To complement their new publication (A vision for primary healthcare in the 21st century), WHO and UNICEF have issued a draft Operational Framework for wide consultation.
A 'flexible set of thirteen “levers” has been identified that countries can employ as they move towards PHC'.
One of these levers is 'Ensuring the delivery of high-quality and safe health care services'
Another is: Digital technologies: Use of information and communication technology (ICT) in ways that improve effectiveness and efficiency and promote accountability
Below are extracts from the section on Digital technologies.
'Information and communication technology (ICT) has changed dramatically in recent decades, with technologies such as the Internet and mobile telephony spreading far more rapidly than earlier technologies. Although access is not yet universal, more than 8 in 10 people in developing countries own a mobile phone and nearly half of the population globally uses the Internet. These technologies are more equitably distributed across the planet than income is, such that even the region with the lowest mobile penetration – sub-Saharan Africa – has 78 mobile cell subscriptions per 100 people.
'The ICT revolution has brought about important shifts in how individuals and communities manage their own health and access information about health conditions, treatment options, and the availability (and sometimes quality) of service providers. This can put new power in the hands of people and shift the nature of the relationship between medical provider and patient by reducing the asymmetry of information. However, too much of the information currently available is only in English or other languages that are typically not the first language of people in low- and middleincome countries, which is limiting the impact of the ICT revolution in these settings. The spread of social media helps address this, as it facilitates peer–peer sharing of medical information, although the information is mostly unvetted for accuracy. Additionally, new technologies are creating new ways that people can hold service providers to account, as well as enabling more effective and larger-scale advocacy efforts...
'The widespread availability of mobile phones makes it far easier to reach individuals with directed messaging aimed at changing behaviours (for example, to promote adherence to medication or to encourage return visits to a health facility) as well as simply providing information...
'An increasing number of countries are attempting to address human resources constraints – particularly in relation to primary care – through e-learning or telemedicine...'
'Political commitment and leadership: actions and interventions:
'Develop, as appropriate, national eHealth strategies and plans...
'Move mHealth and eHealth initiatives from pilots to scale...
'Establish standards, accreditation procedures, and evaluation activities to certify and ensure the quality of training delivered through approaches that include elearning
'Establish mechanisms to learn about new developments around ICT globally and identify gaps in existing efforts that could be addressed through new technologies...
'Support efforts to build platforms that make health information available in local languages...'
You can download the framework here: http://www.who.int/docs/default-source/primary-health-care-conference/op...
and you can submit your comments here:
Best wishes, Neil
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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG firstname.lastname@example.org