Faster diagnosis and treatment of skin disorders with the use of remote imaging and telemedicine technology is now available for patients at Gilgit Medical Centre (GMC).

The new service connects patients to dermatologists at the Aga Khan University Hospital, Karachi (AKUH, K) through live teleconsultations.

Images of the patients’ concerned area are captured by the eHealth coordinator using a dermascope during the consultation. The detailed images are transmitted in real-time to the dermatologist at AKUH, K through VirtualDoc, a secure, online portal to manage teleconsultations, developed by AKDN eHRC.

Through this new service, patients living in remote areas and who lack access to dermatologists will receive timely diagnosis and treatment from qualified dermatologists at AKUH, K. It will also help them save travel time and money.

An eHealth assessment conducted earlier in Gilgit-Baltistan found skin-related issues to be a large concern. This prompted the eHealth Programme to initiate teledermatology at GMC.

A dermascope is used to take detailed images of patients’ skin disorders at Gilgit Medical Centre. The images are transmitted in real-time to dermatologists at AKUH, K for timely diagnosis and treatment.

In an effort to address declining participation by health care professionals in eLearning courses, the Aga Khan University Hospital, Karachi (AKUH, K) is offering credit on Continuing Medical Education (CME) courses broadcast to the Aga Khan Booni Medical Centre, Gilgit Medical Centre and Singal Medical Centre.

The issue was first identified earlier this year when attendance declined from 94 in the 2nd quarter to just 11 in the 3rd, with no change in number of courses offered.

It was determined that attendance was low because participants were not receiving credit for the CME courses they were attending. The Pakistan Medical and Dental Council requires all registered health care providers to receive a certain number of CME training hours annually to maintain their license to practice.

Now, health care professionals attending eLearning courses at these facilities will be able to count them toward their official CME credit hours.

AKUH, K regularly offers CME courses to health care professionals to strengthen their capacity and their ability to provide health care services more efficiently.

It is expected that this new development will yield an increase in attendance at these facilities.

Health care professionals in Booni, Gilgit and Singal attend eLearning sessions broadcast from AKUH, K, aimed at building their professional capacity.

AKDN eHRC has developed Teeko, a mHealth application for a research project conducted by the Aga Khan University (AKU) in collaboration with the Expanded Programme for Immunization, Sindh. The project aims to boost routine immunization coverage in the Tando Mohammad Khan (TMK) district of the Sindh province.

Titled "Improving Routine Immunization Coverage through Health Systems Strengthening", the project uses mHealth technologies to improve and strengthen governance in TMK. This will be done by tracking vaccinators and providing real-time, accurate data to monitor immunization activities.

The immunization rate in Sindh was reportedly less than 30% in 2012-2013 despite a large number of vaccinators being employed under the immunization programme. Poor governance, a lack of transparency, accountability and effective monitoring by the government are contributing factors for the declining rates.

AKDN eHRC designed and developed Teeko to assist with vaccinator and immunization tracking and monitoring. The mobile application provides real-time data on a vaccinator’s field movements through GPS tracking and on the number of children being immunized. The aim is to have a strengthened immunization programme through increased transparency, accountability and monitoring.

Dr Shehla Zaidi, Associate Professor, Community Health Sciences, AKU, is leading this project. Funded by Global Alliance for Vaccines and Immunizations, the project initiated in January 2015 and will conclude in 2017. The mHealth component of the project began in October 2015 and will be implemented over a period of 15 months.

The application has been tested in the field and the intervention was well-received by the end users in TMK. Additionally, immunization-related SMS and health sessions have also been administered which have helped raise awareness in the community on the importance of routine immunizations.

The application has been shared with the Government of Sindh for endorsement and rollout in Sindh.

The mHealth application Teeko uses GPS tracking to provide real-time data on a vaccinator’s field movements and on the number of children being immunized in the Tando Mohammad Khan district of Sindh, Pakistan.

Three hospitals in Kyrgyz Republic are now connected for eHealth services under the AKDN eHealth Programme. This is the first time that solely government-owned facilities have been connected under the Programme.

Acting as a hub site, the Republican Children’s Clinical Hospital in Bishkek offers live teleconsultations in Paediatrics and eLearning sessions in Family Medicine to the Naryn Oblast Hospital and the Naryn Oblast Family Medicine Centre in Naryn, respectively.

This initiative will help improve access to and quality of health services provided to patients, build capacity of health care providers, strengthen the performance of the health facilities, and deepen the relationship between AKDN and the Ministry of Health, Kyrgyz Republic. AKDN eHRC worked with health care staff at the sites to establish connectivity.

Kyrgyz Republic’s addition to the Programme is a testament to AKDN’s commitment to creating an integrated health care system in South and Central Asia. The Programme currently offers eHealth services – teleconsultations to patients and eLearning sessions to health care providers – at over 20 sites across Afghanistan, Pakistan and Tajikistan.

Dr. Nazira Beyshembieva (on screen), head of the Nephrology department at Republican Children’s Clinical Hospital in Bishkek conducts a live teleconsultation in Paediatrics with a patient accompanied by Dr. Munara Musaeva, head of the Paediatric department at Naryn Oblast Hospital.

AKU and AKDN eHRC are conducting a study to determine the effectiveness of telepsychiatry services in Gilgit Baltistan and Chitral districts of Pakistan. In December, the research team travelled to Gilgit Medical Centre (GMC) and the Aga Khan Booni Medical Centre (AKBMC) to carry out training and testing activities.

Data collectors were trained on administering the data collection application, ‘Psychiatry Teleconsultation Evaluation’, to collect information from patients who have utilised telepsychiatry services from GMC or AKBMC. The application has been developed by the research team from AKU, AKDN eHRC and Dalhousie University, Canada.

Reliability of the data collection tool was also tested through pilot testing. The tool will assist the research team to assess patients’ teleconsultation experience in terms of increasing access to health care, improving quality of care and reducing cost for patients.

Based on the results of the pilot test, the research tools will be revised and finalized for optimal use, after which the data collection process will initiate.

This evaluation study is conducted with mixed research methods using quantitative and qualitative tools to collect data from participants. Funded by Global Affairs Canada and the Aga Khan Foundation, Canada, the study initiated in April 2015 and will conclude in January 2017.

Live teleconsultations in Psychiatry are currently being provided by specialists at the Aga Khan University Hospital, Karachi to patients at the two sites.

Local data collectors in Gilgit and Booni received training from AKDN eHRC staff on administering the Psychiatry Teleconsultation Evaluation questionnaire with patients.

A research study is being carried out to evaluate the effectiveness of eLearning intervention among health care providers in Afghanistan and Tajikistan. Challenges encountered by the research team while conducting the study were discussed at this year’s 10th International Conference at the Aga Khan University-Institute for Educational Development.

Azra Naseem from the Blended and Digital Learning Network and Institute for Educational Development and Kiran Qasim Ali of AKDN eHRC delivered a poster presentation titled, “Challenges of Conducting a Tri-Partite Research Study on eLearning Intervention in Afghanistan and Tajikistan”.

One of the challenges is attaining ethics approval for a multi-country research study as each country has separate ethical guidelines. Recruiting local and bi-lingual data collectors and translators who are also experienced in the field of nursing and research is time-consuming. Security issues in Afghanistan have hampered implementation of research activities.

To mitigate these challenges, the research team has adopted several strategies. They have leveraged local networks and engaged stakeholders to hire local data collectors and develop contextually-relevant research tools and processes. Internet-mediated technologies have been utilised for communication, collaboration and research. Training will be provided to local data collection teams.

Several lessons have been learned along the way. Collaboration between research partners at each step of the process is critical. Ample time must be allocated in the planning phase to factor in ethics approvals. Training of local data collectors should be incorporated in research methodologies.

Presenters received positive feedback from the audience who showed great interest in the study’s approach and eventual findings.

Titled, “A Renewed Focus on Teacher, Teaching Quality and Learning: Localised Models and Practices”, the conference called for a ‘renewed focus’ on the three fundamental pillars of the educational system: teacher, teaching quality and learning.

Challenges encountered while conducting an eLearning study were discussed by research partners at the conference. The study will assess the effectiveness of eLearning intervention among health care providers in Afghanistan and Tajikistan.

AKDN eHRC made two presentations on palliative care at the 14th Shaukat Khanum Cancer Symposium hosted by the Shaukat Khanum Memorial Cancer Hospital and Research Centre. The theme of the symposium was ‘Transforming Cancer Care’.

The first presentation was on a research paper titled, ‘Assessment of Challenges, Resources, and Capacity for Palliative Care: A Case Study from Pakistan.’ The paper was part of a larger study conducted by AKDN health agencies from Afghanistan, India, Kenya, Pakistan, Tajikistan and Tanzania.

Sehrish Sajjad, Training and Research Associate at AKDN eHRC shared the study’s scope, challenges and current status; clarified misconceptions under palliative and hospice care; and highlighted the importance of technology in transforming cancer care.

Another poster presentation titled, ‘Issues, Resources, and Capacity in Palliative Care - A Literature Review’ highlighted available literature on palliative care in the Pakistani context.

The presentations resulted in a healthy dialogue with participants who shared their views on the topic, agreeing on the growing need of technology in palliative care. There was also noticeable interest from participants in collaborating with AKDN eHRC to further palliative care using technology.

A case study on palliative care in Pakistan and the importance of technology in transforming cancer care was discussed by AKDN eHRC at the 14th Shaukat Khanum Cancer Symposium.

Partners and Supporters of the AKDN eHealth Programme


View the AKDN eHealth Programme Quarter 3 Activities Report.