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Strengthening use of ICT for Health

Care - Uganda Experience

Dr. Eddie Mukooyo

SEYCHELLES

25-29 February 2008

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Outline

Background

National e-Policy Frame work

Status of e-Health

Challenges

Achievements

Way forward

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Introduction

Health Reforms

Health Policy and Health Sector Strategic Plan

ICT as one of the support systems (UMHCP)

Liberalization Policy of Government - to promote the

development and application of ICT

National e-Health Steering committee

In process of finalizing the Health ICT Policy, strategies

and action plan

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National ICT Policy Framework

The government of the Republic of Uganda

recognises the important role information and

ICT play in national development. Government

consequently unreservedly committed itself to

champion the development and use of ICT in

Uganda (2003)

Dedicated Ministry of ICT

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National Vision

A Uganda where national development,

especially human development and good

governance, are sustainably enhanced,

promoted and accelerated by efficient

application and use of ICT, including timely

access to information

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National Goal

To promote the development and effective

utilisation of ICT such that quantifiable impact

is achieved throughout the country within the

next 10 years in line with PEAP and MDG’s

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Coordination Bodies

In Various Government Departments and

Institutions:

-In case of the Health sector we have the

National e-Health Steering Committee

For harmonization to ensure that all ICT

equipment specifications/configurations can

interface with each other - synergy

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Structure of Uganda's Health System

Primary health care – lower level health

facilities (HSD, HCIII, HCII)

Secondary health care – Referral Hospitals at

both District (General) and Regional Level

Tertiary health care – National Referral

Hospitals

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Areas where e-Health can assist

Lack of access to specialists doctors

Need for second opinion

Lack and need for CME (e-learning)

Lack of proper record keeping of clinical data

and prescription

Need for information in real time

Lack of proper screening before referral

Lack of sufficient equipments/ambulances

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ICT in Health Care Delivery

Continuing Medical Education (e-learning)

Data and records management

Real time access to information

Tele-consultation/Telemedicine, peer support

Health services administration

Health research

For policy formulation

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Role of ICT in Clinical Care

Easy access to information enhances

- timely and accurate Diagnosis,

- appropriate and timely Treatment,

- speedy Referral (continuity of care)

- On- time Consultation/ peer support

Cost saving,

- minimizes wastage, saves on time

Bridging the gap (Inequity)

- “rural/ urban divide” - Telemedicine

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Where we are at:

National & Regional level

– Data Bank

computerized data base for HMIS data including HRH

Integrating GIS with HMIS

– Library

Automated system for retrieval of materials at the center

Developing e-library system (KM Portal)

– E-Governance & UCC Initiatives

– Internet connectivity at MOH HQ (website, LAN), and districts

– Electronic mailing systems

– Sensitisation workshops for Telemedicine

– Basic Infrastructure in Uganda has reached >80% dist

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WHERE WE ARE – MoH (SERVER ROOM)

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WHERE WE ARE - MoH (E-GOVERNANCE)

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Orientation at Ministry of ICT

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Where we are (district )

ICT AVAILABILITY AT DISTRICT LEVEL

61%

41%

29%

48%

100%

57%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Computers

Fax

Machines

Internet/E-

mail

Radio

Calls

Mobile

Fixed

Telephone

ICT TYPE

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Infrastructure at HSD

(2%)

(27%)

(31%)

E-mail

Fax Services

Functional

Radio call

system

HSD with

Computer

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Major Constraints

Management

Local Technical Support (HR)

Developmental cost & Maintenance

Rapid change in technology

Sustainability

Cultural adaptability (Technophobia)

Power availability

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Challenges - information

Inaccurate and incomplete records.

Lack of standard formats of record keeping.

Lack of standard nomenclature.

Parallel data collection systems

Lack of / or unclear guidelines on information policy

and data security

Legal / ethical issues related to information & ICT use.

Low knowledge of ICT policy by health providers.

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Challenges - human resource

Need for ICT based technical cadre to be made

part of public service structure.

Low computer literacy rates among health

providers

Attitudes about ICT use among staff (fear factor /

Techno phobia).

Need for in-service training for ICT use in health

care delivery.

Adjust curricula for health provider trainees to

include ICT.

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Challenges - infrastructure

Low density of ICT equipment in health units.

Low distribution of reliable hydro electricity power in

community health units.

Lack of standardization & specification of ICT

technology in health unit for compatibility.

Due to lack of equipment standardization, development

partners do donate obsolete equipment to the ministry

some do not have local technical support

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Challenges - (security of data & legal

issues)

Lack of security framework for data

management e.g. Pubic keys infrastructure.

Ethical & legal issues related to management

of medical data using ICTS.

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Challenges - (financing & sustainability)

High costs of set-up of ICTS.

High tariffs for communication / networks (ISP) – 50%

waiver on monthly premiums.

Need to budget for ICT services at all levels of health

care services delivery.

Need to negotiate with the Uganda Communications

Commission & government about benefits of rural

communications fund, rural electrifications, tax waivers

on ICTS technologies

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Other challenges

Need to sensitize policy makers & community

leaders about the benefits of integrating ICTS

in health care delivery and education

curriculum..

(Cost benefit analysis).

Need to do research to identify appropriate

ICTS at the different levels of healthcare.

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Accomplishments - 1

E-Governance Initiative with Video Conferencing

facility

Installed a Local Area Network at the MOH head

quarters

Installed a Metro Area Network at the Health

Infrastructure office via leased line

The Ministry of Health has a website at

http://www.health.go.ug

Developed the current draft ICT policy and seeking

approval of top management

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Accomplishments - 2

Developed web-enabled HMIS

Now designing web enabled district databases (facility

& equipment inventory) – on line modules

Have developed Electronic mailing system to facilitate

email communication

Developing integrated HRH IS - web enabled

databases

Developing MoH Institutional memory database

Developing Knowledge Management Portal

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Accomplishments - 3

Working closely with EAC Secretariat to

develop a regional databases with Maps

Working with ECSA to develop HR

Observatory

Collaborating with Makerere University on use

of PDA’s in Health Care Delivery

Carried out Service Availability Mapping using

GIS

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Way Forward

We are Consolidating existing Telemedicine

Projects

Finalizing ICT policy, strategies and action plan

for Health

Coordinating of e-Health projects in country

Increasing awareness among medical

professionals

Establishing Private Virtual Networks

Involvement of all stakeholders for ownership

and sustainability

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Thinking Ahead…

“Developing Countries can no longer

expect to base their development on their

comparative labour advantage. The

competitive advantage that now counts is

the application of knowledge.” Peter

Drucker (1994, p 62)

Challenges need to be identified and

addressed

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Asante Sana

Thank you

Merci