Page 1

1

Strengthening use of ICT for Health

Care - Uganda Experience

Dr. Eddie Mukooyo

SEYCHELLES

25-29 February 2008

2

Outline

● Background

● National e-Policy Frame work

● Status of e-Health

● Challenges

● Achievements

● Way forward

3

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

4

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

5

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

6

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

7

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

8

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

9

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

10

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

11

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

12

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

13

WHERE WE ARE – MoH (SERVER ROOM)

14

WHERE WE ARE - MoH (E-GOVERNANCE)

15

Orientation at Ministry of ICT

16

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

17

Infrastructure at HSD

(2%)

(27%)

(31%)

E-mail

Fax Services

Functional

Radio call

system

HSD with

Computer

18

Major Constraints

● Management

● Local Technical Support (HR)

● Developmental cost & Maintenance

● Rapid change in technology

● Sustainability

● Cultural adaptability (Technophobia)

● Power availability

19

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.

20

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.

21

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

22

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.

23

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

24

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.

25

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

26

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

27

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

28

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

29

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

30

Asante Sana

Thank you

Merci