A hybrid model for managing personal health records in South Africa

Doctors can experience difficulty in accessing medical information of new patients. One reason for this is that the management of medical records is mostly institution-centred. The lack of access to medical information may negatively affect patients in several ways. These include new medical tests that may need to be carried out at a cost to the patient and doctors prescribing drugs to which the patient is allergic. This research investigates how patients can play an active role in sharing their personal health records (PHRs) with doctors located in geographically separate areas. In order to achieve the goal of this research, existing literature concerning medical health records and standards was reviewed. A literature review of techniques that can be used to ensure privacy of health information was also undertaken. Interview studies were carried out with three medical practices in Port Elizabeth with the aim of contextualising the findings from the literature study. The Design Science Research methodology was used for this research. A Hybrid Model for Managing Personal Health Records in South Africa is proposed. This model allows patients to view their PHRs on their mobile phones and medical practitioners to manage the patients’ PHRs using a web-based application. The patients’ PHR information is stored both on a cloud server and on mobile devices hence the hybrid nature. Two prototypes were developed as a proof of concept; a mobile application for the patients and a web-based application for the medical practitioners. A field study was carried out with the NMMU health services department and 12 participants over a period of two weeks. The results of the field study were highly positive. The successful evaluation of the prototypes provides empirical evidence that the proposed model brings us closer to the realisation of ubiquitous access to PHRS in South Africa

Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies

A framework for designing ambient assisted living services for disabled individuals

Physically disabled individuals face a number of challenges when carrying out their everyday activities such as moving around, communicating with others, and their personal care. One way of overcoming these challenges is by using personal assistants. An alternative is to enable independence through assistive technology. This research aimed to investigate how physically disabled individuals experience these challenges, and how assistive technology can enable them to be more independent. In order to achieve the goal of this research, existing literature was reviewed on disability, assisted living, and interaction techniques. The literature study on disability identified some of the challenges faced by disabled individuals in their daily lives. In order to contextualize these challenges, interview studies with eighteen disabled individuals, and twelve personal assistants were carried out in Kampala, Uganda and Port Elizabeth, South Africa. The participants from both Uganda and South Africa were limited to those living in urban areas. The Ugandan participants noted that, whereas technology may assist their daily lives, their most essential needs are basic disability support aids such as wheelchairs and better long canes. This was in contrast with the South African participants, who have access to basic disability support aids. The South African participants identified their key needs as controlling an electronic environment without assistance, e.g. house lights, using a mobile phone, and using a computer without assistance. The interviews narrowed down the scope to focus on individuals with quadriplegia, specifically individuals who have limited hand use, but can comfortably speak and move their heads, and make gestures such as head shake and nod. Literature on assisted living technologies and frameworks, provided the technical foundation for the research. The literature review of interaction techniques identified a number of possible ways in which individuals with quadriplegia can interact with technology. An appropriate set of interaction techniques, namely head shake and nod, voice, and facial feature tracking were identified. Evaluations of the interaction techniques excluded head shake and nod, because of an inconsistency in detecting an individual’s head pose in different lighting conditions, when using a Microsoft Kinect. Voice and facial feature tracking using a standard computer camera were identified as the most suitable interaction techniques for this study. A framework for designing assisted living software services was developed. The framework allows disability researchers and solution developers to understand the needs of a given disability group, and design relevant solutions. To demonstrate that the proposed framework iii | P a g e addresses the main aim of this research, a prototype was developed that enables users to control smart lights (Phillips hue), a Smart TV (Samsung), and carry out basic navigation and webbrowsing on a computer. Users could interact with the software using voice and facial feature commands. A usability study was carried out with fifteen physically disabled individuals in Port Elizabeth, South Africa. The results of the evaluation study were highly positive. The successful evaluation of the prototype provided empirical evidence that the proposed framework does assist in the design of relevant and useful software services, to meet the unique needs of physically disabled individuals

Smallholder farmers in eastern Africa and climate change: a review of risks and adaptation options with implications for future adaptation programmes

This article reviews the published evidence of the climatic risks faced by smallholder farmers in eastern Africa and the adaptation strategies these farmers have so far adopted. In addition, the study draws on two detailed case studies in Kenya for a better understanding of the nuances of climate adaptation, requiring a range of measures to be adopted and institutions working together. Findings from the study reveal that the most consistent observation among farmers is that eastern Africa is experiencing increased temperature and decreased rainfall across all its agro-ecological zones. In response to their perceived climatic risks, smallholder farmers in the region are using both short-term and long-term strategies, with the former mainly consisting of coping mechanisms against climate chocks. In addition, the adaptation strategies implemented by the farmers are influenced by agro-ecological conditions which shape their farming systems and institutional settings including proximity to a major city and markets. The case studies highlight the importance of collaborative efforts between key local and external stakeholders in supporting adaptation to climate change. Key lessons are drawn from this study for the development of future adaptation programmes