The (m)Health Connection: An Examination of the Promise of Mobile Phones for HIV/AIDS Intervention in Sub-Saharan Africa

This thesis offers an examination of the complex opportunities and challenges that characterize the development of innovative, locally appropriate, sustainable, and scalable uses of mobile phones as instruments to support and advance HIV/AIDS work in sub-Saharan Africa. Drawing together the fields of ICT4D and health communication, this thesis establishes a theoretical framework for mobile health (mHealth) interventions in developing countries from a critical media studies perspective. It interrogates the varied applications of mobile phones vis-à-vis health that have been identified, promoted, or piloted in sub-Saharan Africa and elsewhere in the Global South, focusing on the potential for mobile phones to enhance two interrelated aspects of HIV/AIDS work: 1) scaling-up prevention and awareness programs; and 2) enhancing access to treatment, care, and support for people living with HIV. By critically examining real-life applications, focusing in particular on a case study from South Africa (the pioneering mHealth organization Cell-Life), this thesis explores both the opportunities presented by the increasing ubiquity of mobile phones in this region, and the corresponding challenges, limitations, and critical issues that inhibit effective realization of mHealth’s potential in this context

Sustainable technologies for older adults

: The exponential evolution of technology and the growth of the elderly population are two phenomena that will inevitably interact with increasing frequency in the future. This paper analyses scientific literature as a means of furthering progress in sustainable technology for senior living. We carried out a bibliometric analysis of papers published in this area and compiled by the Web of Science (WOS) and Scopus, examining the main participants and advances in the field from 2000 to the first quarter of 2021. The study describes some interesting research projects addressing three different aspects of older adults’ daily lives—health, daily activities and wellbeing—and policies to promote healthy aging and improve the sustainability of the healthcare system. It also looks at lines of research into transversal characteristics of technology. Our analysis showed that publications mentioning sustainability technologies for older adults have been growing progressively since the 2000s, but that the big increase in the number of research works in this area took place during the period 2016–2021. These more recent works show a tendency to study those factors that improve healthy aging, ensure the social inclusion of the elderly through technology and prolong the time in which they can live independent lives thanks to smart environments. Current research gaps in the literature are also discussed.: This work was funded by the Spanish Ministry of Economy, Industry and Competitiveness, (CSO2017-86747-R) and supported in part by the FEDER/Ministerio de Ciencia, Innovación y Universidades-Agencia Estatal de Investigación, through the Smartlet and H2O Learn Projects under Grants TIN2017-85179-C3-1-R and PID2020-112584RB-C31, and in part by the Madrid Regional Government through the e-Madrid-CM Project under Grant S2018/TCS-4307

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;

How the healthcare-seeking socio-cultural context shapes maternal health clients' mHealth utilisation in a Kenyan context

Problem Statement: Many developing countries are still grappling with poor health as a result of strained healthcare systems. Top among health inequalities is maternal care with maternal mortality rates being almost 19 times higher in developing countries than in their developed counterparts. mHealth presents the potential for developing countries to overcome some of the traditional healthcare challenges. However, despite the compelling evidence for the potential of maternal mHealth from the plethora of effectiveness studies, why when and how interventions work/do not work in different contexts are not fully understood. Socio-cultural factors are one of the most cited reasons for variance in uptake and utilisation of such technologies. To date, research explaining how socio-cultural factors shape mHealth utilisation is sparse. Purpose of the study: The main objective of the study was to explain how mHealth utilisation behaviour emerges within the healthcare-seeking socio-cultural context. To achieve the objective, the study identified the socio-cultural characteristics of the maternal healthcareseeking context and analysed the user-technology interaction within this context. Research methodology: Building on the foundation that human experiences are best understood in situ, the study adopted explanatory methods guided by an interpretivist paradigm. The study drew upon Activity Theory as a lens to understand the maternal mHealth utilisation phenomenon. Hence, we theorised healthcare-seeking as an activity whose cultural aspects were further understood using Hofstede typology of culture. The study used a Kenyan maternal mHealth intervention to elucidate the phenomenon. We employed semi-structured interviews, focus group discussions, observations, informal discussions, and document review to gather data. The sample was purposively selected and comprised various maternal health stakeholders: maternal health clients, their partners, project implementers and healthcare professionals. Key findings: The results of the study show that the healthcare-seeking socio-cultural context which is characterised by socio-cultural attributes such as high-power distance, high uncertainty avoidance, gendered relations, and collectivism shapes mHealth utilisation behaviour in a dialectical process. This process takes place as maternal health clients shape and are shaped by mHealth within their healthcare-seeking socio-cultural context through a process of internalisation and externalisation. From an internalisation perspective, uncertainties and risks in the maternal healthcare-seeking context resulted in hesitated adoption. Contextual perceptions of usefulness of the intervention resulted in the use of mHealth to substitute other healthcare structures while having different perceptions of the role of mHealth created dissonance among the maternal health clients. With regards to externalisation, maternal health clients adopted legitimisation strategies to reduce uncertainties and to develop trust required for initial and continued use of the intervention. They legitimised both the intervention artifact, and the information. Since the mHealth intervention presented appropriate social cues, being accompanied by the expected health provider's persona, maternal health clients readily humanised the intervention. The contextual social norms around pregnancy also presented a need for the maternal health clients to make their mHealth use an ‘appropriate behaviour' by negotiating use with relevant stakeholders in the context. Finally, in response to mHealth technology paradoxes that challenged the very motive of healthcare-seeking, maternal health clients coped by abandoning mHealth, or otherwise accommodating it. Originality/contribution: This study contributed to knowledge, theory, and practice. First, the study suggests theoretical propositions that explain how mHealth utilisation behaviour emerges. These findings may be useful to similar developing-country contexts. A further contribution to theory emerges from the use of Activity Theory to understand the phenomenon. The study helps to operationalise Activity Theory concepts in Information Systems research. Second, the study provides recommendations to practise with regard to the design and implementation of mHealth interventions. These insights may be useful to mHealth designers and implementers in designing mHealth solutions that are contextually relevant. Here, we propose the consideration of mHealth intervention characteristics that will aid utilisation, involving healthcare professionals and other community stakeholders in mHealth implementation and integrating mHealth into existing healthcare structures

Social networking services in support of patient centred care: a South African perspective

In an effort to improve the South African healthcare system, the Department of Health in South Africa is investing in National Health Insurance to support and deliver access to quality healthcare services within affordable boundaries. Enhanced delivery and quality of care to patients is supplemented through an increased emphasis on the adoption of eHealth technologies and systems. Within the context of efforts to improve access to quality and affordable healthcare services, there is also increasing awareness of the need to adopt a patient centred care approach as a means of caring for the patient, rather than only caring for the disease. Patient centred care emphasises the need for patients to be actively involved in the decision making process with regards to their needs and treatment. Social networking is viewed as a useful tool to support patient centred care and to improve on healthcare delivery. The use of social networking services beyond the healthcare context has increased exponentially. This has lead to increased interest in the application of social networking in healthcare. This leads to the problem statement of this research, which is the proliferation of social networking services and the lack of understanding of the prospect of social networking services for patient centred care in South Africa. In order to address this problem, the research investigates three areas of focus, namely patient centred care, the South African healthcare sector and social networking services. This generates an understanding of the meaning of patient centred care in general, and also in this study; the status quo in South African healthcare and the incorporation of patient centred care within selected strategic healthcare directives; social networking services in general as well as its application in healthcare; and the factors affecting the use of social networking services for patient centred care in the South African healthcare context. The factors are analysed to explore the prospects of social networking services for patient centred care in South African healthcare. The outcome of this analysis represents a useful input for healthcare providers and administrators in government

Making sense of wearables:new-emerging markets and mediascapes

This document reports on the events of the networking/embedding event, organised by the Epinet WP3 team in Brussels Nov 2013. It summarises observations and key findings. The aim of the event was to involve the expertise of professionals from a range public and private agencies involved in the development of wearable sensor technologies and ICT innovation policy. We learn from their input of new-emerging roles for wearable sensors, how they are situated in visions of the future of healthcare and self care, of changing lifestyles and occupations. We learn of complications in clinical practice and in medical devices regulation. We learn of expectations, of what personalisation can stand for, of conceptions of behaviour and of well-being more generally. Finally, we observe a distinct disconnect between top-down policy developments on the future delivery of personalised healthcare to European citizens and grass-roots developments in self care and in the self-management of medical conditions. The results of this consultation are key to finalising the embedding stage of the case study on wearable sensors, and they provide major input into our attempts to integrating the many different assessments of this innovation domain

ICT-Enabled Social Innovation to support the Implementation of the Social Investment Package: Mapping and Analysis of ICT-enabled Social Innovation initiatives promoting social investment in integrated approaches to the provision of social services: IESI Knowledge Map 2015

This report presents the analysis of the Mapping 2015 of the project 'ICT-enabled Social Innovation to support the Implementation of the Social Investment Package' (IESI). It provides an enriched picture of the existing knowledge base and evidence of how ICT-enabled social innovation initiatives that promote social investment through integrated approaches to social services delivery can contribute to the policy objectives of the EU Social Investment Package (SIP) to support the achievement of the goals of the EU 2020 strategy in terms of inclusive growth and employment. After having introduced the policy and research background outlining the overall objectives and scope of the IESI research and the aim of the mapping 2015, the report provides an overview of the methodology followed for enriching the IESI inventory of ICT-enabled social innovation initiatives through a structured dynamic database and by conducting the mapping and analysis of a selected sample of 210 initiatives. The report then updates the review of the literature and practice in domains related to the role and impact of ICT-enabled social innovation promoting social investment, with a specific focus on the area of active and healthy ageing and long-term care for older people, particularly the theme: prevention, health promotion and rehabilitation. In reviewing the state of the art the report discusses the degree of deployment of ICT-enabled social innovations that promote social investment through integrated approaches to social services provision in terms of geographical spread and different areas of social services covered, providing insight into the levels and types of deployment achieved. Further, the IESI conceptual framework which underpins the research and which has been used to guide the mapping and analysis of initiatives is discussed, proposing additional dimensions in order to enrich the framework of analysis itself. Evolving theoretical approaches are taken into account, the aim being to better explain the implications ICT-enabled social innovation initiatives have or may have for social policy reforms. This is followed by an overview of the consolidated results of the analysis of the initiatives collected as part of the IESI mapping exercise in 2014 and 2015. The analysis presents the IESI Knowledge Map 2015, which aims to provide a better understanding of the main characteristics and patterns of the initiatives identified, according to the IESI conceptual framework. Reference is also made to the different welfare systems and social services delivery models which characterise various EU countries in order to contextualise the potential role played by ICT-enabled social innovation to promote social investment through integrated approaches to social services delivery. The findings of specific thematic analyses conducted on a set of selected topics: 1) the role of social enterprise-driven ICT-enabled social innovation initiatives in support of social services delivery; and the implications of ICT-enabled social innovation that promote social investment through integrated approaches to social services delivery in support of: 2) active inclusion of young people; and 3) active and healthy ageing and long-term care for older people, particularly as regards prevention, health promotion and rehabilitation are then presented. Finally, the main conclusions deriving from the analysis of the mapping in terms of the contribution made by ICT-enabled social innovation promoting social investment through integrated approaches to social services delivery to the implementation of the SIP are outlined. This is complemented by an analysis of the gaps identified; the limitations of the current mapping exercise and recommendations for future research, as well as implications and possible directions for policy.JRC.J.3-Information Societ

State of the art on ethical, legal, and social issues linked to audio- and video-based AAL solutions - Uploaded on December 29, 2021

Ambient assisted living (AAL) technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between high-income countries (HIC) and low and middle-income countries (LMIC). Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things (IoT) devices and ones equipped with artificial intelligence (AI) quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private (e.g., the home). The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues (ELSI). A set of ELSI guidelines is needed to integrate these factors at the research and development stage