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Technology, Health And Media- Searching For Breakthroughs

by Deepa Bhalerao June 10 2015, 4:24 pm Estimated Reading Time: 8 mins, 58 secs

August 1994- Sitting in a state transport bus on way to a remote village in the Gadchiroli district of Maharashtra, I was marvelling at the greenery all around. There weren’t many people on the narrow road. The bus trundled along at a brisk pace, the driver taking care to slow down and sound the horn at every turn, just in case a herd of cattle or a group of women carrying firewood or a bullock cart was coming in from the opposite side.

The monsoons had just touched this part of the state and the weather had suddenly changed to a joyful green from the scorching heat that was earlier bearing down with the mercury lingering between 45 and 47 degrees through the previous two months.

The road trip took more than six hours and having started at 6 am, I was hoping to have a busy day packing at least 3 sessions with the youth, the pregnant women and young mothers. I was armed with a set of new laminated posters in Marathi and brand new equipment for the Multipurpose Worker. This was going to be a fruitful day.

A few minutes into the last hour before we reached, it started raining very hard. The bus slowed down and finally came to a halt. One of the small bridges connecting one village to another was not visible owing to the rise in the water levels of the river. There was nothing to do but wait.

The rain did not stop for the next four hours. When it did, the bridge was still not visible. We had to return to a place where there was a bus station, so we could wait till the flood waters receded.

Two days on Parle G biscuits and tea, and I was beginning to wonder why I had taken up community health work.

After the floods receded, I decided to go ahead to my destination anyway. The work that lay ahead was different now. Together with the community volunteers, I had to deal with flood relief and waterborne diseases. We had to make a plan and evacuate the pregnant mothers and those with young children to safer, drier places.

My glossy health education charts had to wait a few months before they could be used in the field.

Twenty one years ago, we had to wait for news to reach us or had to stumble upon it when we went to the field. Today, we have better means of keeping ourselves informed. With mobile phones, internet and social media, we can get a first hand glimpse of a ground situation even as it unfolds.

Among the different areas it has touched, technology and new media has impacted healthcare in a profound way.

Tertiary care has improved in a major way with the use of state of the art technology. We have sophisticated diagnostic techniques that reduce the need for invasive surgery and provide information with high levels of accuracy wherever surgical intervention is required. Surgery has refined to an extent where very high levels of proficiency is guaranteed with the help of complex equipment and machines.

In primary health care, crucial aspects like monitoring of pregnancies and infant care, we have ways and means of anticipating problems long before they become emergencies, and tools to address all kinds of probabilities.

And yet, the health indicators show that a lot less is achieved in terms of tangible results on the ground than is possible.

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Key facts from World Health Statistics 2015 Report

– Life expectancy at birth has increased 6 years for both men and women since 1990.

– Two-thirds of deaths worldwide are due to non-communicable diseases.

– Over one-third of adult men smoke tobacco.

– Only 1 in 3 African children with suspected pneumonia receives antibiotics.

– 15% of women worldwide are obese.

– One quarter of men have raised blood pressure.

– In some countries, less than 5% of total government expenditure is on health.

– The world is unlikely to meet the MDG target on access to basic sanitation.

– Around 1 billion people have no access to basic sanitation and are forced to defecate in open spaces such as fields and near water sources. Lack of sanitation facilities puts these people at high risk of diarrhoeal diseases(including cholera), trachoma and hepatitis.

– In some countries, more than one-third of births are delivered by caesarean section.

– In low- and middle-income countries, only two-thirds of pregnant women with HIV receive anti-retrovirals to prevent transmission to their baby.

– The number of women who died due to complications during pregnancy and childbirth has almost halved between 1990 and 2013. This rate of decrease won’t be enough to achieve the targeted reduction of 75% by the end of this year.

– The maternal mortality ratio has fallen in every region. However, 13 countries with some of the world’s highest rates have made little progress in reducing these largely preventable deaths.

– In the WHO African Region, 1 in 4 women who wants to prevent or delay childbearing does not have access to contraceptives, and only 1 in 2 women gives birth with the support of a skilled birth attendant.

– Less than two-thirds (64%) of women worldwide receive the recommended minimum of 4 antenatal care visits during pregnancy.

– Since 1990, child deaths have almost halved – falling from an estimated 90 deaths per 1000 live births to 46 deaths per 1000 live births in 2013.Despite great advances, this is not enough to reach the goal of reducing the death rate by two-thirds. Less than one third of all countries have achieved or are on track to meet this target by the end of this year.

–The top killers of children aged less than 5 years are now: preterm birth complications, pneumonia, birth asphyxia and diarrhoea.

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If we have the methods, then why is this gap so obvious?

There are new methods and tools on the one hand, and the underserved populations on the other. What are the various ways in which they can be connected?

Looking at the first needs of healthcare seekers, they fall into the following broad categories.

(i) Health information on development and lifecycle issues, illnesses and chronic conditions– Accurate, timely and relevant health information is the first step to any health intervention. This is a vast area that ranges from readymade tip-sheets on health conditions, to interactive forums on specific diseases and training material for healthcare professionals.

(ii) Information on Health Systems and their functioning. This facilitates easy access and reduces time wasted on searching and waiting for appointments.

(iii) Information in case of Health Emergencies- Proceduresto be followed and Outreach details

(iv) Information on Disaster Management Protocol– Procedures to be followed and Outreach details

Each of the above interventions require a different skill set to address it. Health Education would be created by compiling accurate information from experts and transforming it into a format that would be easily understandable by the receivers. Details on the existing network of Health Systems from the primary health care to the tertiary care outfits need to be accessible to everyone. Health Emergency outreach details and information on procedures needs to be created and maintained in a way that the maximum number of people can avail of it. Disaster management is another crucial issue that comes under the ambit of health as rescue and relief is an integral part of any health intervention in a difficult situation like earthquakes, floods, accidents etc. Some of the above would all encompass a helpline for specific queries.

As the thread that connects the provider to the receiver is where media assumes importance.

Media in its different forms, serves to inform, educate and entertain. We have moved from static printed knowledge to sophisticated audio-visual interactive forms even in primary school classrooms. We have state-of-the-art gaming experiences that easily plunge us into alternate realities. We stay connected through social media platforms.

Adapted well, the available tools and platforms can be that those much- needed bridges to connect the needy to the resources, be they information, services or protocols.

The contemporary term mHealth best describes it. mHealth encompasses the practice of medicine and public health supported by mobile devices where relevant and recent information is made available through cell phones, tablets and laptop computers.

SomemHealth technologies include:

-Patient monitoring devices

– Mobile telemedicine/telecare devices

– MP3 players for mLearning

– Microcomputers

– Data collection software

– Mobile Operating System Technology

– Mobile applications (e.g., gamified/social wellness solutions)

According to Wikipedia, “The mHealth field operates on the premise that technology integration within the health sector has the great potential to promote a better health communication to achieve healthy lifestyles, improve decision-making by health professionals (and patients) and enhance healthcare quality by improving access to medical and health information and facilitating instantaneous communication in places where this was not previously possible. It follows that the increased use of technology can help reduce health care costs by improving efficiencies in the health care system and promoting prevention through behaviour change communication (BCC). The mHealth field also houses the idea that there exists a powerful potential to advance clinical care and public health services by facilitating health professional practice and communication and reducing health disparities through the use of mobile technology.”

As news trickles in steadily from all quarters on how new forms of media impact health interventions, outreach, and dissemination of health information, there is a renewed sense of hope that, as partners to health-educators and healthcare providers, the existing vibrant variety of media will prove to be that crucial link whichassists in reaching out to the ones in need.

A strong focus on achievable goals, consistent communication with all the stakeholders, a carefully designed plan, and the willingness to try innovative methods will ensure success in the endeavour.

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