Information and communication technologies and health in low income countries: the potential and the constraints

This paper outlines the potential offered by technological progress in the information and communication technologies (ICTs) industries for the health sector in developing countries, presents some examples of positive experie nces in India, and considers the difficulties in achieving this potential. The development of ICTs can bring about improvements in health in developin g countries in at least three ways: as an instrument for continuing educati on they enable health workers to be informed of and trained in advances in knowledge; they can improve the delivery of health and disaster management services to poor and remote locations; and they can increase the transparen cy and efficiency of governance, which should, in turn, improve the availab ility and delivery of publicly provided health services. These potential be nefits of ICTs do not necessarily require all the final beneficiaries to be reached directly, thus the cost of a given quantum of effect is reduced. S ome current experiments in India, such as the use of Personal Digital Assis tants by rural health workers in Rajasthan, the disaster management project in Maharashtra and the computerized village offices in Andhra Pradesh and Pondicherry, suggest creative ways of using ICTs to improve the health cond itions of local people. However, the basic difficulties encountered in usin g ICTs for such purposes are: an inadequate physical infrastructure; insuff icient access by the majority of the population to the hardware; and a lack of the requisite skills for using them. We highlight the substantial cost involved in providing wider access, and the problem of resource allocation in poor countries where basic infrastructure for health and education is st ill lacking. Educating health professionals in the possible uses of ICTs, a nd providing them with access and "connectivity", would in turn spread the benefits to a much wider set of final beneficiaries and might help reduce t he digital divide.