Director for Health,
Aga Khan Development Network

The AKDN eHealth Programme first started eight years ago with a teleradiology connection between Afghanistan (French Medical Institute for Children) and Pakistan (Aga Khan University Hospital, Karachi). Eight years in, how would you assess the growth of the Programme?

Let me focus on the Central and South Asia region: with nine additional health units connected in Afghanistan, five in Tajikistan and ten in Pakistan, AKDN eHRC is at a rate of getting three new units connected and inducted per year, which is, with all that is involved, quite impressive. This even more so, if one takes into account that the existing eHealth connected units continue to increase their scope of service delivery. This increase includes, over the last year or so, the addition of telepsychiatry services offered by AKUH, K to the Gilgit and Booni Medical Centres, teleneurology including pediatric neurology services and teleENT services offered by AKUH, K to FMIC, and the addition of teleneurology service offered by FMIC to the Bamyan and Faizabad Provincial Hospitals. There has also been expansion in eLearning with so far more than 350 eLearning sessions benefitting more than 4,500 staff. Further, the new eHealth certificate course has been developed to create eHealth awareness and develop eHealth programme managers and implementers in Afghanistan, Pakistan and Tajikistan. This course is a one-year long course with 11 modules. I understand current enrollment is 20 participants who have completed five modules. I hope that there will be more courses, and many more participants.

There is also the entry into the Kyrgyz Republic before the end of this year, where the AKDN eHRC is to connect three government units in Bishkek and Naryn to facilitate initially pediatrics teleconsultations and eLearning for family medicine. AKDN eHRC has also been able to establish an innovation lab to promote eHealth and mHealth innovations that aim to develop cost-effective health monitoring and early diagnostic products for low-resource settings.

However, there are also challenges that will have to be overcome including reluctance from health care providers to adopt virtual expertise, lack of awareness among patient populations about what eHealth services can and cannot do, and lack of robust connectivity in the technological/electronic infrastructure in areas we operate. There is also lack of knowledge and experience in how to achieve a financially sustainable model once donor funding ends, and in some instances, a lack of interest and/or involvement from partners, including governments.

When talking about the benefits of eHealth, we also hear about the barriers to eHealth or the resistance met from health care professionals and patients in eHealth adoption. What approach can be taken to eliminate these barriers? What do you consider to be the most daunting challenges in eHealth adoption?

I believe reluctance to adopt eHealth as a useful tool can be overcome if we continue to raise awareness and increase 'eHealth literacy'. This is, as with other innovations, largely about understanding through doing, and experiencing how eHealth interventions work and seeing the advantages.

The AKDN eHRC Newsletter is contributing to raising this awareness by promoting an understanding of the benefits of eHealth, including the publication of case studies. I think it is very important that AKDN eHRC continue to monitor, evaluate and document the findings of it's work, and to especially provide evidence on the cost-effectiveness of eHealth solutions above traditional manners of operating health care.

The AKDN eHealth Programme has been expanding gradually in South and Central Asia over the past few years. What impact do you foresee this expansion making on the region's health care landscape?

eHealth interventions can bring high-quality and specialist health care services closer to the homes of people, and this is especially important in the isolated mountainous areas in Central and South Asia where much of AKDN's health service delivery in the region takes place. Health care can therefore become more accessible and equitable. eHealth should mean for these communities earlier diagnosis and treatment, with less traveling and at lower cost. Health care providers can be connected to their colleagues and peers, and this connectivity can result in enhanced capacity building and professional development, again with less time lost due to travelling and, in principle, at lower cost. eHealth can also contribute to the integrated health care systems that we are building, by linking health care providers and health care facilities in hubs and spokes across the region. And lastly, the AKDN eHealth initiatives can also contribute to the public-private partnerships and collaborations with governments that we are keen to expand further.

What is your vision for eHealth and for the AKDN eHealth Programme?

I see eHealth as a catalyst and tool to improve health care service delivery in rural and urban populations, especially in Asia and Africa. I hope that AKDN eHRC will continue to support the development and implementation of the AKDN health service delivery strategies by finding, delivering and measuring relevant and appropriate eHealth solutions for the Network. I hope to see in the coming years, next to the work continuing in Central and South Asia, a rapid expansion in East Africa.

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