eHealth in Zimbabwe: UHC and a case of local techno-social development

Poster (PDF Available) · March 2019with 43 Reads
DOI: 10.13140/RG.2.2.35908.27525
African Health Agenda, International Conference (AHAIC 2019), DOI:10.13140/RG.2.2.35908.27525
Cite this publication
Abstract
Background: In their 2016 report on Global Diffusion of eHealth, the World Health Organisation states that Universal Health Coverage cannot be achieved without the support of eHealth. Existing literature and narratives on eHealth appear to be originating from a western epistemology. Our local research gives a broad introduction to eHealth in Zimbabwe, which can resonate with eHealth deployment in other African settings. Methods: Harvesting from long time and rich experiences, in situboth in rural and urban areas, we position eHealth as a multi-faceted, dynamic and integrative episteme conducive for UHC in Africa. We compile a transdisciplinary eHealth narrative from health professionals and information and communication technology experts in Zimbabwe. Results: Our research presents preliminary deconstructions on how imported platforms and tools can destabilise well-established practices in the health system, both spatially and scalarly. Reflecting upon the genesis of various perspectives-anthropological, computer scientific, and medical, among others-we reconstruct eHealth within an African perspective and present how such a view on eHealth is productive in Zimbabwe. As digital technologies are becoming increasingly mobile, newer types of digital communication, and thus eHealth, will continue to be created. The case of socio-technical developments at the Ministry of Health and Child Care in Zimbabwe and a local NGO SolidarMed provides examples of practices that are sensitive to such a locally embedded development, showing an urgent need to develop eHealth set in African theories and models. Conclusions and Recommendations: We proposes a rationale for aligning eHealth with people, processes, systems and local cultures, taking into account local ways of meaning-making and the value of embedded, local processes. We advocate the development of African eHealth models that are rooted in community engagement, workforce development, and thought leadership that strengthen local capacity development and beneficiation.
TITLE:
eHealth in Zimbabwe: UHC and a case of local
techno-social development
Conference: African Health Agenda, International Conference
(AHAIC 2019)
Abstract Code Number: 650
Dates and Location: 5-7 March 2019, Kigali, Rwanda
Abstract:
Background: In their 2016 report on Global Diffusion of eHealth, the World Health Organisation states that
Universal Health Coverage cannot be achieved without the support of eHealth. Existing literature and
narratives on eHealth appear to be originating from a western epistemology. Our local research gives a
broad introduction to eHealth in Zimbabwe, which can resonate with eHealth deployment in other African
settings.
Methods: Harvesting from long time and rich experiences, in situboth in rural and urban areas, we position
eHealth as a multi-faceted, dynamic and integrative episteme conducive for UHC in Africa. We compile a
transdisciplinary eHealth narrative from health professionals and information and communication
technology experts in Zimbabwe.
Results: Our research presents preliminary deconstructions on how imported platforms and tools can
destabilise well-established practices in the health system, both spatially and scalarly. Reflecting upon the
genesis of various perspectives – anthropological, computer scientific, and medical, among others – we
reconstruct eHealth within an African perspective and present how such a view on eHealth is productive in
Zimbabwe.
As digital technologies are becoming increasingly mobile, newer types of digital communication, and thus
eHealth, will continue to be created. The case of socio-technical developments at the Ministry of Health
and Child Care in Zimbabwe and a local NGO SolidarMed provides examples of practices that are sensitive
to such a locally embedded development, showing an urgent need to develop eHealth set in African
theories and models.
Conclusions and Recommendations: We proposes a rationale for aligning eHealth with people, processes,
systems and local cultures, taking into account local ways of meaning-making and the value of embedded,
local processes. We advocate the development of African eHealth models that are rooted in community
engagement, workforce development, and thought leadership that strengthen local capacity development
and beneficiation.
Keywords: eHealth, Africa, transdisciplinarity
Background
The World Health Organisation, in their 2016 report
on Global Diffusion of eHealth, states that Universal
Health Coverage (UHC) cannot be achieved without
the support of eHealth.
Existing literature and narratives on eHealth appear
to be originating from awestern epistemology.
Zimbabwean research shows that the meaning of
eHealth depends from one’s location and worldview.
Figure 1: No UHC without eHealth (WHO, 2016)
eHealth in Zimbabwe: Universal Health Coverage
and a case of local techno-social development
Authors
Trymore Chawurura1, Ronald Manhibi2, Janneke van Dijk2, Gertjan van Stam2,
1 Ministry of Health and Child Care, Masvingo Provincial Hospital, Zimbabwe
2SolidarMed Zimbabwe
Abstract Code Number: 650
Key words: eHealth, Africa, transdisciplinarity
Results
Our research shows that eHealth:
1. is not subservient to current forms of health care,
but an integral part of such acare
2. does not replace ‘older systems, but gives
scalability and ability to additional forms of care
3. challenges the spatiality (the reach) and scalarity
(the hierarchy) of local practices and established
information flows
4. opens up both exciting opportunities and real
threats to the central features of contemporary
health management in Africa
In Zimbabwe, as many other African countries,
eHealth is still to go beyond the stage of sensitisation,
testing, amending, and small-scale implementations,
into ubiquitous availability and operation.
Figure 2: Various digital health platforms in Zimbabwe
Various ways in which eHealth can be instrumental:
as abackbone of health systems with tools for the
prevention and management of disease with the
aim of epidemiological control
in the measurement and evaluation of health
service delivery as an instrumental part of the
statistical and administrative enterprise
as anetwork of tools, platforms, and applications,
through attention by technology inclined entities
in facilitating the public and private health sectors
to report on health outcomes and, for instance,
providing health messages and the facilitation of
remittances
eHealth is context sensitive.Issues are, among others:
paradigmatic and cultural (ubuntu/unhu versus
individualism)
technical (latency, congestion and variety of
equipment)
dependencies (on people, processes, systems, and
categorisations)
epistemic (socialities, indigenous knowledge, and
cognitive justice of African experience)
Conclusion
eHealth developments in Africa and abroad are
contrapuntal:they are interdependent yet
independent in flow and delineation.
We propose to deconstruct and reconstruct eHealth
rationales to ensure eHealth aligns with African
people, processes, systems and local cultures, taking
into account local ways of meaning-making and the
value of established, embedded, local processes.
We advocate the development of African eHealth
models that are rooted in community engagement,
workforce development, and thought leadership that
strengthen local capacity development and
beneficiation.
Selected References
Bishi, J., Shamu, A., van Dijk, J., van Stam, G.: Community
Engagement for eHealth in Masvingo, Zimbabwe.In:Proceedings of
1st International Multi Disciplinary Conference, 23-25 August 2017,
Lusaka, Zambia (2017)
Chawurura, T., Manhibi, R., van Dijk, J., van Stam, G.: eHealth in
Zimbabwe, acase of techno-social development. In:IFIP WG 9.4
Conference, 1-3 May 2019,Dar es Salaam, Tanzania (2019).
Fulgencio, H., Ong’ayo, A., van Reisen, M., van Dijk, J., van Stam, G.:
mMoney Remittances: Contributing to the Quality of Rural Health
Care.In:Proceedings of Africomm 2016, 6-7 Dec 2016,
Ouagadougou, Burkina Faso (2016).
Hobbins, M., Kavenga, M., Manhibi, R., van Dijk, J., van Stam, G.:
eHealth: Connecting communities for health, selected cases in
Zimbabwe.Medicus Mundi Bulletin, 148 (2018).
Johnson, D., van Stam, G.: The Shortcomings of Globalised Internet
Tech nology in Southern Africa. In:Proceedings of Africomm 2016, 6-7
Dec 2016,Ouagadougou, Burkina Faso (2016).
MoHCC:The National Health Strategy for Zimbabwe, 2016-2020.
Equity and Quality in Health: Leaving No One Behind.Ministry of
Health and Child Care, Harare (2016).
van Stam, G.: Toward s an Africanised Expression of ICT.In:Lecture
Notes of the Institute for Computer Sciences, Social-Informatics and
Tele co mm unication s Engineering, Vol.119 LNICST. Springer: Berlin,
Heidelberg (2013).
van Stam, G.: African Engineering Agency and the Informatisation of
the World. The case of Big Data and Information and Communication
Tech nologi es.In:EAI International Conference for Research,
Innovation and Development for Africa, 20-21 June 2017, Victoria
Falls, Zimbabwe, (2017).
World Health Organisation:WHA58.28 eHealth. EHealth Resolutions
to the 58th Meeting of the World Health Assembly, (4), 121123
(2004).
World Health Organization:Global diffusion of eHealth: making
universal health coverage achievable.In: Report of the third global
survey on eHealth. World Health Organization:Geneva (2016).
eHealth
definition
The
cost-effective and secure use
of
Information
and Communication
Technology
in
support of health and health-related
fields,
including
health-care services,
health
surveillance,
health literature, and
health
education,
knowledge and research .
(WHO,
2004)
Method
Harvesting from long time and rich experiences
living research, in situ both in rural and urban areas,
we regard eHealth as amulti-faceted, dynamic and
integrative episteme conducive for UHC in Africa.
We compiled atransdisciplinary eHealth narrative
from health professionals, participants at Technical
Working Groups at Zimbabwe’s Ministry of Health and
Child Care, and Information and Communication
Technology experts in Zimbabwe.
Zimbabwe’s
National Health Strategy (
2016-
2020
):
Significant
investments in health
system
strengthening
are necessary for the
health
facilities
and other service delivery
and
coordination
platforms to function
optimally.
[...
]new innovative programmes such as
e-
health
are implemented to enhance and not
to
disrupt
what has been working so far
This research hasn't been cited in any other publications.
  • eHealth in Zimbabwe, a case of techno-social development
    • T Chawurura
    • R Manhibi
    • J Van Dijk
    • G Van Stam
    • Chawurura, T., Manhibi, R., van Dijk, J., van Stam, G.: eHealth in Zimbabwe, a case of techno-social development. In: IFIP WG 9.4
  • eHealth: Connecting communities for health, selected cases in Zimbabwe
    • M Hobbins
    • M Kavenga
    • R Manhibi
    • J Van Dijk
    • G Van Stam
    • Hobbins, M., Kavenga, M., Manhibi, R., van Dijk, J., van Stam, G.: eHealth: Connecting communities for health, selected cases in Zimbabwe. Medicus Mundi Bulletin, 148 (2018).
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