e-Health Services in Rural Communities in the developing Countries
Essien, Eyo E. and Williams, Edem E.
Dept. Of Math/Stat & Computer Science, University of Calabar
Health service delivery to rural communities has always been a vexed problem for most governments in developing countries. Several factors impeding the success of government programmes in this sub-sector include corruption, inadequate supply of drugs, paucity and/poor quality of medical personnel, lack of medical equipment and facilities, cost (transportation to the hospital, medical bills) to the patients of obtaining medical attention and interference by unorthodox medical practitioners. This paper surveys the problems that inhibit provision of adequate preventive and curative health care to rural communities and suggests affordable and sustainable ways in which ICT can be used to solve these problems. Special emphasis is given to use of ICT for public enlightenment for preventive health care and also for the implementation of affordable access to curative health care.
Keywords: ICT, Tele-clinic, Health Care, Tele-conferencing, Ambulance Service Support System
Healthcare is the prevention, treatment, and management of illness and the preservation of mental and physical well being through the services offered by the medical, nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”
Health perspectives differ between rural and urban communities. The health perceptions of rural and urban residents significantly reflect their health-promotion behaviours, health maintenance, and illness treatment. Health care agencies, specialized services and infrastructure are usually less available to rural areas. Rural community members learn to distinguish between health impairments that can be tolerated for a period and those that will impede functioning. The poverty and long distances from health care providers influence the way those living in rural areas view health and address illness. Rural men and women of a variety of age groups have reported health as the ability to work and to perform one's usual activities. For example, rural workers have been found to tolerate pain for long periods and not allow it to interfere with their ability to work while urban residents concentrate in the comfort and life-prolonging aspects of health.1
Many of the public healthcare services like Public Health Centres (PHCs) and sub-centres in rural areas are not equipped and staffed to provide quality healthcare to the rural poor. This suggests the yawning divide between rural and urban healthcare services, between the rural poor and the well off. The new developments in healthcare have not percolated to the rural areas and this is a matter of great concern. There is therefore need to explore the ways and means to bring equity in access to health professionals and institutions between rural and urban areas.
Electronic health (e-health) describes the application of ICT across a whole range of functions that affect the healthcare industry when it comes to matters relating to health through the various solutions that exists2. E-health can also be described as any electronic exchange of health related data through an electronic connectivity for improving efficiency and effectiveness of health care delivery.3 The solutions that are provided through e-health initiatives within hospitals include Hospital Management Information Systems (HMIS), telemedicine services and Internet services.
Health Management Information System
The functions of a health information system are to monitor, inform and evaluate a health system and to make clinical and management decisions.4 Reliable and timely information on disease-specific treatment burdens within a health system is critical for the planning and monitoring of service provision. Health management information systems exist to address this need at national scales across Africa but are failing to deliver adequate data because of widespread underreporting by health facilities. Faced with this inadequacy, vital public health decisions often rely on crudely adjusted regional and national estimates of treatment burdens.5
There were days when patients relied on physicians for all the information concerning their health. But nowadays patients are constantly on the lookout for information regarding their health on the Internet hence by the time they arrive at the physician’s offices; they already have an idea concerning the disease that is bothering them.6,7 However the shot coming of this solution is computer illiteracy and internet unavailability.
Aims and Objectives
The main goal this research is to develop healthy and economically productive rural citizenship through facilitating affordable, reliable and high quality health information to the rural poor using ICT.
Specific Objectives of the work can be summarized as follows:
- To develop method of providing emergency healthcare to the rural poor
- To ensure safe delivery and motherhood in rural areas
- To develop a method of providing access to health information and making healthcare accessible to the poor.
- To facilitate quality medical care to the poor in remote rural villages.
- To bridge the gap of professional isolation.
Characteristics of human health conditions in rural developing countries
In this study we use Nigeria as an example of a developing country. It is our belief that what happens in Nigeria cuts across most developing countries.
There is a dearth of medical care facilities in Nigeria’s rural areas. Where health care centre exists, there is often absence of drugs; and where they are available, they are usually beyond the reach of the poor. Nigeria’s mortality and morbidity rates are amongst the highest in the world, with rural areas accounting for the majority of cases.8 Maternal and child mortality rates are particularly disturbing, accounting for the relatively low life expectancy in Nigeria.
The public healthcare in Nigerian rural areas has the following challenges:
(a) Access to healthcare
(b) Quality of healthcare service delivery
(c) Cost of healthcare
a) Access to healthcare
When people become ill, low-income households in rural areas continue to use home remedies, consult traditional healers and local providers who are often outside the formal healthcare system. Men have comparatively better access than women to healthcare options at all levels due to various socio-economic and cultural factors (including their easy mobility). The bicycle is the usual means of transport in rural villages and riding a bicycle by women is not a normal practice although tolerated in some rural communities. It is also important to say that a sick man is better attended than a sick woman. Poor women are most vulnerable to diseases and ill health as they live in unhygienic conditions, carry heavy child bearing burden, place little emphasis on their own healthcare needs, and encounter severe constraints in seeking healthcare for themselves. Fig 1 compares access to healthcare in urban and rural Nigeria.
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Fig 1. Comparisons of access to health services for rural and urban areas in Nigeria (source: 1995 WHO/UNICEF/UNFPA estimate of maternal mortality)