e-Health for Rural Areas in Developing Countries: Lessons from the Sebokeng Experience

  • Massimiliano Masi
  • Rosario Pugliese
  • Francesco Tiezzi
Part of the Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering book series (LNICST, volume 92)


We report the experience gained in an e-Health project in the Gauteng province, in South Africa. A Proof-of-Concept of the project has been already installed in 3 clinics in the Sebokeng township. The project is now going to be applied to 300 clinics in the whole province. This extension of the Proof-of-Concept can however give rise to security flaws because of the inclusion of rural areas with unreliable Internet connection. We address this problem and propose a safe solution.


e-Health systems in developing countries information security healthcare technology standards e-Health experiences 


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  1. 1.
    Health Level Seven organization: Hl7 standards (2009),
  2. 2.
    The epSOS project: An European eHealth Project (2010),
  3. 3.
    The Nationwide Health Information Network (NHIN): An American eHealth Project (2009), (last visited on July 4, 2011)
  4. 4.
    The IHE Initiative: IT Infrastructure Technical Framework (2009),
  5. 5.
    ACR-NEMA: Digital Imaging and Communications in Medicine (DICOM) (1995)Google Scholar
  6. 6.
    OASIS Security Services TC: Assertions and protocols for the OASIS security assertion markup language (SAML) v2.02 (2005),
  7. 7.
    Mosupi, M.: Gauteng Department of Health (GDoH): E-HR.GP, System Implementation (2008), (last visited on July 4, 2011)
  8. 8.
    Wikipedia, the free encyclopedia: Sebokeng, Gauteng. Wikipedia entry,,_Gauteng (last visited on July 4, 2011)
  9. 9.
    Masi, M., Pugliese, R., Tiezzi, F.: Security analysis of standard- driven communication protocols for healthcare scenarios. In: Healthcom, pp. 308–315. IEEE (2011)Google Scholar
  10. 10.
    Fantechi, A., Gnesi, S., Lapadula, A., Mazzanti, F., Pugliese, R., Tiezzi, F.: A Logical Verification Methodology for Service-Oriented Computing. ACM Transactions on Software Engineering and Methodology (2011) (to appear)Google Scholar
  11. 11.
    Wikipedia, the free encyclopedia: Intrusion Detection Systems. Wikipedia entry, (last visited on July 4, 2011)
  12. 12.
    Lowe, G.: A Hierarchy of Authentication Specifications. In: CSFW, pp. 31–44. IEEE (1997)Google Scholar
  13. 13.
    Dolev, D., Yao, A.: On the security of public key protocols. IEEE Transactions on Information Theory 29(2), 198–207 (1983)MathSciNetzbMATHCrossRefGoogle Scholar
  14. 14.
    The Nationwide Health Information Network (NHIN): Threat models (2009), (last visited on July 4, 2011)
  15. 15.
    Yarali, A., Ahsant, B., Rahman, S.: Wireless mesh networking: A key solution for emergency & rural applications. In: MESH, pp. 143–149. IEEE (2009)Google Scholar
  16. 16.
    Armando, A., Carbone, R., Compagna, L., Cuellar, J., Abad, L.: Formal Analysis of SAML 2.0 Web Browser Single Sign-On: Breaking the SAML-based Single Sign-On for Google Apps. In: FMSE, pp. 1–10. ACM (2008)Google Scholar
  17. 17.
    Johnson, J., Langworthy, D., Lamport, L., Vogt, F.: Formal specification of a web services protocol. In: WSFM. ENTCS, vol. 105, pp. 147–158. Elsevier (2004)Google Scholar
  18. 18.
    Blanchet, B.: CryptoVerif: Computationally Sound Mechanized Prover for Cryptographic Protocols. Dagstuhl seminar “Formal Protocol Verification Applied” (2007)Google Scholar
  19. 19.
    Bhargavan, K., Corin, R., Fournet, C., Gordon, A.: Secure sessions for web services. In: SWS, pp. 56–66. ACM (2004)Google Scholar
  20. 20.
    Ma, L., Tsai, J.: Formal verification techniques for computer communication security protocols. Handbook of Software Engineering and Knowledge Engineering 1, 23–46 (2001)Google Scholar
  21. 21.
    Fidge, C.: A Survey of Verification Techniques for Security Protocols. Technical Report 01-22, Software Verification Research Centre, Univ. of Queensland (2001)Google Scholar
  22. 22.
    Armellin, G., Bogoni, L.P., Chiasera, A., Toai, T.J., Zanella, G.: Enabling Business Intelligence Functions over a Loosely Coupled Environment. In: Popescu-Zeletin, R., Rai, I.A., Jonas, K., Villafiorita, A. (eds.) AFRICOMM 2010. LNICST, vol. 64, pp. 122–131. Springer, Heidelberg (2011)CrossRefGoogle Scholar

Copyright information

© ICST Institute for Computer Science, Social Informatics and Telecommunications Engineering 2012

Authors and Affiliations

  • Massimiliano Masi
    • 1
    • 2
  • Rosario Pugliese
    • 1
  • Francesco Tiezzi
    • 3
  1. 1.Università degli Studi di FirenzeFirenzeItaly
  2. 2.Tiani “Spirit” GmbHViennaAustria
  3. 3.IMT Advanced Studies LuccaLuccaItaly

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