Innovation in ICT-Based Health Care Provision

Author(s):  
Synnøve Thomassen Andersen ◽  
Arild Jansen

This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in rural areas in Norway by using mobile phone technology. The authors apply a multilayer and dialectic perspective in the analysis of the innovation process that created the ICT solution that supports this treatment model. The salient challenges of the project were related to the contradictions between the existing, dominant power structures and the emergent structures in the different layers of the design structures. As a result of the development process, a new model emerged with a larger potential for creating a new innovation path than if it had been linked to existing structures. This paper contributes to the understanding of how user-driven innovation can break with existing power structures through focusing on different layers in the change processes.

Author(s):  
Synnøve Thomassen Andersen ◽  
Arild Jansen

This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in rural areas in Norway by using mobile phone technology. The authors apply a multilayer and dialectic perspective in the analysis of the innovation process that created the ICT solution that supports this treatment model. The salient challenges of the project were related to the contradictions between the existing, dominant power structures and the emergent structures in the different layers of the design structures. As a result of the development process, a new model emerged with a larger potential for creating a new innovation path than if it had been linked to existing structures. This paper contributes to the understanding of how user-driven innovation can break with existing power structures through focusing on different layers in the change processes.


Spectrum ◽  
2018 ◽  
Author(s):  
Josiah Michael Villareal De Los Santos ◽  
Sonya Jakubec

Filipinos experience numerous barriers to mental health care in their country, such as stigmatization ofillness and behaviours, lack of mental health care services, and resource deficits. The Philippine MentalHealth Act of 2017 was formed to resolve these issues and is in its early stages of implementation.Legislation and policy interventions of this nature are but one level of many interventions that can addresshealth care at a population level. The influence of this legislation for different levels of society is analyzed inorder to understand the different barriers and alternatives to its implementation. Solutions suggested in thelegislation, such as addressing lack of accessibility in rural areas, creating liaisons between different levelsof mental health care, and educating the population regarding mental health, are explored for their effects ondifferent spheres, or levels, of influence. The comprehensiveness of the legislation to address the needs ofmental health service users are highlighted, as are barriers to implementation that inhibit the realization ofpractical strategies. This policy case review and analysis informs program development by highlighting thestrengths and weaknesses aligned to the legislative articles’ target sphere of influence and the population.


2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.


Author(s):  
Fabienne Reiners ◽  
Janienke Sturm ◽  
Lisette J.W. Bouw ◽  
Eveline J.M. Wouters

Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended.


Author(s):  
Tuhin Kumar ◽  
Piyalee Pal ◽  
Prabhdeep Kaur

Abstract Background: Adolescents constituted 19% population of India in 2011. Adolescents have health seeking behaviour different from that of adults. We estimated the utilisation of available health care services by adolescents and awareness regarding various health issues in the urban and rural Dehradun District, Uttarakhand, India. We also described knowledge and practices of public sector health care providers. Methodology: We conducted a cross-sectional survey among adolescents 10–19 years in the urban Dehradun and rural Chakrata block of the Dehradun District. We used cluster sampling with sample size 680 each in urban and rural areas. We collected data from adolescents using semi structured questionnaire on health awareness and utilisation of health care services. Public sector health care providers were surveyed about their knowledge and practices regarding adolescents health. Results: We surveyed 1463 adolescents. The overall mean age was 14.4 (2.6) years, about half being females. Half of the adolescents who had any illness used the public sector. Awareness about anaemia was 48% in urban and 12% in rural areas. A higher proportion of females (Rural: 89%, Urban: 76%) were aware of condoms as contraceptives than males (Rural: 68%, Urban: 12%). Only 62% of doctors and 49% of paramedical staff had knowledge regarding services under Adolescents Reproductive and Sexual Health (ARSH). Conclusion: Awareness regarding various health issues was low among males as compared to females, especially in rural areas. School based health promotion programs should be carried out to increase awareness among adolescents. Health facilities should be strengthened to provide adolescent friendly health services to enhance utilisation.


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