Ehealth Proposal Outline


Area of focus: Southern Africa

Health issue: HIV/AIDS


Personal Connection

– After spending three months in Zambia in 2008, I felt inspired to pursue international development as a major here at the University of Toronto. I began to be drawn toward international health with a special interest in Sub Saharan Africa and HIV/AIDS development. When I came across ehealth for the first time, I began continually asking myself what role can ehealth play in Africa, a continent typical seen as resource poor and stereotypically labeled as backwards, primitive. Can ehealth play a role in aiding in communicative systems to benefits health? Therefore my research question is proposed around my personal interest in HIV/AIDS in Africa and what this emerging sector in health means for the future of health and healthcare for Southern Africa.


Why is ehealth important?

–       Promoting ehealth in developing regions such as sub Saharan Africa (Ibrahim, 2009)

–       Ehealth is about rethinking how health systems collect, exchange information in order to improve the delivery in the health system.

–       A child born in a developing country is over 33 times more likely to die within the first 5 years of life than a child born in an industrialized country. While nearly 2.5 million people were newly infected with HIV in 2007. EHealth offer a strategy to rethink and define all aspects of health from promotion to treatment.

–       Combating Millennium Development Goal 6 (combat HIV/AIDS , malaria and other diseases: halved by 2015 and begun to reverse the spread of HIV/AIDS).

–       Globally individuals that never ad access to landlines now have access to low-cost handheld devices. According to United Nations Foundation (2009) 64% of all mobile phone users can be found in the developing world. They also estimated that by 2012 nearly half of all remote areas of the world will have mobile phones.

–       Long distance to health centers may impede an individuals willingness to seek healthcare. Ehealth may provide solutions to these long distances.

–       Lack of health professions in rural areas. Ehealth may offer simple technological devices to connect healthcare workers to eachother.



–       What is ehealth (WHO definition) eHelath is the use of information and communication technologies (ICT) for health.

–       Mhealth: using mobile communications – such as PDAs and mobile phones for health services and information.

  • Used for: data collection, remote monitoring, communication and training for health care workers, education and awareness, disease and epidemic outbreak tracking and diagnostic and treatment support.

–       More in death definitions: (G, Eyesenbach) is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”.

–       Ehealth can apply to health systems, and or patients as well as the intersection between both.


Different Sectors of ehealth

–       Mhealth – SMS/MMS (mobile health) from 2003-2008 mobile subscriptions in Africa grew twice as fast as any other part of the world. (pg. 7).

  • SMS messages are low cost way of communicating not only with friends but also by providing outreach services for a wide variety of health issues, education and awareness applications. Messages are sent directly to an individuals phone which offer information about testing and treatment methods, availability of health services and disease management.

–       Internet (video conferencing, social networking, blogging, instant messaging)

–       Computers (netbooks, laptops, servers)

–       Electronic medical records


Different stages where health initiatives can be integrated

–       preventative

–       diagnosis

–       treatment

–       follow up 


Components (Ibrahim, 2009)

  1. surveillance and information Gathering
  2. Research
  3. Provider to provider health care workers (exchange of information within healthcare workers)
  4. Healthcare provider to patient
  5. Education (ensuring health care providers are educated as well as the use of patient education and awareness)
  6. Logistics (delivery of health)



–       primarily I will use academic journals along with publications by the World Bank, World Health Organization and UN. Chapters from selected novels will also be used. Local as well as international news stations will be regularly checked for relevant articles pertaining to HIV within the ehealth sphere.

–       Projects to look into

  • AIDSWEB project World Bank (chapter 5 Bowman)
  • Cell life project South Africa
  • Dimagi inc: softwear company which aids in secure HIV positive status messages via mobile phones.



–       brings together patients and health care providers via ehealth technology and initiatives.

–       Health promotion initiatives that reach youth through SMS devices, and where stigma and shame is still attached to a positive HIV status, SMS offers a more private way of gathering information from support programs, which offer reliable information (United Nations Foundation, 2009).



–       increased breaches of privacy and confidentiality

–       breakdowns of technological systems can impair the delivery of health systems.

–       Loss of autonomy by health care workers

–       Spread of poor quality health information that causes harm to patients.




  1. Southern Africa too large? I wanted to include South Africa due to the abundance of information but also Zambia, Malawi, Madagascar who are yet to advance to the level of ehealth integration currently underway in South Africa.
  2. I want to layout my focus of my research, which would be how ehealth initiatives impact all stages of HIV/AIDs progression including prevention, diagnosis and treatment. Is this specific enough?