IntraHealth International: Fighting Ebola with mobile phones

2nd September 2014

Ebola Voice Response and SMS for frontline health workers

(With thanks to Kate Tulenko, IntraHealth International)

‘The current Ebola epidemic in west Africa is the first Ebola epidemic in region and therefore most health workers have received no formal education on Ebola prevention, diagnosis, or care. During an epidemic, health workers are needed at their posts and there is often not time to bring them to central sites for face to face training. In addition, travel for training risks spreading the disease via health workers who are not aware they are infected. Traditional distance education approaches, such as the internet and DVD are difficult because many community-based health workers often do not have access to the internet or laptops and tablets or are illiterate or semi-literate. In order to address these issues and get information quickly to health workers in Ebola affected and at-risk countries, IntraHealth International has developed [1] an Ebola Interactive Voice Response (IVR) course [and 2] an Ebola SMS course:

[1] Ebola Interactive Voice Response Course for Health Workers

[2] Ebola SMS Messages for Health Workers

‘These messages were developed based on CDC’s Ebola Guidelines for Health Workers. The course is available for general use and modification under a creative commons license. We recommend that the course be adapted to meet national guidelines and language…’

The courses will be available via the IntraHealth International website within the next few days.

HIFA opens up Ebola content for all

22nd August 2014

On 19 August HIFA wrote to the publishers of UpToDate, the ‘premier evidence-based clinical decision support resource’. We requested that their Ebola content be made freely available to all, in full, to assist in global and local efforts to contain the epidemic.

We are delighted to report that they have agreed to this request, and the full content of the Ebola section is now freely available here:

Epidemiology, pathogenesis, and clinical manifestations of Ebola and Marburg virus disease

Diagnosis and treatment of Ebola and Marburg virus disease

Please forward this link to your colleagues and networks:
http://www.hifa2015.org/2014/08/22/hifa-opens-up-ebola-content-for-all/

Neil Pakenham-Walsh, HIFA Coordinator

HIFA Voices launches today!

12th August 2014

We are delighted to announce the launch today of HIFA Voices: Harnessing the knowledge of HIFA members to improve the availability and use of healthcare information. We invite you to visit the HIFA Voices website and give us your feedback.

HIFA Voices is an evolving database that aims to bring together the experiential knowledge of HIFA members: more than 12,000 professionals from over 2500 organisations in 170 countries, ranging from senior executives at the World Health Organization in Geneva to community health workers in rural Gambia, interacting on five global discussion forums.

HIFA Voices contains the following specialised content:
1. HIFA Quotations are selected verbatim extracts from HIFA Global Forum discussions. HIFA Quotations comprise about 90% of the total content on HIFA Voices.
2. HIFA Citations are conventional bibliographic records of formal and informal literature on the availability and use of health information in low and middle-income countries. They include a growing collection of health information and libraries literature related to Kenya, compiled by Nasra Gathoni, President of the Association for Health Information and Libraries in Africa. We aim to introduce other countries in 2015.

HIFA Quotations and HIFA Citations are selected according to their relevance to three critical questions:
1. What are the healthcare information and learning needs of different groups of healthcare providers in different settings?
2. What are the barriers and drivers to meeting those needs?
3. What must be done – and how – to improve the availability and use of relevant, reliable and actionable healthcare information?

(Please note that HIFA Voices is not a database of health information resources – such databases are provided by other organisations, many of whom are represented among the HIFA members.)

You can choose to browse or search HIFA Quotations, HIFA Citations (Formal), or HIFA Citations (Informal). You can search on title, body and/or author, and/or select from a range of values under five different filters [1. users of healthcare information (eg community health workers); 2. healthcare issue (e.g. malaria); 3. knowledge cycle (eg producing reference and educational resources; 4. WHO regions and countries (e.g. Nigeria); and 5. Health systems and HRH (eg task shifting).

The content of the database is currently limited, but will grow substantially over the coming months. The current content includes HIFA Quotations from our main forum, HIFA, from 1st January 2014 to the present day, and this will be kept up-to-date as we progress through the year and beyond. The current content also includes some HIFA Quotations from previous work that we did with the Norwegian Knowledge Centre for the Health Services as a contribution to the WHO Recommendations on Optimising Health Workers’ Roles for Maternal and Newborn Health (2012).

We are grateful to our Lead Sponsors – The Lancet, Elsevier, mPowering Frontline Health Workers and Intel Corporation; Dr Najeeb Al-Shorbaji and Ian Roberts at WHO Geneva; the International Medical Informatics Association (IMIA); and expert advisers Pascal Mouhouelo (Head Librarian, WHO Africa Regional Office) and John Eyers (Emeritus Librarian, London School of Hygiene and Tropical Medicine). Special thanks to our lead database developer Arjun Thandi of Evucan web solutions.

We look forward to continue working with you to realise the HIFA vision: a world where every person and every health worker will have access to the healthcare information they need to protect their own health and the health of those for whom they are responsible.

HIFA Steering Group

HIFA welcomes 12 new Supporting Organisations in Bangladesh, Bhutan, Democratic Republic of Congo, India, Ireland, Nigeria, Pakistan, Peru, Taiwan, UK, and USA

11th August 2014

The HIFA Steering Group is delighted to announce twelve new HIFA Supporting Organisations:

1. Ashavani
Ashavani is a platform for all resources that reflect the voices of women health workers in India. It showcases research, documentation and advocacy efforts that reflect their lives, experiences, motivations and aspirations.

2. Asian Health Literacy Association
The Asian Health Literacy Association (AHLA) is an independent multinational nongovernmental organization that seeks to understand health literacy levels across Asia from a research, education and policy perspective.

3. Awojobi Clinic Eruwa
The Awojobi Clinic Eruwa is a private hospital in the public service and offers not only surgical treatment but also preventive medicine, primary care services, and medical treatments in rural Nigeria.

4. Bhutan Medical and Health Council
BMHC was established by the government of Bhutan to ensure the provision of health services by competent medical and health professionals.

5. Committee for Rural and Urban Development (CRUD)
CRUD is a government registered charity organisation working in health, education and social development since 1998 in Bangladesh.

6. Department of Community & Preventive Dentistry, Dow University of Health Sciences
The DCPD has an important role in imparting knowledge, skills and expertise pertinent to public oriented oral health care and services in Karachi, Pakistan.

7. ecancer
ecancer is committed to improving cancer communication and education with the goal of optimising patient care and outcomes.

8. Institute of Public Health in Ireland
The Institute of Public Health in Ireland (IPH) promotes cooperation for public health on the island of Ireland.

9. Instituto de Medicina Tropical Alexander von Humboldt
Part of the Universidad Peruana Cayetano Heredia (UPCH), the Alexander von Humboldt Institute of Tropical Medicine was founded in Peru in 1968 to create, develop and strengthen the teaching, research and care of infectious and tropical diseases in their basic, epidemiological, clinical, therapeutic, prevention and control aspects; and to train health leaders in this area of medicine.

10. Maqbool Clinic, Research and Training Centre
The Maqbool Clinic, Research and Training Centre in Pakistan is concerned with the advancement of primary healthcare facilities, imparting knowledge and skills of primary healthcare to patients, primary care physicians, nurses, midwives, and TBAs, and improving the safety and quality of care.

11. One Million Community Health Workers Campaign (1mCHW)
Set up by the Earth Institute at Columbia University, the 1mCHW Campaign aims to expand and accelerate community health worker programs in sub-Saharan African countries, scaling them up to district, regional, and national levels to meet the health-related Millennium Development Goals.

12. PISRF – Programme Intégré de Santé de Reproduction et Familial
PISRF, or the Integrated Program of Reproductive and Family Health, aspires to promote effective and adequate reproductive and family health services in the Democratic Republic of Congo.

This brings to 215 the number of organisations that have declared their support for the HIFA vision ­ a world where every person and every health worker has access to the healthcare information they need to protect their own health and the health of those for whom they are responsible. The three new HIFA Supporting Organisations are:

If the goals of YOUR organisation align with the HIFA goal, please join us!
- HIFA Supporting Organisations are under no obligation to provide financial support
- HIFA Supporting Organisations are promoted on HIFA publications and website
- HIFA Supporting Organisations are invited to explore possibilities for collaboration (please contact us for details).

To become a HIFA Supporting Organisation, please download an application form from our home page:
www.hifa2015.org

Dr Neil Pakenham-Walsh
Coordinator, HIFA
On behalf of the HIFA Steering Group

World Medical Association head on Ebola epidemic

7th August 2014

Dr Margaret Mungherera is President of the World Medical Association and a member of HIFA. She gave an 11-minute interview about the Ebola crisis to New Zealand national Radio on Friday 1st August. The audio is freely available here. Dr Mungherera has kindly agreed for us to transcribe the interview (below). We have also translated the interview into French: version française. In it, she highlights the importance of reliable health information and education for health workers and citizens, in addition to material support such as supply of personal protective equipment:

World Medical Association head on Ebola epidemic

Interviewer: The World Medical Association says doctors lives are at risk because of poor medical practices. Dr Margaret Mungherera, the President of WMA, says doctors and health workers need more help.

Dr. Mungherera: “They need to have had the training first of all, so we need to make sure that the training itself has the equipped them with knowledge about haemorrhagic fever and how to manage them. But I think the training first of all has to have done that. Now the other thing of course is that they need to have information, they need to be made aware when there’s a threat but they also need to be able to have the capacity to be able to protect themselves by practising infection control procedures, which are universal. Now, unfortunately these are quite a challenge in many places because we do have health workers in places in particular that don’t have water, they might not have the antiseptics, they might have the gloves and all the other things that are necessary, masks etc. So to be able to protect themselves, the normal infection control measures need to be in place to protect them. Now, if there is a case or a suspected case then of course they need to be able to identify that, and that means that there needs to be a case definition that needs to be made available to them to be able to identify the risks and they need support in terms of management of suspected cases. What we usually want to see is isolation centres put up for suspected cases. They need to have investigations available to confirm that these are cases, and of course if they are suspected or confirmed they need protective gear Here are some of the things mentioned. But there needs to be a protocol on how to proceed, when one suspects that this might be an Ebola or another haemorrhagic disease.

Interviewer: So there’s a lot that’s required, what’s happening in reality? Do doctors have at the very least protective equipment to protect themselves?

Dr. Mungherera: With health facilities in many of the African countries the health systems are weak in terms of resources that are needed to be able to manage epidemics like these. They don’t have the emergency preparedness that is required. The health workers, many of them are junior health workers being that many of the senior health workers are not really there to support the junior health workers and there’s the whole problem of retention. So you do have this happening and as a result many of them are not able to cope with these epidemics and need support from government departments, WHO and all the other organisations that are able to come in.

Interviewer: In fact we have heard of health workers, senior doctors who have died, is that partly because they simply haven’t got what they require?

Dr. Mungherera: Yes, they don’t have what they require, they don’t have the support, they don’t have the training and I think affected countries where the systems are already very weak and they’re countries where there are very few health workers and especially senior, qualified health workers, but they all these juniors that have just come out of medical school, out of training institutions and then are left to struggle on their own without any support. The whole of Africa has a human resource crisis where a lot of the doctors are junior doctors just coming out of medical school and then they’re the ones who are heading the teams and support the rest of the teams and I think it’s quite difficult for them. Now they also need the information and I think the governments need to help but have delayed response in countries that have been affected, but another result that they’re at the frontline and they’re the ones that have been affected the most not only in terms of getting the infection, all the fear, the scare and that is de-motivating them further. So I think they are the ones most affected, yes.

Interviewer: If governments do not step up Margaret and act quickly to bring in better conditions, to bring in isolation centres, to bring in protective gear what are going to be the consequences because this is already spreading so quickly?

Dr. Mungherera: First of all already there is massive loss of life. I mean if you have more than 670 people who have died from this problem in one country, that’s already massive. So there’s massive loss of life, then of course the scare, people keep away from the health facilities and as a result even though they have other infections and diseases, accessing much less than they would normally so that again causes problems. Women who would have delivered in the health facility now deliver at home, people keep away from the health facilities due to beliefs about the causes of this problem, we have our cultural beliefs that have come in as well were people approaching people saying that this is some sort of curse etc. So they keep away from the health facilities. But also it means that the health workers themselves will flee away from these facilities so that again is further another problem and on top of that these are places that have been affected by conflict so they already have the problems that have come out of conflict and various problems etc. And then again this is another insult to injury so it further weakens the system and it makes access to health facilities for the community even more difficult.

Interviewer: The WHO has announced $100 million as a response plan. What will the WMA be looking for from this amount of money? A considerable amount of money but what do the priorities need to be?

Dr. Mungherera: I think the priorities need to be measures: first of all awareness, public awareness, the communities need to be made aware, of course the anxieties have to be allayed, information has to be given and all the myths and misconceptions dealt with so a lot of public awareness is important, especially working with the media, but also there is a need for training, massive training of health workers, I hope that will happen, but also the protective gear, fitting up the isolation centres but also providing the basics, fluids, basic sundries and supplies and drugs that are needed. We don’t have the treatment for this haemorrhagic fever, but just to make sure the other issues that come up are to be managed. But I hope that is what is going to happen with the priorities: the protective gear, the isolation centres, the training – because it’s one thing putting up the isolation units but you’ve got to train and I think that’s what we’re hearing from the doctors who are reporting to us and the junior doctor networks especially, the junior doctors they need their support, the support supervision for what’s necessary. I hope that can be the sort of priorities they could look at, consider with that sort of funding.

Interviewer: Do you believe that this Ebola outbreak Margaret has been taken seriously enough internationally? Or there a concern that the rest of the world will go well thats Africa’s problem we’ll be fine.

Dr. Mungherera: You know what’s happening is I think that was the main response to it and I think that has caused a bit of a problem because we now hear cases all the over the west of Africa and we are beginning to hear cases that are suspected. We had a case that came up today in Uganda about a case where somebody who died of what appears might be Ebola. But you know he’s had no contact with anyone else so you know all of these ideas come in. But then of course you know people are mobile, with their mobility in the African continent, so definitely governments come in but they come in so late and they don’t put their own domestic resources they look for funding, but you can’t fund something that other people have to deal with, and I think that should not happen, I think governments need to be more clear about committing more resources to management of these epidemics especially emergency funding, the training that needs to be done and the public awareness. But I think to come in late with all the mobility and all these borders are so porous, people just walk through and many of these borders are between countries and so it’s very difficult to contain. But also the anxieties, the apprehension that it does in an already de-motivated health workforce and stretched already, it helps to further the stress and it gets further weakened. So I think governments need to take these epidemics more seriously and act more quickly. But also the international community also need to come in, its already done a lot but you know we need a bit more in terms of committing resources early in the epidemic and not as late as it has been, it’s been massive loss of life. Communities are really being affected, even just mentally, you can see the type of social issues problems that come up as a result of these sort of epidemics.
END

Two new Lead Sponsors for the HIFA Voices database

5th June 2014

We are delighted to announce two new Lead Sponsors for the new HIFA Voices database:

(1) Elsevier
(2) mPowering Frontline Health Workers in association with Intel Corporation.

1. Elsevier’s support will be channelled especially to promote further exploration by HIFA around issues of access to research for health professionals, policymakers, researchers and citizens in low- and middle-income countries (LMICs).

2. mPowering and Intel Corporation’s support is for further exploration around the information and learning needs of community health workers and other primary health workers in LMICs, who are the focus of the HIFA 2014 Challenge

We have published a free-access article about this on the ElsevierConnect website for the global science, health and technology communities: HIFA Voices tackles information poverty to improve global health: Healthcare Information for All’s new program aims to provide greater access to health knowledge where it’s needed most

Over the past 9 months, we have been working on the IT infrastructure of the database, with financial support from our first Lead Sponsor, The Lancet, announced in October 2013. We aim to launch the database in July 2014.

Through HIFA Voices, we aim to answer three critical questions, drawing from the insights and experience shared on the five HIFA Global Forums (12,000-plus members):
- What are the healthcare information and learning needs of different groups of citizens and health workers in different settings?
- What are the barriers and drivers to meeting those needs?
- What must be done – and how – to improve the availability and use of relevant, reliable, actionable healthcare information?

This is an ambitious undertaking and we have a lot of work to do over the coming months. We are grateful to The Lancet, Elsevier, mPowering and Intel Corporation for their generous support.

Let’s build a future where people are no longer dying for lack of healthcare knowledge: Join HIFA

HIFA Steering Group

Three new HIFA Supporting Organisations

28th May 2014

The HIFA Steering Group is delighted to announce three new HIFA Supporting Organisations. This brings to 203 the number of organisations that have declared their support for the HIFA vision – a world where every person and every health worker has access to the healthcare information they need to protect their own health and the health of those for whom they are responsible. The three new HIFA Supporting Organisations are:

1. Complete Emergency Care
‘Complete Emergency Care centers are state of the art walk-in 24 Hour Emergency Rooms located in San Antonio, El Paso and Fort Worth, USA.’

2. Medical Students Association of India
‘Medical Student’s Association of India is affiliated to the International Federation of Medical Students Association. Its mission is “An organization of, for and by medical students, endeavours to improve medical education, encourage public health awareness”.’

3. The Spice Route Movement
‘THE SPICE ROUTE is the WONCA South Asia Region (SAR) working group for new and future doctors who have an interest in Family/General Practice (FP/GP):
- Doctors and undergraduate medical students who are planning to train as FP/GP
- Doctors who are undertaking post-graduate training as FP/GP
- Doctors who have completed their post-graduate training in FP/GP within the last 10 years.

If the goals of YOUR organisation align with the HIFA goal, please join us!

HIFA Supporting Organisations are under no obligation to provide financial support
HIFA Supporting Organisations are promoted on HIFA publications and website
HIFA Supporting Organisations are invited to explore possibilities for collaboration (please contact us for details).

To become a HIFA Supporting Organisation, please download an application form here.

HIFA Steering Group

The CHILD2015 forum is hosting a thematic discussion on Child Abuse

19th May 2014

The CHILD2015 forum is hosting a thematic discussion on Child Abuse, in the run-up to the ISSOP meeting in Sweden on 17th June 2014 (International Society for Social Pediatrics and Child Health). Join CHILD2015 here.

We are exploring the following three questions – starting today!

1. Please give examples of the kind of problems you have faced in relation to the management of child abuse which you have encountered in your practice over the last five years (just provide a heading and age rather than full clinical details, e.g. acute physical abuse, chronic physical abuse, neglect, sexual abuse, emotional abuse)

2. please specify any action which you have taken following the discussion of child abuse on CHILD2015, to improve the management of child abuse in your own setting

3. please indicate how CHILD2015 might assist you in future in relation to the further management of child abuse in your clinical or public health practice

Thank you very much and we look forward to hearing from you

Tony Waterston
Gonca Yilmaz

CHILD2015 profiles: Tony Waterston is a retired consultant paediatrician who worked mainly in the community in Newcastle upon Tyne, UK. He spent 6 years working in Zambia and Zimbabwe and currently directs the Royal College of Paediatrics and Child Health Diploma in Palestinian Child Health teaching programme in the occupied Palestinian territories. He was an Editor of the Journal of Tropical Pediatrics and is on the Executive Committee of the International Society for Social Pediatrics. His academic interests are child poverty, advocacy for child health and children’s rights. Tony.Waterston AT newcastle.ac.uk

Gonca Yilmaz is a member of the executive committee of the International Society for Social Paediatrics and Child Health. She is a social pediatrician in a training hospital in Ankara, Turkey, and has a postgraduate degree in social pediatrics. Her interests include child rights, child abuse and neglect management, well child baby care, and infant nutrition. goncay AT gmail.com

New publication: Health Information Indicators – Measuring governments’ commitment to health information

16th May 2014

We are delighted to announce a new publication on the HIFA website: ‘Health Information Indicators – A preliminary attempt to measure commitments by governments to fulfil their obligations under international human rights law to ensure the progressive availability of healthcare information for citizens and health workers’. We are grateful to law student Hannah Glass and academic supervisor Professor Molly Land of the University of Connecticut School of Law and Human Rights Institute for preparing this paper for us.

The paper represents a significant step on our HIFA-Watch journey to hold governments to account with regard to their legal obligations under international human rights law, as demonstrated by our White Paper (2012) in collaboration with the New York Law School.

The new paper by Hannah Glass starts to explore the challenging question of how we can measure governments’ commitment to health information, drawing examples from India, Nigeria and Rwanda. We look forward to discuss the methods and findings on the HIFA Global Forums so that we can improve and extend the tool to other countries.

HIFA is now supported by 200 organisations worldwide

19th April 2014

The HIFA Steering Group is delighted to announce eight new HIFA Supporting Organisations. This brings to 200 the number of organisations that have declared their support for the HIFA vision – a world where every person and every health worker has access to the healthcare information they need to protect their own health and the health of those for whom they are responsible. The eight new HIFA Supporting Organisations are:

1. Digital Campus
2. Doctoori
3. Friends of Chitambo
4. Global Health through Education, Training and Service
5. Health Prospect: Journal of Public Health
6. mPowering Frontline Health Workers
7. School of Library & Information Science, San Jose State University
8. WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity

1. Digital Campus
‘Digital Campus is committed to promoting learning research, innovation and developing capacity through the use of appropriate technology.’
http://digital-campus.org

2. Doctoori
Doctoori is a health information and well-being portal in the Arabic language.
http://www.doctoori.net/

3. Friends of Chitambo
‘This project builds on existing links with Chitambo Hospital including longstanding historical links between Scotland and Chitambo… The hospital was founded in 1908, by Scottish missionaries, in memory of David Livingstone who died nearby. It was staffed by a succession of Scottish nurses and doctors and is now a government hospital managed by an all Zambian staff.’
http://www.thet.org/hps/health-partnerships/jvalli

4. Global Health through Education, Training and Service (GHETS)
‘Global Health through Education, Training and Service (GHETS) is a non-governmental organization dedicated to improving health in underserved communities around the world. We believe that well-trained and supported doctors, nurses, and allied health workers are the key to sustainable change. By providing seed grants and project support to a network of health professionals and advocates, we promote an increased utilization of local knowledge and expertise.’
http://www.ghets.org

5. Health Prospect: Journal of Public Health
‘Health Prospect is the first scientific Public Health Journal published by Nepal Public Health Students’ Society, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal. This journal has aimed to provide better space for sharing experiences and views, and for disseminating the results of scientific researches related to public health discipline.’
http://www.nphss.org.np/jhprospect

6. mPowering Frontline Health Workers
‘The goal of the mPowering Frontline Health Workers partnership is to contribute to the elimination of preventable child and maternal deaths by accelerating the use of mobile technology to improve the skills and performance of frontline health workers.’
http://www.mpoweringhealth.org/

7. School of Library & Information Science, San Jose State University
‘The School of Library and Information Science at San José State University (SJSU) prepares individuals for professional careers in the information professions, with a focus on the information needs of our global communities, connecting the user and the content.’
http://slisweb.sjsu.edu/about-slis

8. WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity
‘The Centre promotes the concept of technology assessment, the establishment of technology assessment systems, methodological support, training seminars in member countries, and collaborating among institutions with similar intent. To date, the Centre has focused on the development of a “tool kit” for needs-based and equity-oriented policy decisions and decision-aids for patient information.’
http://www.cgh.uottawa.ca/whocc/

200 organisations worldwide have now officially declared their commitment to the HIFA goal.

If the goals of YOUR organisation align with the HIFA goal, please join us!

  • HIFA Supporting Organisations are under no obligation to provide financial support
  • HIFA Supporting Organisations are promoted on HIFA2015 publications and website
  • HIFA Supporting Organisations are invited to explore possibilities for collaboration (please contact us for details).

  • To become a HIFA Supporting Organisation, please download an application form from our home page.

    Dr Neil Pakenham-Walsh
    Coordinator, HIFA2015
    On behalf of the HIFA2015 Steering Group