This community is in archive. Visit community.xprize.org for the current XPRIZE Community.
Potential countries for testing eHealth programs
![SevagKechichian](https://us.v-cdn.net/6031116/uploads/userpics/036/nXLVPLN8YOXO8.jpg)
We are so grateful for the insights previously shared around potential locations for the competition. We would appreciate your help in curating a “Top 3” and “Bottom 3” based upon our current sorting of potential countries.
The countries below have been prioritized through a quantitative and qualitative analytical approach. The countries listed in the left column have received an endorsement from experts through this online community or in multiple expert interviews. The countries on the right have not been mentioned, however we would like to hear your thoughts on both lists, before eliminating countries from consideration.
We would like to hear your thoughts. Please comment and share your list for a “Top 3” and “Bottom 3” as well as a rationale for why you made your selections. The best comment wins a $100 gift card.
The countries below have been prioritized through a quantitative and qualitative analytical approach. The countries listed in the left column have received an endorsement from experts through this online community or in multiple expert interviews. The countries on the right have not been mentioned, however we would like to hear your thoughts on both lists, before eliminating countries from consideration.
We would like to hear your thoughts. Please comment and share your list for a “Top 3” and “Bottom 3” as well as a rationale for why you made your selections. The best comment wins a $100 gift card.
![rvn2mt56ez59.jpg](https://us.v-cdn.net/6031116/uploads/editor/rg/rvn2mt56ez59.jpg)
0
Comments
Another important issue will be the mindset and literacy level of the population if they are open and willing to adopt DH, we have to do it.
There is so much saturation in Nigeria, India and Kenya, however, that Ghana stands out to me as an interesting option. Senegal and El Salvador as well.
Stability is critical, and advancement of digital health policies is an important factor to consider.
Rwanda is a strong leader in policy and stability, as well as infrastructure, it is also densely populated, and has a strong level of homogeneity which makes it a good candidate for testing things that are new, though comes with other challenges.
Also in these countries, the healthcare policies are getting defined, it make sense to give right inputs to incorporate them into the policy.
Thanks
Dr. Veena, it would be nice if you could name the countries you feel are of high priority.
Assumption: Digital health here does not limit to software apps only. It also includes electromechanical tools like breathing support devices (especially in COVID, monitoring tools etc. )
Bias: Even though my recommendations are based on the data and facts but Personal experience of working in some countries and understanding of their healthcare system can influence my recommendations.
1. Rwanda
Reason: A getaway to digital health base intervention in the African region. Government and legal procedures are in place. WHO, WEF and many other international organizations are working in Rwanda to do pilots for Africa. I have a lot of experience in working in the African health system and found that any digital health intervention can here lead to a big impact which is not just an incremental impact but if sustained can save lives at a scale.
2. India
India is 2nd most populist country in the world with one of the lowest health outcomes and limited resources both physical and human resources. India has multiple organizations to design and execute a strong pilot. Pilots in India also becomes a path to the whole of South Asia and with the patient numbers and diversity, it is fast to complete a pilot and prove the efficacy of the intervention.
3. Philippines:
I choose it for the number 3 spot because doing a pilot in the Philippines can give insights about the East Asian healthcare system. It has a fairly clean system and policies in place to implement a digital health system.
Bottom 3:
Sudan: Corruption and armed conflicts make it difficult to deploy any solution.
Ukraine: Similar corruption and conflicts makes it difficult to implement things operationally.
Sudan: Again operationally it is difficult to roll out something fast and safely to the bottom of the pyramid.
I hope this is useful.
There you have it, Bill' (Avatar) suggests we choose as follows:
Community Health Workers | Frontline Health
1. Brazil,
2. Liberia,
3. Ethopia,
4. Bangladesh,
Vaccine Delivery
1. Senegal,
2. Zambia,
3. Nepal
See details: https://drive.google.com/file/d/1-gYNkS4xeowfIZd4PPUY6U9H-wfbOHNS/view?usp=sharing
@Fractalman, @vipat, @DrAhimsa, @DanielaHaluza, @Stefania, @siimsaare, @stepet, @alafiasam, @dokgva, @jda, @ClaireM - Curious if you might have any input on the optimal location to pilot test digital health solution?
Bottom 3 on the list:
Brazil
@SevagKechichian @Nitesh @boblf029 @Fractalman, @vipat, @DrAhimsa, @DanielaHaluza, @Stefania, @siimsaare, @stepet, @alafiasam, @dokgva, @jda, @ClaireM- kindly note that:
According to Wikipedia "The population of Brazil is very diverse, comprising many races and ethnic groups. In general, Brazilians trace their origins from three sources: Europeans, Amerindians and Africans. Historically, Brazil has experienced large degrees of ethnic and racial admixture, assimilation of cultures and syncretism. The Brazilian population is said to be one of the most mixed in the world".
@SevagKechichian @Nitesh @boblf029 @Fractalman, @vipat, @DrAhimsa, @DanielaHaluza, @Stefania, @siimsaare, @stepet, @alafiasam, @dokgva, @jda, @ClaireM
1. Brazil_has an urbanisation rate of 86.57% from a 209 million population_and an 8.5m sq km landmass.
2. Liberia_has an urbanisation rate of 51.62% from a 4,8 million population_and a 100k sq km landmass.
3. Ethiopia_has an urbanisation rate of 21.22% from a 109,2 million population_and a 1.1m sq km landmass.
4. Bangladesh_has an urbanisation rate of 36.63% from a 161,4 million population_and a 147k sq landmass.
Bottom 3 in no particular order:
- Zimbabwe
- Siera leone
- Sudan
*All due to political and security concerns.1. Tunisia: the only country on the African continent with a formalized agency to assess the clinical benefit and cost-effectiveness of new health interventions, reasonably stable and secure governance on international indices, a smaller country with a well-coordinated health system that would make a useful testbed.
2. Vietnam: also a formalized approach to health technology assessment (HTA) within the ministry of health, a well-coordinated health system and communications infrastructure, and a reasonably stable economy and political environment.
3. Egypt: while a bit less stable politically, a robust infrastructure to assess the economic impact of new health interventions, a mature research enterprise to conduct such evaluations, and reasonable economic and communications infrastructure.
My bottom 3, in no particular order (although it was hard to pick 3 given instabilities with many of them):
1. Phillipines: unstable government with demonstrated lack of willingness to thoughtfully consider population-health interventions.
2. Pakistan: concerns with government stability, large country with poor communications infrastructure and many rural areas not reachable by devices.
3. Niger: government stability concerns, political unrest, residual crime and terrorism issues. Concerns exacerbated because of border with Chad, where things are even worse.
Project ECHO is already in many of these countries, but if narrowing this list down to three countries most ready for the adoption and scaling of ehealth initiatives, there are a few questions to consider:
Is the public sector in the country ripe for collaboration and for the adoption of ehealth? To scale across a country and bring access to quality healthcare to rural and underserved communities, it takes engaging the public sector. What does the technology infrastructure look like? What does cell phone penetration look like? Are these countries with both large need and populations? We want to maximize impact.
If Project ECHO is to reach its goal of helping 1 billion people by 2025, we will need to focus on geographies where there’s both need and population - with this in mind, India and Africa, in general, are major priorities for us.
In 2019, ECHO India (Project ECHO’s India operation) signed an MoU with MoHFW to enable National Programs, National Institutes and Hospitals under Ministry of Health and Family Welfare to further benefit from using the ECHO Model. With COVID alone, we have trained over 300,000 clinicians across India using the ECHO Model. This was only made possible by partnering with the public sector. The point being, any country chosen needs to be ripe for public private partnership (PPP) in digital health. Engaging Ministries of Health / the public sector is critical to increasing access to health care for underserved and rural communities.
Kenya is both a hotbed of social entrepreneurship, and a country with a tradition of tech innovation, which makes it a good choice, similar to India, but on the African continent. We feel it’s important to have at least one country of the three be in Africa. With the need for access to quality healthcare across the continent, Kenya could serve as a pilot or model to scale across the African continent.
The Philippines is also a country ready for collaboration and adoption of digital health. As a country with over 7,000 islands, they have always been early adopters of technology, out of necessity.
Our strategy is to partner with local partners on the ground, and engage the public sector. By doing so, we can achieve widespread adoption more efficiently and in a way that considers the cultural context.
Hello @creativiti, @namkugkim, @Haruyo, @barati, @poppyfarrow, @dzera @msrjoy, @gajewski, @andwhite, @angelfoster, @acowlagi, @Sujana - Curious if you might have any input on the best locations to pilot test digital health solution? Any items that jump out at you as key things to explore?
1) diverse populations, good penetration of MOBILE HEALTH (m health) and possibility of adding and building on exiting work in the digital health in these countries
2) good record of large number of community health workers and front line health providers
3) interest in using technology for UHC
4) Need based as large parts of countries are still inaccessible for good quality health care that would require tele mentoring , capacity building , tele health and basic digital platform
5) comprehensive digital platforms can target both MCH services as well as the new epidemics of NCDs.
5) Most important point is to have academic collaboration to test adequacy and feasibility before rolling out large programs and testing with costly experimental designs
6) final justification is if you can do multi site country evaluation and establish proof proof of concept they can be expanded anywhere and tested fro effectiveness. The lack of robust evaluation designs and empirical data with costing data is often the make and break in such experiments so would request to integrate this into the testing of the pilots by independent bodies