Isolated and marginalized communities of rural regions in South and Central Asia lack access to specialists and to quality health care services. Health care is either very basic or absent. Patients are often forced to travel long distances - across lakes and through mountainous areas - to major cities, where specialist care is available. Harsh weather conditions and rugged terrain make travel challenging for villagers. Often, delays in medical care lead to further complications and sometimes, even to death. Patients have to invest a considerable amount of time and money during travel, burdening them financially.
To help overcome these challenges, the the Aga Khan Development Network (AKDN) eHealth Programme was initiated in 2007 with an aim to improve health status of remote, resource-poor communities. The Programme employs Information and Communication Technologies (ICTs) to support eHealth activities of AKDN and governmental health care institutions in South and Central Asia. The Programme links health care facilities and health care providers within and across Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan for teleconsultation and eLearning services. Through a hub and spoke model that connects service-receiving facilities with service-providing facilities via ICT, the Programme aims to provide comprehensive and coordinated care to communities, minimizing barriers of distance and time and resulting in a robust and integrated health care system.
Currently, the AKDN eHealth Programme consists of 31 health care facilities across four countries, which are provide eHealth services, including teleconsultations and eLearning services.
Teleconsultations enable patients to receive timely diagnosis and treatment directly from specialists who are connected to them at a distance. This reduces the burden of travel time and cost on patients. Live (synchronous) and store-and-forward (asynchronous) teleconsultations are provided to patients. These include diagnostic services in teleradiology, telepathology and teleopthalmology and cover various specialties, including obstetrics and gynaecology, paediatrics, neurology, psychiatry, surgery and cardiology, among others.
Health care providers also benefit under the Programme through eLearning. The Programme aims to build professional, clinical and managerial capacities of health care providers in remote areas through eLearning, reducing professional isolation. In rural areas, where resources are limited, eLearning has the potential to aid continuing professional development, when health care professionals are unable to undertake time-consuming and costly travel to attend courses. eLearning sessions on medical and nursing topics and online courses are offered, enabling them to provide better health care services.
During 2016, 7152 teleconsultations were provided while 2080 eLearning participants were trained. Furthermore, two new sites in Tajikistan and one new site in Pakistan initiated eHealth services. The Dushanbe Medical and Diagnostic Centre initiated live teleconsultations while and the Post-Graduate Medical Institute initiated eLearning services for health care professionals at the Khorog Oblast General Hospital. In Pakistan, Garam Chasma Tehsil Hospital started offering teleconsultation services, allowing patients to seek psychiatric care available at the Aga Khan Medical Centre, Gilgit. Furthermore, in addition to store-and-forward teleconsultations, live teleconsultation services were initiated at two health centres in Pakistan. Patients coming to the Chatorkhand and Soust health centres are now able to benefit from live teleconsultation services. The graphs below depict the progress of the Programme since initiation.
The AKDN eHealth Programme is funded by multiple donors, including Global Affairs Canada; Aga Khan Foundation, Canada; Agence Française de Developpement; the French Ministry of Foreign Affairs; Kreditanstalt für Wiederaufbau; Roshan Telecom; and the United States Agency for International Development. In 2017, charging mechanisms have been put in place for Tajikistan and Pakistan to sustain operations.
Let’s take a look at what the AKDN eHealth Programme is offering in Pakistan.
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