National Space Conference, Pakistan · 2013. 10. 30. · National Space Conference, Pakistan National Space Conference Role of WHO in promoting space technology for health: tele-health

National Space Conference, Pakistan


National Space Conference Role of WHO in promoting space

technology for health:

tele-health initiatives around the world

17- 19 September 2012

Islamabad, Pakistan

Najeeb Al-Shorbaji, Director Knowledge Management and Sharing

World Health Organization

National Space Conference, Pakistan | 25 September 2012 3 |

eHealth tools an services

Technicians erecting

VSAT dishes in

Islamabad,

Pakistan, to provide

the vital satellite

health

communications

links required

between WHO

headquarters and

the field.


eHealth tools an services

WHO emergency response team member collecting surveillance data and transmitting it to WHO/HQ after the devastating earthquake in Pakistan in October 2005.


The context: WHA Resolutions 58.28 on

eHealth

eHealth as the cost-effective and secure use of

information and communication technologies in

support of health and health-related fields, including

health-care services, health surveillance, health

literature, and health education.

The resolution requested the Director-General of

WHO, among other things, to promote international,

multisectoral collaboration, to provide technical

support to Member States, to facilitate the integration

of eHealth in health systems.


eHealth resolution: Countries

Draw up plans for eHealth services

Develop ICT infrastructure

Closer collaboration with private and non-profit

sectors in ICT

Reach communities, including vulnerable

groups, with eHealth services appropriate to

needs


e-Learning e-Care

Scope of eHealth applications and

services

e-Surveillance

e-Management

eHealth

Governance


Satellite potential benefits to public health

Final report of the Action Team on Public Health:

the use of space technology to improve public

health of the Committee on the Peaceful Uses of

Outer Space Scientific and Technical

Subcommittee Forty-eighth session, Vienna, 7-

18 February 2011,

Satellite communication,

Global positioning systems and

Remote sensing space technologies.


Satellite utilization by WHO

Public health mapping

Disease surveillance (eSurveillance)

Epidemiology (eEpidemiology or Tele-Epidemiology)

Water supply and delivery

Poverty mapping

Emergency and disasters

Data and voice communication

Enabling access to health information and learning materials

Partnerships and technical advice


De-isolating care

professionals

Dr Diakaridia Traoré continued to serve

his community in Rural hospital in

Dimmbal, Mali.

800 km away from the capital.

120 km away from the first Internet access.

20 km away from telephone access.


HINARI reaches the most remote areas

through a satellite connection

Three other factors helped significantly in making

this a successful workshop. The Internet access

probably was the best from all the workshops I

have conducted in HINARI eligible institutions

(the satellite dish was right outside the window of

the computer lab) and the IT staff were very

helpful.

http://www.mlanet.org/resources/global/lwb_elibr

arytraining_workshops.html

http://www.mlanet.org/resources/global/lwb_elibrarytraining_workshops.html

http://www.mlanet.org/resources/global/lwb_elibrarytraining_workshops.html


IHR implementation requires stable

connectivity

Under the International Health

Regulations, (IHR), WHO has a

commitment to countries to have a team

on the ground within 24 hours and they

need to be able to hit the ground running.

Critical to disease outbreak response is

having teams in the field that are able to

communicate with each other as well as to

WHO country and regional offices and

headquarters. But in remote areas and

inhospitable environments, telephone

connections, data transmission and

access to the Internet are often limited and

unreliable


Pilot in Nigeria and Pakistan demonstrated the

utility of GIS in (supplementary immunization activity/activities) SIA

operation

• Identify the missed area during implementation

–Visualize the geographic gap of team's activity

–Enables effective supervision and revisits

•Digitize team's movement

–Specify "ideal" movement of each day

–Reduce risk of missing areas and enable better supervision

•Digitize Union Council (UC), area and team boundaries

–Clarify the exact team/area responsibilities

– Identify gaps and ensure all areas are accounted for


Overview on Quantitative Evaluation in Pakistan

Selected Four UCs in Peshawar and Karachi for Evaluation

•Two Intervention UCs (one in Peshawar and the other in Karachi)

•Two Control UCs (with similar risk profile to intervention UCs)

In Intervention UC, GIS was used to improve SIA quality

• Intervention were done during May/June SIA in Peshawar and two rounds in July SIA in Karachi

• In Peshawar, UC/Area in Charge (AIC) and all team boundaries were clarified, team movement was digitized and implementation was monitored with GPS

• In Karachi, only UC and AIC boundaries were clarified due to deteriorating security situation in the city

The change in SIA quality was monitored in all UCs

• Number of children immunized (before and after intervention)

• LQAS results


Area-in-charge (AICs)

walked around their areas

with GPS and digitized

area/team boundaries

This exercise enabled to

clarify discrepancy between

team boundaries and UC

boundaries (yellow) as well

as unclaimed areas (purple)

Boundaries are Clarified in Tekhal Bala UC

(Peshawar)


PICs

No one is assigned from

this UC (yellow)

No AICs assigned in some

areas (Purple)

Two AICs claims the

responsibility of the same area

Boundaries are clarified in Gaddap UC (Karachi)


All 20 team's activities were analyzed after three days of SIA

GPS coordinates identified possible missed areas

WHO staff/AIC confirmed missing areas and send teams during revisit

Geographic gaps were identified during May

SIA (Tekhal Bala, Peshawar)


Daily team movement was digitized (Tekhal

Bala, Peshawar)


Overview on quantitative evaluation in Pakistan: key take away messages Use of GIS is feasible and effective in the field

This concept is easily trained and implemented locally

Use of GIS has improve the SIA coverage significantly by clarifying

responsibility and ensuring accountability.

Digitizing UC/Team/Area boundaries alone is

effective enough to improve SIAs There are many gaps and misunderstanding in many places

This is less sensitive and more acceptable to the local communities than

implementation monitoring

Local community engagement and GPS use is critical in

setting up boundaries

Local team leaders (e.g., Area in Charge, UC officers) should meet and

confirm the responsibilities after the exercise

Without GPS, drawing boundaries on the satellite image is difficult.


Global Alert and Response

Rift Valley Fever (RVF) forecasting model in Africa and Middle East with NASA

http://www.who.int/csr/disease/riftvalleyfev/en/

CCHF (Crimean-Congo Hemorrhagic Fever) risk mapping models with Oxford University

The Meningitis Environmental Risk

Information Technologies (MERIT) project in West Africa with International Research Institute for Climate and Society (IRI)

http://merit.hc-foundation.org/aboutMERIT.html

Plague project in Kazakhstan with CNES










21 21

*1 [Source] Eastern Mediterranean Regional Office, WHO (2001)

Setting up a satellite for voice, data and

internet

Afghanistan*1:

Setting-up of satellite and its related hardware is relatively easy since 2001.

Data transmission through satellite has been used in a sustainable manner since 2001.

In addition to fixed satellite stations in multiple location, mobile unit (RBGAN) were used and satellite phones for health professionals use.

Voice, data and internet access.


The WHO eAtlas of disaster risk

for African Region

for European Region

for the Eastern Mediterranean Region


International cooperation and partnerships

RAFT -

Distance Learning program webcast, and tele-

consultation forums via satellite in 18 African

countries, and expanding;

Pan Africa eNetwork;

An eNetwork covering all countries in Africa.

Funded by the Indian government, and

connecting hospitals and universities in each

African country with their counterparts in India;


International cooperation and partnerships

ESA

An EC funded satellite-based project supporting health services in Sub Saharan Africa.

WHO served as a member of the task force (WHO, EC, AUC, ADBank, African sub-regional organizations) guiding the development of the Pan African eNetwork programs;

Possible collaboration between JAXA and WHO

Data transmission services for developing world

Provide free services of data transmission and GPI along with mapping particularly for rural/remote areas of Pacific Island countries and Sub-Saharan Africa.

A JAXA satellite may become a first WHO collaboration centre in the space!


Challenges to wide use and scaling up of

satellite use in public health

High cost

unaffordable cost of data transmission has lead to short lived projects

Limited availability & up-datedness of GIS

despite its great demand for global health purposes, GIS in Africa is poorly available and updated, due to difficulty in commercialization

Licensing and political sensitivity

difficult to license for services and to manage

the gap between satellite data and government data.


Challenges to wide use and scaling up of

satellite use in public health

Interoperability and standardization

has lead to fragmentation, duplication of effort and unsustainable and more costly projects.

Absence of national eHealth strategies and

plans has lead to short term un-scalable projects, lack of intersectoral collaboration and chaos.

Week infrastructure

has lead to interrupted or absent power supply, shortage of skilled human resources, lack of coordination between different government agencies.


Recommendations for implementation of

space technology in public health in Pakistan

Development of public-private partnerships between UN agencies, the government, national space agency and commercial satellite companies aiming to provide free transponder space on commercial satellites with small aperture antenna in different provinces in Pakistan;

Urging federal ministries of telecommunications and telecommunication regulatory authorities to facilitate licensing of satellite services to support the humanitarian use of satellite such health services, disaster management, eLearning and epidemiological surveillance, especially in remote areas of Pakistan.


Recommendations for implementation of

space technology in public health in Pakistan

Establishment of collaborative programmes at the national level (Space agency, finance, health and telecommunication authorities) to:

Develop integrated national systems for the management of health data and link the systems to digital maps for use by technical programmes,

Build, develop and maintain a comprehensive collection of national and provisional digital maps including detailed administrative, health levels, water resources, transportation, hazardous areas, disaster-prone areas and health care facilities. Develop,

Support capacity building to acquire and use satellite images, converting them to digital maps and linking them to health data through integrated geographic information systems.


(Space agency, finance, health and

telecommunication)

Collaborate with WHO to develop Pakistan national eHealth strategy, roadmap and plans through:

Strengthening human and institutional capacity at the government level to conduct national eHealth planning.

Ensuring high-level political commitment to lead the process.

Providing technical expertise during the planning process in specific areas identified and requested by implementing agency.

Facilitating knowledge sharing at country levels and link at regional and global level.


Thank you

Q / A

Documents

National Space Conference, Pakistan · 2013. 10. 30. · National Space Conference, Pakistan National Space Conference Role of WHO in promoting space technology for health: tele-health