Adopting Digital Technology in Midwifery Practice – Experiences and Perspectives From Six Projects in Eight Countries (2014 – 2016)

This paper describes the cases of six midwifery projects of the Women Observatory for eHealth at the Millennia2025 Women and Innovation Foundation, to support the adoption of information and communication technologies (ICTs) in midwifery practice in eight countries from 2014 to 2016. The WeObservatory is a digital inclusion incubator aimed at reducing maternal and neonatal mortality in countries with limited resources by strengthening midwifery practice through the access to ICTs and eHealth applications. This paper describes how the collaboration with the WeObservatory supported these projects in the development and adoption of digital solutions for midwifery practice. It examines responses from the project leaders to an online survey conducted by the WeObservatory in January of 2018. Their responses provide insights on opportunities and challenges faced by these projects that can inform future midwifery eHealth projects. Building capacity among midwives for the adoption of digital competencies will help improve the quality of healthcare provided to mothers and their newborn babies in low-income countries

A systematic review of reviews to identify key research opportunities within the field of eHealth implementation

Introduction: This paper is a systematic review of the relevant literature surrounding the implementation and utilisation of eHealth to identify key challenges and opportunities to future eHealth applications. Methods: NHS Evidence, PubMed, IEEE Explorer, Cochrane Library and JMIR Publications were all searched for reviews published between 1 January 2010 and 30 June 2017. Results: A total of 47 papers met the final inclusion criterion. The published literature focused on a wide array of challenges categorised into five areas, facing the implementation and utilisation of eHealth; from this, four areas of opportunity to advance eHealth were identified. Discussion: The five challenge areas are (C1) stakeholders and system users, (C2) technology and interoperability, (C3) cost-effectiveness and start-up costs, (C4) legal clarity and legal framework and (C5) local context and regional differences. The four opportunity areas are (O1) participation and contribution, (O2) foundation and sustainability, (O3) improvement and productivity and (O4) identification and application. Conclusion: The literature analysed in this systematic review identifies design and implementation priorities that can guide the development and utilisation of future eHealth initiatives

eHealth Conversations : using information management, dialogue, and knowledge exchange to move toward universal

The publication of eHealth Conversations, developed with the support of the Spanish Agency for International Development Cooperation (AECID), represents a major step forward for the PAHO/WHO Strategy, since it explores ways of implementing regional mechanisms with free and equitable access to information and knowledge sharing. These initiatives aim to advance the goals of more informed, equitable, competitive, and democratic societies, where access to health information is considered a basic right. This publication is one of the instruments used by PAHO/WHO to develop the initiatives outlined in the Strategy, which coincides with the global eHealth strategy. One of the fundamental needs for the improvement of eHealth is the dissemination of information, and PAHO/WHO is assuming a leading role in this effort. The development of this new electronic publication is a key step in disseminating information that will be useful for decision makers on applying these technologies for the health of the Americas. This electronic book is one of the products of PAHO/WHO’s project: “eHealth Conversations: Using Information Management, Dialogue, and Knowledge Exchange to Move Toward Universal Access to Health.” Participants in these conversations included experts on electronic health and other specialties. Through virtual dialogues, the experts contributed with knowledge and reflections on the present and the future of eHealth in the Americas, analyzed the situation, and made recommendations for the implementation of electronic health initiatives. These recommendations are not only intended for PAHO/ WHO, but also for governments and the private sector. The aim of the project is to guarantee the convergence of local, national, and regional initiatives regarding the adoption and application of ICTs for public health, with special attention on critical issues in this field. It also intends to strengthen individual and collective capacities of health workers and institutions, connecting them in a network of on-line health networks, as well as to reinforce the PAHO/WHO eHealth program.Acknowledge the Spanish Agency for International Development Cooperation (AECID) for its financial support in preparing this publication and developing the project titled “eHealth Conversations: Using Information Management, Dialogue, and Knowledge Exchange to Move Toward Universal Access to Health;

Application of information and communication technologies for health systems in Belgium, Denmark, Spain, the United Kingdom and Sweden

Incluye BibliografíaThis document describes and analyzes implementation of eHealth in several European countries, as well as strengths and weaknesses, using this experience in order to support the management and execution of this kind of projects in other scenarios. Five EU member States evidencing different degrees of advancement in their national eHealth projects have been selected for this purpose: Belgium, Denmark, Spain, the United Kingdom and Sweden. In addition to these five cases, a brief study has been made of several international collaboration projects for the implementation of cross-border spaces for eHealth that most of these countries are currently participating in

Towards a better understanding of the intention to use eHealth services by medical professionals :the case of developing countries

PhD ThesisHealthcare services are a necessity for every country, and particularly in developing countries, where the shortage of medical professionals is greatest. To resolve this issue, it requires substantial resources that are not available. Therefore, the recent advancement in Information and Communication Technology (ICT) provides the platform for innovative eHealth services and the opportunity for improving access to medical services. Despite Governments, International Organisations, and companies‟ growing interest in eHealth Services for enabling access to medical treatment using ICT, research in developing countries related to user behavioural intention of these services remains relatively scarce. This is a research study to identify and measure the motivational factors that would expedite the introduction and widespread use of eHealth services in developing countries. More specifically, it endeavours to understand what factors would motivate medical professionals to successfully adopt eHealth Services. The study aims to identify and measure the determinants that would lead to successful adoption of eHealth services. This thesis is, thus, a services marketing study. To achieve this goal, a literature review was conducted in order to develop an original conceptual model of eHealth services in developing countries. Based on the literature review, an exploratory qualitative study was undertaken to assess awareness and gain insight into specific motivational factors which are incorporated into the original conceptual behavioural model. A reliable and valid model to measure behavioural intention to use eHealth services in developing countries was developed. This model incorporates several influencing factors determining usage intention and the analysis also tests a set of hypotheses covering moderating effects. The experimental fieldwork was conducted in cooperation with the International Telecommunications Union Study Group on eHealth and with local medical institutions in several developing countries having formalized cooperation agreements with the University where the researcher works. The study draws on responses from a sample of 549 medical professionals from ten developing countries. As the nature of this study is exploratory, factor and multiple regression analysis were used to test the hypotheses.This thesis answered the research questions, “What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries”, and the managerial sub-questions, “What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? Can medical professionals be segmented on the basis of eHealth early adoption dimensions? What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? The main contributions of this thesis to theory and practice are as follows: Overall Research Question: - What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries? Value-added #1: Created a new unique behavioural intention model for developing countries (did not exist before) Value-added #2: Validated and measured new influencing factors Value-added #3: Validated new scales for a new domain, eHealth and in a new context, developing countries The Managerial sub-questions are: - What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? - Can medical professionals be segmented on the basis of eHealth early adoption dimensions? - What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? Value-Added #4: Principles of marketing strategies developed based on measured influencing factors Value-added # 5: Identified the early adopters of eHealth services based on moderation effects Value-added #6: Developed a Segmentation and positioning framework This study contributes to academic theory through the creation of a behavioural intention model for eHealth services in developing countries, and by extending and modifying the UTAUT model to a new service (eHealth) and a new environment (developing countries). eHealth has not reached critical mass and this research study aims to move this new innovative service from pilot to full-scaled schemes. The study contributes to management practice by providing a new understanding of the factors that would encourage medical professionals and medical administration to use eHealth Services. These results can be used to develop principles for a marketing strategy framework aimed at providers of eHealth services in the private sector. Specifically, this thesis identifies the early adopters of these services and proposes a market segmentation and positioning strategy focused on the key stakeholders in this field. The results of this study can also inform international bodies tasked with promoting eHealth solutions in developing countries, such as the International Telecommunications Union Development Sector to help in the progression of eHealth services in developing countries. eHealth is an important international topic and is on the agenda of international and governmental organisations, such as: the International Telecommunications Union (ITU), the World Health Organisation (WHO), the European Union (EU), and others for more than ten years. However, the diffusion of eHealth services is rather slow and for this reason it is important to understand the main obstacles and user influencing factors for developing an applied marketing strategy

The Impact of the Digital Health Interventions in Curbing COVID-19 in Zimbabwe

Amid ongoing research about, Digital Health Interventions (DHI) in Zimbabwe, is the largely overlooked impact of DHI to mitigate the spread of COVID-19. To contribute towards filling this knowledge gap, the study seeks to examine the DHI strategies that have been adopted to curb the inimical effects of COVID-19 in Zimbabwe. DHI such as telemedicine, use of social media, Electronic Medical Records (EMRs), Mobile Health (mHealth), and Healthcare Information Systems (HIS) have been disposed to curtail the spread of COVID-19. The limitations and hurdles crippling DHI are discussed extensively. This study adopts a qualitative research design, comprising personal and targeted interviews and documentary review. Preliminary findings are that DHIs are effectively working for employing routine and innovative forms of Information and Communications Technology (ICT) to address health needs. However, the research noted that various factors such as corruption lack of funding, shortage of qualified workforce and medical expertise, and weak healthcare infrastructure are militating against robust deployment of DHIs. This study includes measures that can be adopted to address these challenges

The Development of eServices in an Enlarged EU: eGovernment and eHealth in Estonia

In 2005, IPTS launched a project which aimed to assess the developments in eGoverment, eHealth and eLearning in the 10 New Member States at national, and at cross-country level. At that time, the 10 New Member States were Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, and Slovakia. A report for each country was produced, describing its government and health systems and the role played by eGovernment and eHealth within these systems. Each report then analyzes, on the basis of desk research and expert interviews, the major achievements, shortcomings, drivers and barriers in the development of eGovernment and eHealth in one of the countries in question. This analysis provides the basis for the identification and discussion of national policy options to address the major challenges and to suggest R&D issues relevant to the needs of each country ¿ in this case, Estonia. In addition to national monographs, the project has delivered a synthesis report, which offers an integrated view of the developments of each application domain in the New Member States. Furthermore, a prospective report looking across and beyond the development of the eGoverment, eHealth and eLearning areas has been developed to summarize policy challenges and options for the development of eServices and the Information Society towards the goals of Lisbon and i2010.JRC.J.4-Information Societ

Accountability in Health Systems and the Potential of mHealth

The rapid spread of information and communication technologies (ICTs) (and of mobile phones in particular) across low- and middle-income countries (LMICs) has generated considerable excitement in development circles regarding their potential to revolutionise service delivery in health systems. Broadly speaking, such innovations, widely referred to as mHealth, make possible new ways of collecting, collating and managing health and health service-related data, and novel means of communication between and among citizens, civil society, health service personnel and government actors. This can empower citizens to better understand, care and advocate for their own health; health workers to deliver improved services; and government actors to enforce or build health policies that uphold the health rights of all citizens, including poor and marginalised groups who are often systematically excluded from health systems. As mHealth is in its infancy, and most projects to date have been small in scale, this potential is still being tested. Furthermore, most research has focused on the extent to which mHealth has improved service delivery and/or health outcomes in the short term. There has been little explicit attention given to whether and how mHealth might improve accountability for public health services – that is, to what extent mHealth can enhance citizens’ abilities to demand improved services from providers and government in line with their rights, and/or augment the capacity and willingness of providers and government to respond to citizens’ needs and demands – both in the short and the long term. This Working Paper aims to begin to fill this gap by exploring literature on accountability in health systems and on mHealth and to build theoretical and empirical bridges between them. In so doing, we lay out a clearer understanding of the role that mHealth can play in accountability for public health services in LMICs, as well as its limitations. At the centre of this role is technology-facilitated information which, for instance, can help governments enforce and improve existing health policy, and which can assist citizens and civil society to communicate with each other to learn more about their rights, and to engage in data collection, monitoring and advocacy. Ultimately however, information, facilitated as it may be by mHealth, does not automatically lead to improved accountability. Different forms of health care come with different accountability challenges to which mHealth is only variably up to task. Furthermore, health systems, embedded as they are in diverse political, social and economic contexts, are extremely complex, and accountability requires far more than information. Thus, mHealth can serve as a tool for accountability, but is likely only able to make a difference in institutional systems that support accountability in other ways (both formal and informal) and in which political actors and health service providers are willing and able to change their behaviour.Future Health Systems Research Programme ConsortiumMaking All Voices CountUnited States Agency for International DevelopmentSwedish International Development Cooperation AgencyOmidyar NetworkUK Department for International DevelopmentEconomic and Social Research Counci