Depression for Naheed1, a 26-year-old female, appeared suddenly and hit her
like a ton of bricks. It started in March 2021 with jitteriness and loss of appetite and led to
persistent irritability and elevated heart rate. She was low on energy, and a constant feeling
of hopelessness and loneliness made it impossible for Naheed to enjoy any activities she had
Naheed reported these symptoms to her doctor at the Aga
Khan Medical Centre Booni, 10 km away from her home in Charun, Upper Chitral, Pakistan. The
doctor examined her through tests and assessments, in efforts to diagnose the causes of her
symptoms. However, to her surprise, all tests confirmed that Naheed was in good physical health.
She continued to feel tightness in her throat, severe headaches, and epigastric pain. Soon
after, her complaints included sleeplessness and complete loss of appetite.
Using teleconsultation services offered through the AKDN
Digital Health Programme, Dr Shazia Mir, a Psychologist at the Aga Khan Medical Centre, Booni
decided to take a second opinion from Dr Adil Khan, who is a Consultant Psychiatrist at the Aga
Khan Diagnostic Centre, Jutial. Dr Khan performed a thorough physical exam with the assistance
of the medical team in Booni and took a detailed history of Naheed’s symptoms. Dr Khan, along
with Naheed and her family, came to the conclusion that she was depressed with somatic
complaints. He prescribed medication with regular follow-up teleconsultations over a course of
nine months. Slowly, Naheed was able to recover with the help of teleconsultations and
medication and she was finally able to manage her condition better.
Through teleconsultations, Naheed was able to consult a
specialist, Dr Khan, 298 km away from her home, at the Aga Khan Diagnostic Centre in Jutial,
Gilgit. In absence of the Programme, Naheed would have had to travel to Jutial to seek better
health care service. The AKDN Digital Health Programme helped Naheed and her family save US
$12202 , that would otherwise have been
paid towards accommodation, meals and travel expenses from Charun, Upper Chitral to Jutial,
The AKDN Digital Health Programme allowed Naheed to
receive quality health care services she needed through the live teleconsultation services,
resulting in an accurate diagnosis and treatment.
Naheed has not recovered and is happily living her life
at her home in Charun, Chitral.
Mental health issues can be chronic, with recovery
taking longer than one would expect. They cause periods of stability along with difficult
periods, which require a combination of medication and therapy. For anyone facing mental health
challenges, early intervention and treatment is critical to recovery.
1 The name of the
patient has been changed
to protect patient privacy.
2The amount is based on
costs associated with accommodation, meals and travel for trips from Charun, Upper Chitral
to Jutial, Gilgit-Baltistan.
Telemedicine Reverses Alopecia
Jamal Mohammad1 was a playful and energetic five-year old boy, who lived with his parents in Bahar village in Ishkashim district in Afghanistan. It was February 2021, when he began losing his hair. He started noticing when other children began staring and pointing at him.
At first, his scalp had mild redness and itch; then some sparse patches appeared on his head and soon he lost a majority of his hair. Alarmed, his parents took him to several doctors in their village but no one was able diagnose his condition or offer a clear treatment plan.
Jamal’s parents reached the Community Health Centre (CHC), Ishkashim, 5 km away from their home, in hopes to find specialised care. The AKDN Digital Health Programme connects Ishkashim CHC to the Faizabad Provincial Hospital (FPH) for teleconsultation services. A live teleconsultation with Dr. Qutbuddin Fazli, Dermatologist, at the FPH was conducted.
Dr. Fazli diagnosed Jamal with Alopecia, an autoimmune condition that causes hair loss. He prescribed antibiotics and advised him to take precautions. As a result of the teleconsultation, Jamal was able to make a complete recovery.
Before Jamal’s parents learned about the AKDN Digital Health Programme, they made numerous visits to clinics and hospitals, but failed to receive a clear diagnosis. Through telemedicine services, Jamal received holistic treatment, without having to travel to Faizabad, saving his family a considerable amount of time and travel expenses.
1 The name of the
patient has been changed
to protect patient privacy.
WHO Roundtable Discussion (May 2021):
Leveraging digital health technologies to improve NCD
outcomes in underserved, vulnerable populations
Health Systems Research Symposium (HSR) 2020 – presented on March
Topic: Hayat’s role in improving maternal health, gender
equality and strengthening health systems
Africa Telehealth Conference (June 2021):
AKDN Digital Health Programme and Sustainability through
Invitation to Deep Dive on Primary Health Care Innovation (September
Hayat’s role in improving maternal health, gender equality
and strengthening health systems
11th Public Health Conference Contemporary Medicines, Health
Technologies and Vaccines for Emerging Public Health Risks (September 2021):
Health Systems Strengthening through Digital Health
Technologies (Hayat & CIRP)
Canadian Conference on Global Health (November 2021):
Hayat’s role in strengthening maternal, newborn, and child
health provision in health systems of Pakistan and Afghanistan
Environmental Health: Challenges and Solutions Identified
Pandemic Resilience: COVID-19 Innovation Research Project
COVID-19 Innovation Research Project (CIRP)
The COVID-Innovation Research Project (CIRP) aims to
investigate the effectiveness of developing and scaling up three COVID-related digital health
innovations in strengthening health systems and improving access to care in at-risk populations
in select geographies in Afghanistan, Pakistan, Tajikistan, Kenya, Tanzania and for
The study undertakes a multi-pronged applied research
approach on the following three digital health innovations:
AI-based mobile application, which aims to contribute to early detection of COVID-19 and
positively influences health-seeking behaviour among at-risk populations;
mobile-based teleconsultation application, which aims to improve access to care for
hard-to-reach populations; and
Overall, the study focuses on the extent of which these
three digital health innovations are effective, feasible, usable and sustainable within health
systems in target geographies. The project is underpinned by the integration of these
innovations in health systems through public-private partnerships (PPPs) with local and national
During 2021, as part of project activities, CIRP was
selected to be showcased at the 11th Annual Public Health Conference: Contemporary Medicines,
Health Technologies and Vaccines for Emerging Public Health Risks September and the Canadian
Conference on Global Health (CCGH) in November.
CIRP is a two-year research project, led by AKDN
dHRC in 2020, with research funding from the Government of Canada through the International
Development Research Centre (IDRC) and the Aga Khan Foundation (AKF).
aims to test the effectiveness of a mobile application, which helps to empower
health workers with technologies to improve coverage of and access to Reproductive, Maternal,
Newborn and Child Health (RMNCH) services, immunisation and child growth services, by
digitalizing health worker operations. The Hayat application has successfully been
implemented in select regions of Afghanistan and Northern Pakistan and is being used by 665
Hayat is designed to primarily benefit
children under 2 years of age and women of reproductive age in catchment populations of select
areas of Gilgit-Baltistan and Chitral and in Bamyan and Badakhshan in Afghanistan.
Hayat uses a quasi-experimental study to
evaluate the effectiveness of the use of the Hayat application in the existing health system in
improving utilization of essential RMNCH services provided by frontline health workers.
Antenatal care (ANC), postnatal care (PNC), family planning and childhood immunization were
assessed using baseline and endline cross sectional surveys in intervention and control areas.
The difference-indifference (DID) was calculated to see the effect of intervention.
The assessment in the pilot and transition-to-scale
phases has demonstrated that Hayat has exhibited adequate levels of feasibility,
interoperability, usability, and efficacy in the research areas.1
The study findings demonstrate that use of smart
phone-based Hayat application has high acceptability among the health care providers in both
Afghanistan and Pakistan. has benefitted the existing health system functioning but providing
reliable data and transparency, and better monitoring methods of the frontline workers and the
This is better than the manual procedure and no doubt, the timely information [it provides] is very helpful.
Vaccinator, Phandar, Gilgit-Baltistan, Pakistan
The study revealed high usability of
both by the end users and stakeholders at district level. Overall, the app helped in
quality and timeliness of data, improved immunization coverage and maternal care through
supportive supervision and monitoring of CHWs and LHWs both in Pakistan and Afghanistan.
validity improved and health managers were confident of the reliability of data
through the app.
The data sharing process is
improved specially the data of the LHW program. There are less chances of
manipulation in the digitized system and it will be much better if the whole data is
EPI Coordinator, Gilgit-Baltistan, Pakistan
According to most of the vaccinators this application
resulted in better coordination with the supervisors and all the features of the app are
relevant to their work and provide ease in their routine immunization process. The app was well
taken and appreciated by all the vaccinators and CHWs. In comparison, younger CHWs and
vaccinators were more satisfied with the use and understanding of app features as compared to
senior staff, who faced difficulty in adopting the technology in the initial phase.
In the opinion of the managers the vaccinators were now
better organized and over the time they have noted improved efficiency in their work. The
problem of absenteeism has also been resolved to some extent.
The attendance has improved,
because, before, it was difficult to [keep track of] the attendance, even if a
vaccinator is not on duty for a whole month. Now, we call the vaccinators on the
phone and they tell us that they are busy with the outreach vaccination
CHS, Shebar, Afghanistan
1Zaidi S, Kazi AM, Riaz A, Ali
A, Najmi R, Jabeen R, Khudadad U, Sayani S Operability, Usefulness, and Task-Technology Fit of
an mHealth App for Delivering Primary Health Care Services by Community .
Digital Health Beyond Borders
Saleem Sayani, Director, AKDN dHRC presents Hayat
to key government stakeholders from the Department of Health,
Gilgit-Baltistan and Department of Health, KPK at the Hayat
Dissemination Workshop in Karachi
AKDN Digital Health Programme
A patient enters the Comprehensive Health Centre,
Bashore to avail telemedicine services from the Faizabad
Supporting COVID-19 Teleconsultations
A healthcare provider at the Tele-ICU at the Aga
Khan Medical Centre, Gilgit seeks medical advice from a
consultant at the Aga Khan University Hospital, Karachi for a
Patented COVID-19 Innovations
AKDN dHRC's Emergency Ventilator with tablet-based
app and patented technology for use in ambulances and
Message from the Director
Unprecedented. Challenging. Resilient.
2021 has been an eventful year, with new waves of the pandemic and variants of the COVID-19 virus coming and going. There have been months of challenges, however, many collective achievements and progress has been made.
As a part of a leading health care institution, the Aga Khan Development Network Digital Health Resource Centre (AKDN dHRC) has continued to step forward in unimaginable circumstances - fighting the global threat by delivering unconventional modes of health care service provision and conducting rigorous research to bring quality digital health interventions, innovations and recommendations to communities.
The year 2022 brings with it many opportunities for us to reflect and learn from our work and renew our energies to further mould our responses to the everchanging COVID-19 landscape. More than two-thirds of the world’s population subscribes to mobile phone services. The falling prices of connectivity and 5G networks roll out promise to accelerate the use of digital technology. Properly leveraged, we can employ digital solutions and applications to transform health systems from reactive to proactive and even preventive, helping people stay healthy. With Artificial Intelligence (AI), we aim to augment the existing health ecosystem that can be more predictive by detecting risk factors and helping health professionals respond faster to prevent disease.
AKDN dHRC looks forward to leveraging digital health technologies to bring innovative research and service delivery solutions in response to the emerging health needs of underserved, marginalized populations across the globe.
Director, Aga Khan Development Network Digital Health Resource Centre