ICTworks

Way back in 2001, the SATELLIFE PDA Project demonstrated the viability of cutting-edge handheld computers at the time – Personal Digital Assistants or PDAs – for addressing the digital divide among health professionals working in Africa.

Do you even remember PDAs? Well, if you read their case study, you’ll be sure to recognize the seven lessons they learned. Check how far we’ve come with technology, and yet how good implementation practices don’t change

1. Implement and Disseminate Best Practice.

It is widely recognised that ICT can play an important role in combating disease and improving healthcare by aiding the collection of community health information to support decision-making; improving doctors’ access to current medical information; linking healthcare professionals so they can share information and knowledge; and enhancing health administration, remote diagnostics, and distribution of medical supplies.

SATELLIFE carefully examined the use of PDAs in healthcare in the United States, and built this project on knowledge gleaned from the successful experiences of others. SATELLIFE engaged bridges.org to conduct an independent evaluation of the PDA trial that looked at the technology itself, the content loaded on it, and the impact that the PDA had on the behavior of health professionals and the quality of care they delivered.

The evaluation report presents the lessons learned in this project to inform decision-making about future uses of PDAs and other ICT for development. It also provides resource materials for planning and implementing future steps in the SATELLIFE project or related initiatives.

2. Ensure Local Ownership, Find a Champion.

The project connected with local implementation partners in order to ensure local ownership and buy-in. The American Red Cross was the local implementation partner that linked the PDA project with a broader measles immunization programme underway in Ghana.

The Uganda phase of the project was implemented in cooperation with Makerere University Faculty of Medicine. Professor N.K. Sewankambo, Dean of the Makerere Faculty of Medicine, acted as a main point of contact and local champion for the project. HealthNet Uganda, located at Makerere, acted as a local implementation partner and a full-time SATELLIFE project field manager was based there to coordinate implementation at ground level. A HealthNet Uganda site coordinator provided technical support and project assistance.

In Kenya, the project was implemented in cooperation with Moi University Medical School and the Indiana University (IU) Kenya Program. Dr. B.O. Khwa Otsyula, Dean of the Moi Faculty of Health Sciences, acted as a key point of contact and local champion for the project. Moi staff members worked together with the IU Kenya Program to handle local implementation.  The SATELLIFE field manager in Uganda also traveled frequently to Kenya and helped to coordinate implementation.

3. Do a Needs Assessment.

This project responded to a need for better information to improve medical treatment and disease management in developing countries. PDAs are widely used in the medical profession in the developed world, but are a relatively new technology in Africa, and little work has been done before now to demonstrate their utility as a tool for healthcare in developing countries.

4. Set Goals and Take Small Achievable Steps.

The pilot was divided into three distinct phases to make it more manageable. The first phase of the project took place in Ghana in December 2001. The Kenya and Uganda phases were conducted in parallel during March-December 2002. SATELLIFE plans to build on this pilot with future projects using handheld computers for healthcare in Africa.

5. Critically Evaluate Efforts, And Adapt.

SATELLIFE and its project partners carried out a series of mid-term evaluations on this project, which were taken into consideration by bridges.org as part of its overall project evaluation.

A number of key lessons learned were gleaned from these evaluations, and SATELLIFE and its partners introduced a number of appropriate changes during the project to overcome the identified challenges. SATELLIFE issued regular project updates (at approximately 3-month intervals) to keep clients and supporters current and involved.

6. Address Key External Challenges.

As part of the pilot a number of external challenges that affected the current and future use of the PDAs in these healthcare environments were identified, including bureaucratic hurdles, technology problems, lack of local technology supply, project management issues, and overall project implementation challenges. SATELLIFE is taking steps to tackle these external factors head-on as it moves forward in this area.

7. Make Your Project Sustainable.

Handheld computers proved to be an inexpensive alternative to PCs in terms of computer power per dollar. In an environment where PCs are beyond the reach of most people, even healthcare professionals, the PDA offered a reasonably priced alternative that gave significant computing power for the price.  However, the cost of the PDAs may still be too high for the average person in Africa.

The biggest challenge for the technology is whether average people in developing countries will be able to afford PDAs. There is a significant potential market for affordable handheld technology in the developing world, where there is little ICT infrastructure and a lack of conventional ICT such as PCs.

The high uptake of cellular telephones in countries such as Uganda, Kenya and South Africa is an indication that people in developing countries are willing to spend money on technologies that prove to be really useful and relevant to them.

The industry should produce a cheaper PDA that is targeted to poorer markets. There is clearly a market opportunity for handheld computers in African countries. (Wow! Little did they know that was the understatement of the decade!)