1. 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

2. Why ICT4MPOWER in Uganda?
ICT4MPOWER -Empowering Communities in Uganda

3. 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

4. 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

5. 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,

6. 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

7. 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,

8. ICT4MPOWER – Project Implementation Area
Isingiro District
population
ICT4MPOWER -Empowering Communities in Uganda

9. 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

10. 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
ICT4MPOWER -Empowering Communities in Uganda

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

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

13. 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.

14. 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

15. 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

16. 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
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 ,

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

18. Unique Client ID – 3 Step Process
Workshop “ICT4MPOWER, Rustam Nabiev,