Submitted by admin on 23 June, 2006 - 09:28.
This evaluation looks at a project led by Massachusetts-based organisation SATELLIFE, to test the use of PDAs in healthcare environments in three African countries. The project put PDAs into the hands of physicians, medical officers, and medical students in different settings in order to demonstrate their viability and usefulness, especially for the collection of health data and dissemination of medical information. The project was conducted in Ghana, Uganda, and Kenya during December 2001-December 2002.
View: Executive summary | Public Announcement
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Executive Summary Healthcare is one of the leading issues affecting African development today. HIV/AIDS is devastating the continent, and that is only one aspect of the healthcare crisis. For example, malaria is by far the most lethal tropical parasitic disease, killing more people than any other communicable disease except tuberculosis (TB), and it is estimated to have cost Africa USD $100 billion over the last 30 years. Yet malaria, TB, and other diseases can be managed if promptly diagnosed and adequately treated, and in many cases prevention methods are relatively cheap and simple. But lack of information on treatments and disease management is often an underlying issue that hinders effective patient care and prevention. Information and communications technology (ICT) can play an important role in combating disease and improving healthcare. ICT can be used as a tool for collecting community health information to support decision-making; improving doctors' access to current medical information; linking healthcare professionals so they can share information and knowledge; and enhancing health administration, remote diagnostics, and distribution of medical supplies.
Even though ICT can help, the solution to Africa's healthcare crisis is not as simple as installing computers in every hospital and clinic and linking them to the Internet. Infrastructure and hardware mean nothing if ICT is not used effectively because it is not appropriate to the real needs of healthcare professionals at ground level, there is no locally relevant content available, healthcare providers are not trained to use it, or they cannot afford to use it. One ICT that offers promise is handheld computers - also called personal digital assistants or PDAs - which are widely used in the medical profession in the developed world. But PDAs are a relatively new technology in Africa, and little work has been done before now to demonstrate their utility as a tool for healthcare in developing countries.
This evaluation looks at a project led by Massachusetts-based organisation SATELLIFE, to test the use of PDAs in healthcare environments in three African countries. The project put PDAs into the hands of physicians, medical officers, and medical students in different settings in order to demonstrate their viability and usefulness, especially for the collection of health data and dissemination of medical information. The project was conducted in Ghana, Uganda, and Kenya during December 2001-December 2002.
Bridges.org was engaged as an outside consultant to conduct an independent evaluation of the PDA trial. The bridges.org evaluation focused on the aspects of the project implemented in Uganda and Kenya, and both qualitative and quantitative data was collected during site visits to Makerere and Moi Universities in October 2002.
This evaluation report presents the lessons learned in this project to inform decision-making about future uses of PDAs and other ICT for development. The intended audience for this evaluation includes: the Acumen Fund and its investors, SATELLIFE and its staff members, project partners, project participants, future donors, technology companies, other research and development organisations, government bodies, and other non-governmental organisations (NGOs).
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TABLE OF CONTENTS
1INTRODUCTION
2ABOUT THE SATELLIFE PDA PROJECT
2.1 Project overview
2.2 The institutions involved
2.3 The technology used
2.4 The medical reference materials used
2.5 Overview of implementation for the three project phases
2.5.1Ghana
2.5.2Uganda
2.5.3Kenya
3EVALUATION OBJECTIVES AND METHODOLOGY
3.1 Mid-term evaluations
3.2 The bridges.org evaluation
3.3 Limitations of this evaluation
4RESULTS OF THE EVALUATION
4.1 Physical access to technology
4.2 Availability and use of relevant content
4.3 Appropriateness and use of PDA for data collection in this environment
4.4 Appropriateness of technology to local conditions
4.5 Affordability of technology and content
4.6 Training and skills required for effective technology use
4.7 Need for and availability of technical support
4.8 Integration of technology use into daily routines
4.9 Socio-cultural factors that affect technology use
4.10 Confidence in technology use in terms of privacy, security, or cybercrime
4.11 Enthusiasm for technology use
4.12 The effects of the national legal and regulatory framework on technology use
4.13 Political will in government to enable widespread technology use throughout society 4.14 Impact of technology use on the community and larger society
4.15 Ideas and plans for future uses of PDAs
4.16 Key external challenges that may have limited technology use in this project
5MAIN FINDINGS, LESSONS LEARNED, CONSTRAINTS AND OPPORTUNITIES
5.1 Key findings of the evaluation
5.2 Key lessons learned in this project
5.3 Challenges that must be overcome
5.4 Opportunities for the future that emerged from this project
6CONCLUDING REMARKS
Annex 1. Timeline of project activities
Annex 2. Hot tips for PDA users, and list of additional reference materials for download
Annex 3. Project update, March 2002
Annex 4. Project update, May 2002
Annex 5. Project update, August 2002
Annex 7. SATELLIFE malaria survey – Uganda
Annex 8. COBES II survey evaluation – Kenya, May 2002
Annex 9. COBES IV survey evaluation – Kenya, August 2002
Annex 10. 6th-year students evaluation report – Kenya, August 2002
Annex 11. Mid-term evaluation report – Uganda, August 2002
Annex 12. Evaluation interviews, October-November 2002
Annex 13. Bridges.org questionnaire and summary of results – Uganda, October 2002
Annex 14. Bridges.org questionnaire and summary of results – Kenya, October 2002
Annex 15. Report on content challenges and solutions, May 2002
Annex 16. About bridges.org
Acknowledgments
We would like to thank the doctors, medical students, and medical school administrators in Kampala, Uganda and Eldoret, Kenya who took time out of their busy schedules to provide information for this evaluation. We especially appreciate the input we received from Dean N.K. Sewankambo of the Makerere University Faculty of Medicine and Dean B.O. Khwa Otsyula of the Moi University Faculty of Health Sciences, who welcomed us to their institutions. We applaud their leadership as local champions for practical, relevant technology use. Finally, we would also like to acknowledge the invaluable contribution of Fred Kakaire and HealthNet Uganda who helped us to organize the on-site visits and interviews.
