How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

Private Enterprise for Public Health: Opportunities for Business to Improve Women's and Children's Health

This guide, developed by FSG and published by the Innovation Working Group in support of the global Every Woman, Every Child effort, explores how companies can create shared value in women's and children's health. The document sets out opportunities for multiple different industries to develop new product and services, improve delivery systems and strengthen health systems that can support global efforts to save 16 million women's and children's lives between now and 2015. It particularly notes that companies need not wait for health services to "catch up" with their economic model, but rather they can work proactively to help accelerate change, by partnering with other industries, civil society and the public sector to create collective impact in a specific location. The aim of the guide is to catalyze these transformative partnerships

How Aids Changed Everything - MDG 6: 15 Years, 15 Lessons Of Hope From The Aids Response

The AIDS targets of Millennium Development Goal (MDG) 6 -- halting and reversing the spread of HIV -- have been achieved and exceeded, according to this report. Released in Addis Ababa, Ethiopia, on the sidelines of the Third International Conference on Financing for Development, the report demonstrates that the response to HIV has been one of the smartest investments in global health and development, generating measurable results for people and economies. It also shows that the world is on track to meet the investment target of US$22 billion for the AIDS response by 2015 and that concerted action over the next five years can end the AIDS epidemic by 2030.The report celebrates the milestone achievement of 15 million people on antiretroviral treatment -- an accomplishment deemed impossible when the MDGs were established 15 years ago. It also looks at the incredible impact the AIDS response has had on people's lives and livelihoods, on families, communities and economies, as well as the remarkable influence the AIDS response has had on many of the other MDGs. The report includes specific lessons to take forward into the SDGs, as well as the urgent need to front-load investments and streamline programs for a five-year sprint to set the world on an irreversible path to end the AIDS epidemic by 2030

Task Shifting To Nursing For A Sustainable Staffing Model Of School-Based Health Center In Under-Resourced Areas

Background: There is a well-established link between health and education (Bundy and Guyatt 1996). An efficient and cost effective way to increase access to care is through school-based services. Methods: The purpose of this study is to develop a sustainable staffing model of a school-based health center in a country with limited health care resources. Two specific steps towards developing such a model are: (1) to critically review and analyze the evidence in the literature supporting an expanded nursing care practice model for the school-based health center, and (2) to merge the literature review findings with participatory field notes taken at a rural Kenyan school. An integrative review was triangulated with observational field notes. Online databases were reviewed. Data from 17 articles was compiled into a summary table. Field notes and transcriptions of recordings were categorized by the following themes: identified stakeholders, local health needs, local health practice, and local health services. The findings from the review were triangulated with the findings from participatory field notes of informal discussions and governmental documents. Results: The findings suggest equivalent outcomes between nurse-led care and physician-led care. Stakeholder involvement is key to addressing potential barriers. From these findings, a nurse-staffed, school-based health center model was developed, focusing on the nurse as the care provider. The nurse-staffing model identifies key institutional and governmental influences and their impact on the ability to achieve the goal of providing affordable, accessible, and acceptable quality health care for students in rural, under-resourced areas. Conclusion: The evidence from the review supports the nurse-staffed, school-based health center model and deems it an effective strategy for offering high quality, cost effective care to children in under resourced areas

Volume 5 #2 Full Issue

Volume 5 #2 Full Issu

Leveraging Knowledge-Based Approaches to Promote Antiretroviral Toxicity Monitoring in Underserved Settings

As access and use of antiretroviral therapy continue to increase, the need to improve antiretroviral toxicity monitoring becomes more critical. This is particularly so in underserved settings, where patterns of antiretroviral toxicities possibly alter the need for and frequency of antiretroviral toxicity monitoring. However, barriers such as few skilled healthcare providers and poor infrastructure make antiretroviral toxicity monitoring in underserved settings difficult. The purpose of this dissertation was to investigate how standard clinical guidelines, knowledge-based clinical decision support, and task delegation could be leveraged to overcome barriers to antiretroviral toxicity monitoring in underserved settings. The strategy adopted in this dissertation was guided by the Design Science Research Methodology that emphasizes the generation of scientific knowledge through building novel artifacts. Two qualitative descriptive studies were conducted to characterize the contextual factors associated with antiretroviral toxicity monitoring in underserved settings. Supported by the findings from these studies, a knowledge-based software application prototype that implements clinical practice guidelines for antiretroviral toxicity monitoring was developed. Next, a quantitative validation study was used to evaluate the structure and behavior of the prototype’s knowledge base. Lastly, a quantitative usability study was conducted to assess lay health worker perceptions of the satisfaction and mental effort associated with the use of checklists generated by the prototype. This dissertation research produced empirical evidence about the broad motives and strategies for promoting medication adherence, safety, and effectiveness in underserved settings. It also identified barriers and facilitators of antiretroviral toxicity monitoring within ambulatory HIV care workflows in underserved settings. Additionally, it provided evidence about the extent to which antiretroviral toxicity domain knowledge could be implemented in a knowledge-based application for supporting point-of-care antiretroviral toxicity monitoring. Lastly, the research provided previously unavailable empirical evidence about the perceptions of lay peer health workers on the use of checklists for the documentation of antiretroviral toxicities

Universal Access to Antiretroviral Therapy in Thailand: An Analysis of the Policy Process

Antiretroviral therapy (ART) is effective in reducing HIV morbidity and mortality as well as improving patients' quality of life. However, because of several hurdles, resource-poor countries have provided treatment to only a few people in need. Thailand is unusual in having opted to offer universal coverage for therapy. This thesis aims to understand the process by which ART reached the Thai Government agenda, and to explore the lessons learned from the design and implementation of the publicly-organised treatment programme. This study suggests that Thailand's ART programme was influenced by the networks and learning of several actors which evolved over time. During a period of policy continuity between 1992 and 2000, the policy process developed within a relatively closed subsystem dominated by health officials in the Disease Control Department and HIV experts. The cost of antiretrovirals was the major factor restraining treatment coverage. The dramatic shift in ART service towards universal access took place in 2001, as a consequence of drug price reduction and political transformation that allowed participation of new Health Minister, health financing reformists, and an alliance of non-governmental organisations (NGOs). Apparently, local and external treatment experiences inspired these actors to pursue similar paths in Thailand. The rapid policy formulation process was facilitated by common interests, shared experience, previously established collaboration, as well as awareness of interdependency among members of the Ministry of Public Health's Technical and Administration Panels. Learning about the intricacy in ART administration, especially from existing programmes and research studies in the country, played a crucial role in devising treatment expansion plans. The individual expertise of clinical specialists, researchers, health officials, NGOs and PL WHA helped to accelerate lesson drawing from policy feedback, anticipating future obstacles and selecting appropriate policy options. At the sub-national level, the process by which the universal ART policy was translated into action involved another set of actors, comprising hospital administrators, health professionals, officials in the Health Ministry's Regional and Provincial Offices, local NGOs and PLWHA groups. A key feature of policy in this phase was that the front-line workforce struggled to carry out the tasks prescribed by national policy makers. The discrepancy between the programme's expectation and actual therapy delivered in two study provinces was significant, resulting from insufficient number of experienced health personnel, increased workload as an effect of parallel reforms in the health and public administration systems, and stigma attached to HIV. To counter these impediments, treatment execution networks of government staff and civic groups were instigated. Collective learning among service providers, supporters and clients had an important role in ART scaling up. Different coping strategies were implemented in study hospitals, aiming to balance the contradictory goals of achieving the allocated targets while maintaining treatment quality. This thesis demonstrates that to understand policy development in such a complex circumstance governments cannot unilaterally deal with particular problems. Employing a policy network concept to address the partnership between state and non-state actors is not only useful but essential as the policy environment has expanded beyond merely state actions, to depend, to some extent, on non-state actors. Moreover, the integration of policy learning model into policy analysis framework can provide insights into the increasingly dynamic interactions between actors, context and processes of public policy in focus

The Emerging Threat of Drug Resistant Tuberculosis

Cite: Academy of Science of South Africa (ASSAf), (2011). The Emerging Threat of Drug Resistant Tuberculosis. [Online] Available at: DOI http://dx.doi.org/10.17159/assaf/0013An estimated 2 billion people, one-third of the global population, are infected with Mycobacterium tuberculosis (M.tb.), the bacterium that causes tuberculosis (TB) (Keshavjee and Seung, 2008). Spread through the air, this infectious disease kills 1.8 million people each year, or 4,500 each day (WHO, 2009a). TB is the leading killer of people with HIV, and it is also a disease of poverty—the vast majority of TB deaths occur in the developing world (WHO, 2009a). Exacerbating the devastation caused by TB is the growing threat of drug-resistant strains of the disease in many parts of the world. The development of drug resistance is a predictable, natural phenomenon that occurs when microbes adapt to survive in the presence of drug therapy (Nugent et al., 2010). Although antibiotics developed in the 1950s are effective against a large percentage of TB cases, resistance to these first-line therapies has developed over the years, resulting in the growing emergence of multidrug-resistant (MDR) and extensively drugresistant (XDR) TB, and even totally drug-resistant (TDR) TB (see Box 1-1 for definitions). In recognitionUS Academy of Science