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The Use of ICT in the Health Sector in Pacific Island Countries

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Book cover Achieving Sustainable E-Government in Pacific Island States

Part of the book series: Public Administration and Information Technology ((PAIT,volume 27))

Abstract

The health of their people and the delivery of better health services are core development goals for all Pacific Island countries (PICs). Information and Communication Technology has a critical role to play in this sector, and e-health is a recognized part of e-government. But in PICs this role is largely limited to the collection and management of health data ; where ICT plays a major role in improving health outcomes in industrialized countries, for example , clinical decision support for clinicians, and telemedicine , the use of ICTs in PICs is more sparsely adopted. Examples of applications tend be local, ad hoc projects, although valuable in the limited contribution they make. This chapter outlines the burden of disease and other challenges, such as lack of funding, that PICs face in delivering health services. It explains how ICTs are used in the collection and analysis of health data, the contribution made by regional organizations and the high level of regional collaboration this entails. In the second half of the chapter some ICT projects to support clinicians and other health workers (e-learning, e-resources and telemedicine) and the use ICTs in the delivery of health services, are outlined. In the final section, the use of mobile technology in both health care and public health initiatives is discussed. The chapter concludes that the health sector in Pacific SIDs is so resource-sensitive that any technological ‘intervention’ must clearly add considerable value to justify the allocation of resources that would otherwise be spent on staff, medicines, equipment and facilities.

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Notes

  1. 1.

    The WHO defines health services as all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health. This includes personal (health care) and non-personal health services (http://www.who.int/topics/health_services/en/).

  2. 2.

    In PICs where there are many small remote islands that comprise a number of provinces, several provincial hospitals may be linked to one regional ‘referral’ hospital, which in turn refers on to a national referral hospital.

  3. 3.

    OECD figures for 2013 are: Kiribati, 0.2 doctors and 2.79 qualified nurses per 1000 population (2014); Marshall Islands, 0.45 doctors and 2.18 qualified nurses per 1000 (2014); Vanuatu, 0.19 doctors and 1.33 qualified nurses per 1000 (2013); in Australia and New Zealand doctors are 3.4 and 2.78 per 1000 population, and nurses 11.52 and 10.4 per 1000 population respectively (http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data.htm).

  4. 4.

    The international dollar (Int’l $) is a hypothetical currency that, in the cited country and at the same time, would buy a comparable amount of goods and services a U.S. dollar would buy in the United States.

  5. 5.

    This figure which is affected by relatively high GDP per capita figures for Fiji and Samoa (Int’l $8792 and Int’l 5789 respectively) disguises the fact that the majority of PICs have GDP per capita figures between Int’l $1000 and 3000.

  6. 6.

    GDP figures do not take into account the fact that in most PICs there is a large non-monetary subsistence rural economy which is not part of GDP; at the same time, it cannot contribute to the cost of modern health services (although traditional health practices may be a part of it).

  7. 7.

    Out of pocket expenses are charges paid directly by patients and any other non-reimbursable costs of health care. In PICs, especially for those living in remote villages a long way from health services and reliant on a subsistence economy, such charges can be prohibitive. Even for poorly paid urban dwellers they can be a substantial burden.

  8. 8.

    Radio (both broadcasting and HF/HVF radio) is used by a number of PICs as a means of disseminating public health messages and for communications with isolated communities. While it must be acknowledged as one of the ICTs used in the health sector, it is not discussed in detail in this chapter (see Chap. 1 for a more detailed discussion of this issue).

  9. 9.

    A critical issue in the Pacific in light of research by Hetzel et al. (2014), and others.

  10. 10.

    Health surveillance is the systematic and continuous collection of health-related data primarily to provide warning of public health emergencies such as outbreaks of infectious diseases.

  11. 11.

    The WHO is an agency of the United Nations, but countries can be members of the WHO even when they are not member states of the UN itself, e.g. Cook Islands. The non-self-governing territories and dependencies of the Pacific are associate members, through the WPRO.

  12. 12.

    Data from the Pacific territories is provided by the WHO member country (France, United States, New Zealand) responsible for them.

  13. 13.

    This is discussed in more detail in Chap. 8 on Statistics and ICTs in development.

  14. 14.

    See also Chap. 8.

  15. 15.

    http://hiip.wpro.who.int/portal/Home.aspx. This data covers the entire region including Australia, New Zealand, China and Japan and includes health financing data; some data is a decade or more out of date for all countries, and does not always match WHO data which is projected forwards using a larger range of sources.

  16. 16.

    http://www.getinthepicture.org/subregional-initiatives.

  17. 17.

    A monitoring and evaluation program is an essential feature of the Pacific CVRS program and milestones and outcome indicators have been identified, but no reports are yet available.

  18. 18.

    The local pidjin language used in PNG.

  19. 19.

    Personal communication from Amanda Watson, 17 August, 2016.

  20. 20.

    A town of about 3500 people, with electricity supplied by generators and extremely limited cell phone coverage and Internet access. Medical students from Australia and nursing staff from Japan provide the main support to the salaried doctor in charge of the 30-bed hospital.

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  1. School of Government, Victoria University of Wellington, Wellington, New Zealand

    Rowena Cullen

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  1. Rowena Cullen
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Correspondence to Rowena Cullen .

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Editors and Affiliations

  1. School of Government, Victoria University of Wellington, Wellington, New Zealand

    Rowena Cullen

  2. School of Government, Victoria University of Wellington, Wellington, New Zealand

    Graham Hassall

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Cullen, R. (2017). The Use of ICT in the Health Sector in Pacific Island Countries. In: Cullen, R., Hassall, G. (eds) Achieving Sustainable E-Government in Pacific Island States. Public Administration and Information Technology, vol 27. Springer, Cham. https://doi.org/10.1007/978-3-319-50972-3_11

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