The Cell-Life Project: Converging technologies in the context of HIV/AIDS

This article presents the development of a technology initiative called Cell-Life which addresses the need for information management in the HIV/AIDS sector. Cell-Life started in 2001 as a research collaboration between staff of the Engineering Faculties at the University of Cape Town (UCT) and the Cape Peninsula University of Technology (CPUT). Based on the need to support the primary health care sector in providing sustainable treatment options for HIV+ people in under-resourced and rural areas, converging technologies were identified as a possible solution for creating a ‘virtual infrastructure’ between the patient and the medical staff. In 2003 the Government of South Africa clarified in its operational plan for HIV/AIDS that anti-retroviral treatment (ART) increased life expectancy of people living with AIDS. It also highlighted that provision of anti-retroviral drugs (ARVs) required the regular assessment of the compliance rate to the treatment plan in order to avoid side effects and multiple resistant strains. For under-resourced primary health care centres in disadvantaged areas, HIV/AIDS treatment, and particularly the requirement to monitor patients regularly, became a near impossible task. Cell-Life investigated the use of readily available information and communication technologies to support the provision and distribution of medication, continuous patient monitoring, and communication of relevant data. By combining open source software, cellular technologies and a new approach to software design, a variety of solutions were developed that would take cognisance of the context of HIV/AIDS support and treatment across the country. In 2006 Cell-Life became a not-for-profit organisation and was spun out of the University of Cape Town. The organization currently implements Information Communication Technology (ICT) systems that (as of late 2009) manage the dispensation of ARVs to approximately 70 000 patients, representing one-sixth of South Africans on state- or donor-sponsored ART. This article reflects on the development of Cell-Life as a case study for one of the first socially responsible research projects in the Engineering field at UCT and highlights some of the challenges, enablers and barriers experienced

The use of a spatial information system in the management of HIV/AIDS in South Africa

BACKGROUND: South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. RESULTS: The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. CONCLUSIONS: The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information

A Review of ICT Systems for HIV/AIDS and Anti-Retroviral Treatment Management in South Africa

HIV/AIDS is a major global health problem. In South Africa, it is estimated that 5.4 million people are infected by HIV, out of a population of nearly 48 million, giving a prevalence rate of about 11%. About 600,000 individuals are infected with AIDS. Furthermore, the estimates show that, by mid-2006, some 711,000 people were in need of anti-retroviral treatment (ART), while 225,000 were actually receiving it

Experiences of African women in STEM careers: A systematic literature review.

The discourse on women\u27s underrepresentation in science, technology, engineering, and mathematics (STEM) mainly centres on the global north, leaving a gap in understanding the perspectives of African women in STEM. To address this, a systematic literature review was conducted to explore African women\u27s experiences in STEM careers and education. After applying inclusion and criteria, 18 published articles were analysed. 8 key issues emerge: work environment, education system, work-life balance, gender-based stereotypes, racial bias, sexual harassment, inadequate support/mentorship, and self-imposed limits. These themes intertwine, with some aspects influencing others. Grasping the complexities and interactions of these factors provides insights into challenges along the \u27demand side\u27 of the leaky pipeline. By addressing these challenges stakeholders can develop more targeted interventions to create a more inclusive environment and sustain the participation of African women in STEM fields. This research contributes to ongoing efforts to promote gender equality in STEM disciplines in Africa

Open source GIS for HIV/AIDS management

<p>Abstract</p> <p>Background</p> <p>Reliable access to basic services can improve a community's resilience to HIV/AIDS. Accordingly, work is being done to upgrade the physical infrastructure in affected areas, often employing a strategy of decentralised service provision. Spatial characteristics are one of the major determinants in implementing services, even in the smaller municipal areas, and good quality spatial information is needed to inform decision making processes. However, limited funds, technical infrastructure and human resource capacity result in little or no access to spatial information for crucial infrastructure development decisions at local level.</p> <p>This research investigated whether it would be possible to develop a GIS for basic infrastructure planning and management at local level. Given the resource constraints of the local government context, particularly in small municipalities, it was decided that open source software should be used for the prototype system.</p> <p>Results</p> <p>The design and development of a prototype system illustrated that it is possible to develop an open source GIS system that can be used within the context of local information management. Usability tests show a high degree of usability for the system, which is important considering the heavy workload and high staff turnover that characterises local government in South Africa. Local infrastructure management stakeholders interviewed in a case study of a South African municipality see the potential for the use of GIS as a communication tool and are generally positive about the use of GIS for these purposes. They note security issues that may arise through the sharing of information, lack of skills and resource constraints as the major barriers to adoption.</p> <p>Conclusion</p> <p>The case study shows that spatial information is an identified need at local level. Open source GIS software can be used to develop a system to provide local-level stakeholders with spatial information. However, the suitability of the technology is only a part of the system – there are wider information and management issues which need to be addressed before the implementation of a local-level GIS for infrastructure management can be successful.</p

WATER alert!: using mobile phones to improve community perspective on drinking water quality in South Africa

Drinking water quality, in many parts of South Africa, is far below acceptable standards. With a high number of illnesses and deaths in the country due to diarrheal diseases, the impact is critical. This research addresses the challenge of reporting complex and critical water quality information in a way that is accessible to all South Africans. High illiteracy rates, the presence of 11 official languages and limited-to-no access to technology in many areas, present some of the major challenges to the design of an alert notification and reporting system. We describe the design of WATER Alert!, a symbol-based prototype mobile phone application to alert and report water quality information to consumers and allow for citizen involvement in water management. Our findings from a preliminary evaluation revealed that WATER Alert! is simple to use and has a perceived usefulness amongst participants. The findings also suggest that such an application would help to improve consumers' understanding of water quality information leading to an improved Community Perspective on drinking water quality

Developing Mobile Graphic Reminders for Reinforcing Compliance in Tuberculosis Treatment in Africa

A mobile graphic reminder is part of an application that reminds a patient about the need to follow the routine of taking medicine, and helps to monitor this process. The program is especially helpful for patients with limited literacy, language barriers or deaf. The purpose of this paper is to present and discuss (1) the benefit potential of visual-based communication in the medical context; (2) how graphics as reminder interventions to support tuberculosis (TB) treatment were designed and developed; and (3) how these graphics were evaluated. Thirty-four people, including TB patients, TB health workers and academics from the University of Cape Town, South Africa and Zanzibar, Tanzania participated in the evaluation exercise. The findings revealed that participants interpreted the meaning of most of the graphics correctly. It also found that the applications of images in the medical context might have potential to support patient treatment compared to other mobile interventions. The developed graphics are then embedded with mobile application on supporting TB patients to adhere to treatment through reminder methods. The paper contributes to mobile health (ICT4D) of developing an approach of mobile graphic-based reminder applications with literacy level, language and resource constraints

Designing for Sustainability: Involving Communities in Developing ICT Interventions to Support Water Resource Management

Rural Africans have poor access to clean and safe water compared to other developing areas. Many Information and Communication Technology (ICT) interventions have been implemented to address the information gaps that hinder improved service delivery but have subsequently failed. The inability to provide suitable content, failure to address priority needs of communities and foster local buy-in are seen as the main causes. The transition from developing technologies for users to developing with users has created the need to harness collective ideation. Developing community-based ICT interventions collaboratively with the user communities provides a better understanding of the cultural nuances that can easily affect the use and adoption of an intervention. In this paper, we present a landscape analysis of rural water supply management in Uganda and an ICT intervention implemented to support the community management model. We present findings and a justification for a more user-centered approach to developing sustainable ICT interventions through co-design

Evaluating the effectiveness of mobile graphic-based reminders to support treatment of tuberculosis patients

Low adherence rates to tuberculosis (TB) treatment are one of the major barriers to improving TB cure rates. Developing regions such as sub-Saharan Africa are adversely affected for a number of reasons, such as low patient follow-up, limited medical, and treatment resources. The use of mobile graphic-based reminders potentially offers a cost-effective, easy to use and time efficient strategy to increase adherence in order to improve cure rates among patients with TB. This paper shows the results of a study in Zanzibar, Tanzania, which investigated the effectiveness of graphic-based reminders in supporting TB patients with low literacy levels to adhere to treatment. Participants were randomly selected from a group of TB patients and assigned into three groups: control (no reminder) group, graphic-based reminder group and speech-based reminder group. A total of 29 participants were analysed. The treatment adherence rates of the control group, speech-based group and graphic-based group were 41.7%, 60% and 85.7%, respectively. The rates in the graphic-based group were significantly higher than in the speech-based and the control groups. Results also show that there were high efficacy and acceptability of mobile reminders in the graphic-based group, with the average response rates of 76.8% compared with 67.1% in the speech-based group (p<0.001 of 95% confidence intervals). The findings highlight that mobile phone reminders are improving treatment adherence of TB patients. The graphic-based reminder was more beneficial, cost-effective and accepted for use by the majority of patients including those with limited education

Development of a Mobile Image-Based Reminder Application to Support Tuberculosis Treatment in Africa

This paper presents the design, development and evaluation of an application prototype developed to support tuberculosis (TB) patients’ treatment adherence. The system makes use of graphics and voice reminders as opposed to text messaging to encourage patients to follow their medication routine. To evaluate the effect of the prototype applications, participants were given mobile phones on which the reminder system was installed. Thirty-eight people, including TB health workers and patients from Zanzibar, Tanzania, participated in the evaluation exercises. The results indicate that the participants found the mobile image-based application is useful to support TB treatment. All participants understood and interpreted the intended meaning of every image correctly. The study findings revealed that the use of a mobile visual-based application may have potential benefit to support TB patients (both literate and illiterate) in their treatment processes