I previously indicated in my previous entries that the intervention that I wish to develop shall be useful in the context of the community. One of the problems that I have previously encountered is the lack of accessible healthcare in the indigenous community that I used to work for. This community was located in Sitio Maporak, Zambales and it was inhabited by the aetas. It took a 1 hour hike to get from the main road to the community and another 2 hours of travel by bus to get to the nearest health facility. Clearly there is a problem in terms of geographical access. Consequently, the village had to rely on the local hilot for their healthcare needs. This problem has also been documented in a study by the WHO
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| Community members of Sitio Maporak (community mentioned for the intervention) |
Distance and long travel times to health facilities remain key barriers to access in many rural communities in the Region. A study of demand for antenatal care among pregnant women in Cebu, in the Philippines, found that health care services were less accessible for rural than urban women. The study showed that rural women faced significantly longer travel times than women living in urban areas and that the travel costs in rural areas were almost double those in urban areas.
Urban-rural disparities in the coverage of measles vaccination are also evident in Viet Nam, and significant rural-urban differences are also found in the number of children fully immunized before the age of one year in the Philippines.
Evidence points to similar inequalities in the coverage of child health interventions among marginalized populations. For example, a UNICEF baseline survey in Viet Nam revealed that the coverage of measles vaccination was significantly lower in the Northern Upland provinces, with the gap in coverage between the Kinh majority and ethnic minorities ranging from 27-49 percentage points.
Analysis from Cambodia indicates that the reasons that certain areas and populations are underserved with immunization services are predominantly socioeconomic, including distance from the health facility, ethnic status, poverty and low education.
Source:(http://www.wpro.who.int/NR/rdonlyres/C1BA83FE-283B-4F31-AFC9-42EBDC08255A/0/ReachingthePoor_ChildHealthandPoverty_Part2.pdf)
This problem is also seen in the United States wherein there is clearly a gap between rural and urban healthcare due to a lack of health care professionals who practice in the rural sector.
The classic geographic barrier, which is very prominent in Utah is the issue of being in a rural area--literally living somewhere where there aren't health professionals. When we look at physicians, the vast majority of them choose to practice in urban or suburban communities. We have a very small proportion, about 5%, who are practicing in rural America. (Source:http://www.kued.org/productions/healthcare/barriers/geographic.php)
This problem is also seen in the United States wherein there is clearly a gap between rural and urban healthcare due to a lack of health care professionals who practice in the rural sector.
The classic geographic barrier, which is very prominent in Utah is the issue of being in a rural area--literally living somewhere where there aren't health professionals. When we look at physicians, the vast majority of them choose to practice in urban or suburban communities. We have a very small proportion, about 5%, who are practicing in rural America. (Source:http://www.kued.org/productions/healthcare/barriers/geographic.php)
I believe that this situation can be alleviated with the use of telehealth. The challenge, however, is developing a system that would cater to this need. With this being said, there is a need for certain factors for an intervention such as this one to be implemented and these are the following:
1. standby physicians for the local hotline
2. an organized system in the community to ensure that there are no duplication of calls
3. presence of a signal that would make telecommunication possible (sun, globe or smart)
4. funding from the government for the compensation of hotline physicians along with efforts to increase healthcare coverage to the rural sector
The system would entail a single point person for the community namely, the village head and he shall call a hotline which would deal a response to the condition at hand. Communication can be done in the form of text messages or direct calls. The beauty in this system is that it takes advantage of a resource that filipinos already have, the cellphone. In addition, telecommunications companies have made an effort to put up cell sites in rural areas to ensure that their subscribers still get the benefit of a great signal despite their proximity from the city.
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| Diagram of the Proposed Intervention in the Selected Community (click to enlarge) |
Future developments for this technology would involve combining this form of technology with that of teleradiology and using a similar intervention with other diagnostic tools ultimately resulting in a holistic telehealth technology that ensures that all the pertinent information is delivered to physicians who are located in the city. This would benefit people who are situated in far-flung areas because the more holistic the technology is, the better it would be for the patient because of the fact that the physician's decisions would be based on concrete data and pertinent findings.
