Technology in Public Health: The Way Forward

Technology, in the form of medicines, medical equipment and diagnostic devices, has long catered to the curative approach towards health. Public health on the other hand mostly looks into primary health care and preventive and promotive care- improving health seeking behaviour, prevention of diseases, and health system strengthening. While technology has always played an enabling role in public health, it is increasingly assuming a central role in many public health interventions. Affordability, quality, wider reach, simplicity and scalability are often adjectives used when technology solutions are built for global health and international development. Unfortunately, the adoption of technology in public health has not kept pace with the advancements in the field. Cases of successful usage of technology in public health interventions are few and are not yet utilized to their full potential. The presence of various actors with differing objectives and operating in multiple geographical areas can lead to effort duplication, counteractive programs, and even conflicts. From Swasti health resource centre’s experience in working with technology-driven innovations in the field of public health, there are a number of reasons for this low rate of adoption:

1. Existing technologies are designed by people with little knowledge of the development sector
2. Duplication of and conflicts between efforts due to low market research and a lack of understanding between providers, implementers and communities.
3. Clear disconnect between demand and supply
4. Lack of drive to integrate technology as a key component in development interventions
5. Lack of information and knowledge among developments sector stakeholders on technology-driven innovations

Many technology interventions tend to be supply focused rather than demand-led, often due to the knowledge gap between the Civil Society Organizations, consultants working in the development sector and the developers of new technologies. This leads to a disconnect between the designed technology, client requirements and implementation on the ground. On the other hand, CSOs and consultants in the development sector are not fully aware of the possibilities to use new technologies in their project and program design. Adding to this list is the fear among community members to change from tried and tested methods to new and innovative methods: for example, moving from face to face doctor consultations to telemedicine. We also note a lack of will to invest time and effort to adjust to the new technology; for example, asking Auxiliary Nurse Midwives to use a decision support and record keeping tool for maternal and neonatal care, instead of the outdated process of manually recording health information and maintaining registers

Through CHMI, Swasti has identified and have worked with many programs with a focus on technology. From diagnostic devices, decision support softwares, information and communication technology to process innovations, these programs attempt to provide solutions to a range of  public health issues.  By working closely with some of these programs, including Project Suyojana, Dtree, iCalQ, Meradoctor and  AYZH, we have realised the need for a platform for these technology providers and other stakeholders to discuss and direct the space of technology in the public health space.

As an initial step towards building this forum, Swasti recently hosted a ‘Technology Round Table’ in Bangalore, India which saw the participation of a number of technology providers (including a number of CHMI programs), private consultants and community representatives. The roundtable introduced the idea of a forum focusing on technology in public health, and had a participative process of deciding the structure, design, stakeholder participation and format of such a forum.

One of the participants asked “ There are multiple forums like the one you proposed. What exactly is the gap we are trying to fill through this forum?” Yes, there are a number of similar forums, but most of the existing forums are lead by investor networks who very often have a hidden agenda i.e. investor networks who want a pipeline of programs they could potentially fund or collaborate with. Swasti’s forum aims to build an ecosystem for the various stakeholders to come together and leverage learning to accelerate impact. The forum would not just see success stories, but would be a platform to discuss opportunities, failures, and issues faced at a technology front or while implementing solutions on the ground. In short the forum would aim at bridging the gap between how different stakeholders understand technology, encourage collaboration and work towards a common goal of leveraging technology to accelerate health outcomes.

The discussion ended with a consensus on the need for the proposed learning and collaboration platform.  Many participants enthusiastically volunteered to be part of the design and implementation of this platform. A platform like such would be the beginning of a new approach towards health and dealing with health problems; a true sense of collaboration where every partnership need not be a case of win-win but where individuals/organizations see victory in bring others who need a supportive hand at pace with them. This could help the program implementers build a perspective about using technology to enhance efficiencies and effectiveness but also help understand real problems, build solutions and minimise effort duplication in both developed and developing countries in the long run.  We are all geared up to brainstorm, debate and crack this puzzle to realise our dream - Will this be a physical platform or a virtual one, open to all or on invitation, who should be part of this and sustainability are some of the areas we will explore - Watch this space!

- Madhavi Jayarajan and Shrish NR