Communities living in remote and isolated regions of South-Central Asia and East Africa lack access to specialists and to quality health care services. Health care is either very basic or absent. These rural regions are marked by harsh weather conditions and rugged terrain with deep valleys, rivers and high mountains, making life challenging for villagers. The only alternative for patients seeking quality health care is to travel long distances - across lakes in boats and through mountainous areas - to nearby cities, where specialists are available. Often, travel is hindered by the severe weather conditions, especially in the winter in South-Central Asia. Often, delays in medical care lead to complications, deteriorating medical conditions, sometimes even lead to death. During travel, patients spend a lot of time and money to travel to avail health care services in nearby cities, burdening them with unnecessary expenses
The AKDN Digital Health Programme initiated in 2007 with an aim to provide affordable access to quality health services in remote and rural regions of South-Central Asia. It plays a pivotal role in strengthening local health systems by providing comprehensive and coordinated health care services to remote populations through telehealth and helping develop clinical and managerial capacities of health care professionals working in these regions through eLearning. Leveraging the potential of Information and Communication Technologies (ICTs) in supporting health care, the Programme adopts a hub and spoke model, which connects service-receiving facilities with service-providing facilities for teleconsultation and eLearning services.
Digital health activities first initiated in Afghanistan when the French Medical Institute for Children in Kabul was connected to the Aga Khan University Hospital, Karachi for teleradiology services in 2007. Over 11 years, the Programme has evolved into a network of 41 health facilities across Afghanistan, Kyrgyz Republic, Pakistan, Tajikistan in South-Central Asia and in Kenya and Tanzania in East Africa. It currently supports the operations of health care facilities that are owned by AKDN, and health care facilities that result from public-private partnerships (PPP) including those owned by the government but managed by AKDN, or owned and managed by the government. Government-owned and managed facilities are selected for inclusion in the digital health system based on a set of quality criteria and standards of operation.
Through the Programme, patients receive a variety of teleconsultation services while health care professionals avail capacity building opportunities through eLearning services. Teleconsultations enable patients from low-resource settings to receive high quality, low cost health care. The AKDN Digital Health Programme offers both live (synchronous) and store-and-forward (asynchronous) teleconsultations. Over the years, the programme has expanded to include other diagnostic services: telepathology and teleopthalmology, and teleconsultations in specialties such as obstetrics and gynaecology, paediatrics, neurology, and psychiatry, among others. eLearning services help reduce professional isolation by addressing educational needs of health professionals based in remote areas, who are unable to undertake time-consuming and costly travel to attend courses in urban areas. eLearning enhances the clinical and managerial skills of physicians, nurses and other medical and allied health professionals by offering courses on various medical and nursing topics. This supports local health systems, thereby improving delivery of care.
The AKDN Digital Health Programme is funded primarily by Global Affairs Canada and the Aga Khan Foundation Canada (AKFC) and other funding agencies, i.e., Agence Française de Developpement (AFD); Aga Khan Foundation, Geneva; Aga Khan University; French Ministry of Foreign Affairs; Kreditanstalt für Wiederaufbau (KfW); Roshan Telecom and the United States Agency for International Development (USAID). It is implemented with the support of various AKDN agencies and through public–private partnerships with government health ministries in each country of operation, like the Ministry of Public Health in Afghanistan; the Ministry of Health in Kyrgyz Republic; the Ministry of Health, Tajikistan and the various Departments of Health in Pakistan.
In 2014, the AKDN Digital Health Programme was recognized for its contribution to eHealth when it won the Manthan Award 2014 in the eHealth category. The Manthan Awards recognise the best use of Information and Communication Technologies and digital tools to create holistic and comprehensive impact on people in South Asia and Asia Pacific.
The Programme provides greater access to quality health care to the region, which benefits communities as well as provides great learning for the region. It ensures all health facilities have an equitable quality of services by bringing those sites with low quality services to par with existing facilities offering high quality services by linking them through digital health.
The Programme supports telehealth services to enable electronic delivery of quality health care to patients in remote areas lacking needed expertise, thereby reducing the burden of diseases; and make continuous professional development accessible to health care providers through eLearning. Public-private partnerships ensure effectiveness and sustainability of digital health and show how it is a valuable and powerful mechanism to provide high-quality, low-cost, accessible and equitable health care services.
From June 2007 to November 2019, 46,643 teleconsultations were carried out while 19,347 eLearning participants were trained through 1693 eLearning sessions, across different health facilities in South-Central Asia and East Africa.
eLearning Participants Trained