 population ICT4MPOWER -Empowering Communities in Uganda

ICT4MPOWER – Sub Goals E-infrastructure Development with support from UCC Electronic Health Record and Electronic Referrals Unique Patient ID Tele-consultation Learning platforms for continuous Human Resource Development (Drug decision and stock management system based on WHO developed algorithms ) ICT4MPOWER -Empowering Communities in Uganda

ICT4MPOWER – Supporting Health Care System All health units connected to EHR Patient data follows the patient Second opinion via telecommunication links Effective referrals Continuous Professional Development Drug decision and stock www.ict4mpower.org ICT4MPOWER -Empowering Communities in Uganda

Tele-Consultation- Shrinking distacnes ICT4MPOWER -Empowering Communities in Uganda

Human Resource Development Through E-learning ICT4MPOWER -Empowering Communities in Uganda

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 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 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 ICT4MPOWER -Empowering Communities in Uganda

Uganda – Structure of Health Delivery 30.7 million population Specialized Services, 2) Research and Training ENT, Pathology, Ophtalmology, Radiology, Psychiatry, Higher level surgical and Medical Services, Referrals to National Referral Hospital, Research and Training 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 100000 population 20000 population 1 doctor, 1 nurse, 1 laboratory assistant Diagnostics with limited equipment (Ultrasound, ECG, Blood Pressure), 2) Laboratory Analysis, 3) Referral to HC4, 4) Distribution of drugs to lower level 5000 population, 1 nurse usually Help Community Workers, 2) Distribution of drugs to community, 3) 1st help to rural people, 4) assistance for giving birth, 5) referral to HC3 1000 population Village Health Team (VHT) 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 ICT4MPOWER -Empowering Communities in Uganda ,

Electronic Health Records and Electronic Referrals ICT4MPOWER -Empowering Communities in Uganda

Unique Client ID – 3 Step Process Workshop “ICT4MPOWER, Rustam Nabiev, 2009-09-10