Can developing countries afford wireless broadband technologies to deliver healthcare?

While working recently on a paper on WiMAX healthcare applications in developing countries, one of the key questions faced was whether wireless and wireless broadband in particular can truly help rural and underserved communities – where people may subsist on less than a dollar a day, houses have no running water or electricity, and kids only have access to the most basic education.

Countries with a critical shortage of health care workers.
Source: World Health Organization. The World Health Report 2006

Simply put, we do not know the answer to this question yet and, in most likelihood, different communities will develop a wide range of approaches, and some will be more successful than others.  Right now, we are in the very initial phase of exploring the opportunities that wireless broadband brings and there is hardly any historical data to measure the impact of wireless broadband on health care in emerging markets.

However, the indications we have so far are extremely encouraging and fascinating.  In developed countries we still think of wireless broadband as a luxury service mostly limited to the business users that afford a $60/month contract.  In emerging countries, wireless broadband can address basic community needs and not just health care: education, ability to develop small businesses, access to government services can equally benefit-by making scarce resources available more widely and more efficiently.  This is because wireless technologies are often the first communication technologies to reach the communities that need most assistance.  In these communities, wireline connectivity is often not available, and people are often quite isolated as they do not own cars or live in villages only reachable by foot.

Emerging countries have shown to be extremely quick at adopting wireless technologies.  Even in the most remote villages, cell phones are widely used, as they offer the only way to keep in touch with friends, relative or customers.  In health care, SMS messaging to remind people to take their daily pills or to encourage them to get HIV testing have proven to deliver substantial results with little cost.

Wireless broadband provides the next step.  For sure, developing countries have limited funding available for health care.  But what they crucially lack are resources – there are few doctors and most of them do not want to work in remote or poor areas.  They often do not even speak the same language as many of the people in these communities.  To get care, people living in rural or poor areas have to spend huge amounts of time to travel to the hospital and wait to be seen by a doctor-and, because of this, they often postpone the trip to the hospital until it becomes much more expensive and difficult to treat the condition.

According to Dr.  Manuel Dayrit, Director of the Department of Human Resources for Health at the World Health Organization, “even if you have the medicine, the vaccines, and the bed nets, you need the health workers to deliver the service.  With the experience of the last few years, where you have had huge global funds move into an activity to provide resources…we’ve found that the bottleneck is really the delivery.”

This is exactly where wireless broadband and WiMAX fit and where cellular technologies, powerful as they are for narrowband applications, are not sufficient.  The ability to establish a data connection between visiting nurses in remote or underserved areas and doctors in urban hospitals brings affordable health care exactly where and when it is needed.  A broadband connection allows the nurse, which has often very limited training, to get immediate answers from attending doctors and to avoid costly referrals.  Basic tests can be done remotely and the data can be analyzed in real-time at the hospital.  VoIP and video sessions allow doctors to interact directly with the patient and the nurse.  Remote learning courses can be made available on-line to give additional training to nurses without taking them away from the community where they operate.

Wireless broadband applications encourage a shift from the still dominant urgent-care treatment that is often administered too late, to more effective preventive and early-stage treatment that reduces both the medical and social costs of health care.

These wireless broadband applications play are uniquely positioned to bring health care closer to the patient, where the need is strongest and the resources more scarce.  This new approach has been recently championed by the World Health Organization to address the very basic needs that current health care systems struggle to meet.  It is an approach that certainly requires some initial funding, but that also promises to deliver a more cost-effective, equitable and effective framework to provide primary health care services in emerging countries.