Semantic interoperability is the ability of computer systems to exchange data with unambiguous, shared meaning. Semantic interoperability is a requirement to enable machine computable logic, inferencing, knowledge discovery, and data federation between information systems.^[1]

Semantic interoperability is therefore concerned not just with the packaging of data (syntax), but the simultaneous transmission of the meaning with the data (semantics). This is accomplished by adding data about the data (metadata), linking each data element to a controlled, shared vocabulary. The meaning of the data is transmitted with the data itself, in one self-describing “information package” that is independent of any information system. It is this shared vocabulary, and its associated links to an ontology, which provides the foundation and capability of machine interpretation, inferencing, and logic.

Syntactic interoperability is a prerequisite for semantic interoperability. Syntactic interoperability refers to the packaging and transmission mechanisms for data. In healthcare, HL7 has been in use for over thirty years (which predates the internet and web technology), and uses the unix pipe (|) as a data delimiter. The current internet standard for document markup is XML, which uses “< >” as a data delimiter. The data delimiters convey no meaning to the data other than to structure the data. Without a data dictionary to translate the contents of the delimiters, the data remains meaningless. While there are many attempts at creating data dictionaries and information models to associate with these data packaging mechanisms, none have been practical to implement. This has only perpetuated the ongoing “babelization” of data and inability to exchange of data with meaning.

Since the introduction of the Semantic Web concept by Tim Berners-Lee in 1999,^[2] there has been growing interest and application of the W3C (World Wide Web Consortium, WWWC) standards to provide web-scale semantic data exchange, federation, and inferencing capabilities….more on Wikipaedia

Teaching undergraduate students in rural general practice: an evaluation of a new rural campus in England

Citation: Bartlett M, Pritchard K, Lewis L, Hays RB, McKinley RK.  Teaching undergraduate students in rural general practice: an evaluation of a new rural campus in England. Rural and Remote Health (Internet) 2016; 16: 3694. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3694(Accessed 26 June 2016)

Introduction:  One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week ‘student attachment’ in primary care during the final year, which required the development of a new network of teaching practices in a rural district of England about 90 km (60 mi) from the main campus in North Staffordshire. The new accommodation and education hub was established in 2011–2012 to enable students to become immersed in those communities and learn about medical practice within a rural and remote context. Objectives were to evaluate the rural teaching from the perspectives of four groups: patients, general practice tutors, community hospital staff and students. Learning outcomes (as measured by objective structured clinical examinations) of students learning in rural practices in the final year were compared with those in other practices.
Methods:  Data were gathered from a variety of sources. Students’ scores in cohort-wide clinical assessment were compared with those in other locations. Semi-structured interviews were conducted with general practice tutors and community hospital staff. Serial focus groups explored the perceptions of the students, and questionnaires were used to gather the views of patients.
Results:  Patients reported positive experiences of students in their consultations, with 97% expressing willingness to see students. The majority of patients considered that teaching in general practice was a good thing. They also expressed altruistic ideas about facilitating learning. The tutors were enthusiastic and perceived that teaching had positive impacts on their practices despite negative effects on their workload. The community hospital staff welcomed students and expressed altruistic ideas about helping them learn. There was no significant difference between the rurally placed students’ objective structured clinical examination performance and that of their peers in other locations. Some students had difficulty with the isolation from peers and academic activities, and travel was a problem despite their accommodation close to the practices.
Conclusions:  Students valued the learning opportunities offered by the rural practice placements. The general practice tutors, patients and community hospital staff found teaching to be a positive experience overall and perceived a value to the health system and broader community in students learning locally for substantial periods of time. The evaluation has identified some student concerns about transport times and costs, social isolation, and access to resources and administrative tasks, and these are being addressed.

Key words: general practice, medical education, primary health care, rural clinical placements, undergraduate, United Kingdom.

The Cumbria Rural Health Forum: initiating change and moving forward with technology

Citation: Ditchburn J, Marshall A.  The Cumbria Rural Health Forum: initiating change and moving forward with technology. Rural and Remote Health (Internet) 2016; 16: 3738. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3738 (Accessed 26 June 2016)

Introduction:  The Cumbria Rural Health Forum was formed by a number of public, private and voluntary sector organisations to collaboratively work on rural health and social care in the county of Cumbria, England. The aim of the forum is to improve health and social care delivery for rural communities, and share practical ideas and evidence-based best practice that can be implemented in Cumbria. The forum currently consists of approximately 50 organisations interested in and responsible for delivery of health and social care in Cumbria. An exploration of digital technologies for health and care was recognised as an initial priority. This article describes a hands-on approach undertaken within the forum, including its current progress and development.

Methods:  The forum used a modified Delphi technique to facilitate its work on discussing ideas and reaching consensus to formulate the Cumbria Strategy for Digital Technologies in Health and Social Care. The group communication process took place over meetings and workshops held at various locations in the county.

Results:  A roadmap for the implementation of digital technologies into health and social care was developed. The roadmap recommends the following: (i) to improve the health outcomes for targeted groups, within a unit, department or care pathway; (ii) to explain, clarify, share good (and bad) practice, assess impact and value through information sharing through conferences and events, influencing and advocacy for Cumbria; and (iii) to develop a digital-health-ready workforce where health and social care professionals can be supported to use digital technologies, and enhance recruitment and retention of staff.

Conclusions:  The forum experienced issues consistent with those in other Delphi studies, such as the repetition of ideas. Attendance was variable due to the unavailability of key people at times. Although the forum facilitated collective effort to address rural health issues, its power is limited to influencing and supporting implementation of change. Within the implementation phase, the forum has engaged in advising and facilitating policy change at all levels. Thus, the forum has become a voice to influence change towards the advancement of health and social care through digital technologies. The forum continues to serve as a think tank and influencer for change in rural health and social care issues in Cumbria. The forum has increased awareness of digital health and social care solutions, mapped best practice and developed a digital strategy for health and social care in Cumbria.

Key words: digital technology, e-health, England, health services, needs and demand, social care, strategy, telecare, telehealth, telemedicine.

Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries

• Zulu J.M
• Kinsman J
• Michelo C
• Hurtig A.-K

BMC Public Health-14 (2014)

WONCA News – June 2016
The latest WONCA News is available via the WONCA website, packed with WONCA news, views and events.

Featured Doctor – A/Professor Pavlo Kolesnyk
One of this month’s featured doctors is A/Professor Pavlo Kolesnyk from Ukraine.  Pavlo is Associate Professor of the Family Medicine Department of Postgraduate Faculty of Uzhgorod National University (Ukraine) and also practices at the municipal family medicine clinic.  Find out more about family medicine practice in Ukraine by reading all about Pavlo in this month’s news.

“Polaris” in Tobago
“Professional conferences have been considered an effective way to improve knowledge, make connections and build skills. These have also served as personal investments in one’s own professional growth. A particular conference in the idyllic island of Tobago from May 14th to 19th, 2016 was unique in blending the elements needed to engage the local professional body while instilling a sense of community in a wider audience from various countries.  The meeting – hosted by the Caribbean College of Family Physicians’ (CCFP’s) Tobago Chapter – served to combine the island’s annual meeting and the WONCA Polaris Forum.”

Read more about this unique blend of Caribbean College and Polaris on the WONCA website.

World Mental Health Day 2016 
The World Federation for Mental Health (WFMH) has announced the theme for World Mental Health Day coming on October 10, 2016:
Dignity in Mental Health – Psychological & Mental Health First Aid for All 

Mental health crises and distress are viewed differently because of ignorance, poor knowledge, stigma and discrimination. This cannot continue to be allowed to happen, especially as we know that there can be no health without mental health.   Psychological and mental health first aid should available to all, and not just a few. This is the reason why WFMH has chosen psychological and mental health first as its theme for 2016. You can read more about World Mental Health Day on the WONCA website:

OneHealth Webinars – Antibiotic Resistance and Cysticercosis
One Health is a movement to forge collaborations between human and veterinary medical healthcare providers, social scientists, dentists, nurses, agriculturalists and food producers, wildlife and environmental health specialists and many other related disciplines.  OneHealth has advised us of a series of webinars which might be of interest to WONCA members.  Further details of all of these, including how to register, can be found at www.onehealthcommission.org 

28th June (1300-1500 GMT/UTC) – OneHealth approach for elimination of Taenia solium Taeniosis / Cysticercosis
6th July (1500-1600 GMT/UTC) – The politics of antimicrobial resistance (Part 1 of 2)
13th July (1500-1600 GMT/UTC) – Antimicrobial resistance and the environment (Part 2 of 2)

CITATION: Evaluation of SMS reminder messages for altering treatment adherence and health seeking perceptions among malaria care-seekers in Nigeria

Jenny X. Liu & Sepideh Modrek

Health Policy Plan. (2016)

doi: 10.1093/heapol/czw076

First published online: June 16, 2016

Corresponding author: jenny.liu2@ucsf.edu

ABSTRACT

In Nigeria, access to malaria diagnostics may be expanded if drug retailers were allowed to administer malaria rapid diagnostic tests (RDTs). A 2012 pilot intervention showed that short message service (SMS) reminder messages could boost treatment adherence to RDT results by 10–14% points. This study aimed to replicate the SMS intervention in a different population, and additionally test the effect of an expanded message about anticipated RDT access policy change on customers’ acceptability for drug retailers’ administration of RDTs. One day after being tested with an RDT, participants who purchased malaria treatment from drug shops were randomized to receive (1) a basic SMS reminder repeating the RDT result and appropriate treatment actions, (2) an expanded SMS reminder additionally saying that the ‘government might allow pharmacists/chemists to do RDTs’ or (3) no SMS reminders (i.e. control). Using regression analysis, we estimate intent-to-treat (ITT) and treatment effects on the treated for 686 study participants. Results corroborate previous findings that a basic SMS reminder increased treatment adherence [odds ratio (OR)?=?1.53, 95% CI 0.96–2.44] and decreased use of unnecessary anti-malarials for RDT-negative adults [OR?=?0.63, 95% CI 0.39–1.00]. The expanded SMS also increased adherence for adults [OR?=?1.42, 95% CI 0.97–2.07], but the effects for sick children differed—the basic SMS did not have any measurable impact on treatment adherence [OR?=?0.87, 95% CI 0.24–3.09] or use of unnecessary anti-malarials [OR?=?1.27, 95% CI 0.32–1.93], and the expanded SMS actually led to poorer treatment adherence [OR?=?0.26, 95% CI 0.10–0.66] and increased use of unnecessary anti-malarials [OR?=?4.67, 95% CI 1.76–12.43]. Further, the targeted but neutral message in the expanded SMS lowered acceptance for drug retailers’ administration of RDTs [OR?=?0.55, 95% CI 0.10–2.93], counter to what we hypothesized. Future SMS interventions should show consistent positive results across populations and be attuned to message length and content before initiating a larger messaging campaign.

KEY MESSAGES

– A short message service (SMS) reminder message intervention was successfully replicated among a different population of adults in Nigeria seeking treatment for malaria at drug shops, showing that a basic SMS can increase medication adherence after rapid diagnostic test (RDT) malaria testing and suggesting that the resulting effects may be generalizable among adults.

– The basic SMS reminder intervention had no impact on behaviours for caregivers of sick children, suggesting that small informational reminders may not be effective when strong priors underpinning health behaviours exist. The difference in outcomes for children and adults highlights the importance of replicating behavioural interventions in multiple population segments before being scaled and the need for testing different message content for caregivers of children.

– The targeted, but neutral message in the expanded SMS informing participants of the potential expansion of RDTs at drug vendors actually lowered customer acceptance for pharmacists to conduct RDTs. Hence, small differences in message language, even if seemingly neutral, may have unintended consequences.

—

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Hey All

I am at Wikimania this week, our yearly Wikipedia conference. Have met with a number of technology people who are doing some amazing things. A gentleman by the name of Tim Moody is with Internet in a Box. They have a product that is basically a wifi hotspot linked to a 128Gb SD card that runs off a battery pack.

They have a setup where they have loaded all of Wikipedia plus a bunch of TED talks, Khan Academy videos, etc onto the thing such that people who are nearby are able to download the content to their cell phones via wifi. Basically it is ready to be shipped.

The question is are organizations interested in:

Buying these devices for about 200 to 250 USD, maybe less if a bunch are ordered? Such a device could be placed in libraries, health clinics, or schools.

Interested in putting further content onto these devices before they are shipped?

—

James Heilman

MD, CCFP-EM, Wikipedian

The Wikipedia Open Textbook of Medicine

www.opentextbookofmedicine.com

CITATION: Burns. 2016 Jun;42(4):938-43. doi: 10.1016/j.burns.2016.03.019. Epub 2016 May 5.

Knowledge, attitude, and belief regarding burn first aid among caregivers attending pediatric emergency medicine departments.

Alomar M, Rouqi FA, Eldali A.

Abstract

BACKGROUND AND OBJECTIVES: Emergency departments witness many cases of burns that can be prevented with various first-aid measures. Immediate and effective burn first aid reduces morbidity and determines the outcome. Thus, it is imperative that measures of primary burn prevention and first-aid knowledge be improved. This descriptive study determines the current level of knowledge, attitude, and belief regarding burn first aid among caregivers.

MATERIALS AND METHODS: Caregivers attending four pediatric emergency departments answered a structured questionnaire for demographic information, knowledge, and the burn first aid they provide including two case scenarios. Applying cold water for 15-20min, smothering burning clothes, and covering the pot of oil on fire with a wet cloth were considered appropriate responses. The main outcome measure was the proportion of caregivers who were aware of burn first aid and did not use inappropriate remedies. Additional questions regarding the best means of educating the public on burn first aid were included. Individual chi-squared tests and univariate logistic regressions were performed to correlate knowledge with demographic features, history of burns, and first-aid training.

RESULTS: The 408 interviewed caregivers (55% women) reflected a wide range of age, occupation, and educational level. Sixty percent (60%) of respondents had a large family, with 52% reporting a history of burns. Overall, 41% treated burns with cool or cold water, although 97% had inappropriate or no knowledge of the duration. Further, 32% treated burns with nonscientific remedies alone or in combination, including honey, egg white, toothpaste, white flour, tomato paste, yogurt, tea, sliced potato, butter, or ice. Only 15% had first-aid training. While 65% of caregivers covered a pot of oil on fire with a wet cloth, only 24% reported smothering burning clothes. Participants preferred learning more of first aid for burns via social media (41%), hospital visits (30%), and television (TV) (16%). No significant correlation was found between age, family size, language, history of burns, or training and knowledge; however, female gender and higher educational level were associated with increased awareness, although this was not statistically significant (p=0.05 and p=0.17, respectively). The logistic regression accounting for all significant variables showed that the history of burns had the greatest effect on knowledge of first aid (p<0.03).

CONCLUSION: Knowledge of burn first aid among caregivers is limited, with many resorting to non-scientific remedies. Use of social media, hospital visits, and TV for first-aid education might improve caregivers’ awareness. A nationwide educational program emphasizing first-aid application of only cold water and reduced use of inappropriate home remedies for burns is recommended.

—

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

PUBLIC transport users living within the Gauteng city region will soon find travelling around the province a whole lot easier.

This comes as the Gauteng provincial government on Friday officially endorsed the establishment of a single transport authority that is affordable‚ accessible‚ sustainable and customer centred, for residents of the city region.

Speaking at the provincial offices‚ Gauteng premier David Makhura said this was an important step the government was taking towards ensuring that all structures and institutions that give effect to the vision of a Gauteng City Region (GCR)‚ are formalised and regularised. …more

‘There are many millions of papers of clinical research — approximately 1 million papers from clinical trials have been published to date, along with tens of thousands of systematic reviews — but most of them are not useful.’ This is the central message of an essay by John Ioannidis in the open-access journal PLoS Medicine. Below are two extracts, citation, and abstract. The full text is here:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002049

“Useful clinical research” means that it can lead to a favorable change in decision making (when changes in benefits, harms, cost, and any other impact are considered) either by itself or when integrated with other studies and evidence in systematic reviews, meta-analyses, decision analyses, and guidelines.’

‘Overall, not only are most research findings false, but, furthermore, most of the true findings are not useful. Medical interventions should and can result in huge human benefit. It makes no sense to perform clinical research without ensuring clinical utility. Reform and improvement are overdue.’

CITATION: Ioannidis JPA (2016) Why Most Clinical Research Is Not Useful. PLoS Med 13(6): e1002049. doi:10.1371/journal.pmed.1002049

Published: June 21, 2016

SUMMARY POINTS

– Blue-sky research cannot be easily judged on the basis of practical impact, but clinical research is different and should be useful. It should make a difference for health and disease outcomes or should be undertaken with that as a realistic prospect.

– Many of the features that make clinical research useful can be identified, including those relating to problem base, context placement, information gain, pragmatism, patient centeredness, value for money, feasibility, and transparency.

– Many studies, even in the major general medical journals, do not satisfy these features, and very few studies satisfy most or all of them. Most clinical research therefore fails to be useful not because of its findings but because of its design.

– The forces driving the production and dissemination of nonuseful clinical research are largely identifiable and modifiable.

– Reform is needed. Altering our approach could easily produce more clinical research that is useful, at the same or even at a massively reduced cost.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Sitting in a classroom at Georgetown Medical School usually reserved for committee meetings, we begin by reading an Emily Dickinson poem about the isolating power of sadness:

I measure every Grief I meet
With narrow, probing, eyes –
I wonder if It weighs like Mine –
Or has an Easier size.

It’s a strange sight: me, a surgical resident, reading poetry to 30 medical students late on a Tuesday night. Some of us are in scrubs, others in jeans; there are no white coats. Over the past four years, as the leader of the group, this has become my routine.

The students are here after long days in class and on the wards because they have discovered that medical education is changing them in ways that are unsettling. I remember that uneasiness well. My own medical education began with anatomy lab. The first day with the cadaver was unnerving, but after the first week the radio was blaring as we methodically dissected the anonymous body before us….more

See here

Go here to see more

ECONOMISTS and many policy makers think about how things are done, but they do not think much about where things are done. Where economic activity is concentrated in a country can be the difference between poverty and prosperity – for people as well as countries, says the World Bank. No rich country is predominantly rural. No country has grown to middle-income status without urbanising, and none has grown to high-income status without vibrant cities. Cities are the most potent force for social and economic progress and they make possible a standard of living that is inconceivable without them. Cities produce more than 80% of global economic output. The key platforms for national, regional and global growth are urban. The economies of SA’s major cities consistently outperform those of its towns and rural areas. The eight largest cities are home to about 37% of South Africans, yet they account for 59% of economic activity. Average per capita income in the metropolitan areas is about 60% higher than the national average, and is nearly four times higher than that in the rural areas……more

The Hippo Water Roller is used to gather water in developing countries. It was designed by two South Africans who grew up in rural areas. here

Below are extracts from an excellent blog (book chapter) by Kate Tulenko, IntraHealth International’s Vice President of Health Systems Innovation. The full text is available here: http://bit.ly/1Q7X7dC

—

This is the tenth chapter of the CHW Reference Guide produced under the Maternal and Child Health Integrated Program, the United States Agency for International Development Bureau for Global Health’s flagship maternal, neonatal and child health project.

Chapter 10 of the CHW Reference Guide explores the critical and complex issue of the supervision of community health workers (CHWs). Supervision of CHWs is a core health systems function that is often poorly understood and undervalued. Supervision is often incorrectly viewed as policing or as an unnecessary expense, but as this chapter shows, when supervision is properly designed and implemented, it can yield significant rewards in terms of quality of care, productivity, and retention of health workers…

There is still much to be done in the field of supervision, many innovations to be tested and challenges to be explored… The role of supervision of CHWs as a form of governance also needs greater recognition and exploration. CHWs are often the only formal representative of the central government in many communities.

Supervision is strongly linked to citizen voice and to women’s empowerment. When community members have a role in supervising their CHWs, they can — sometimes for the first time — have a say in the delivery of government service…

Ultimately, CHWs have special supervision needs. Their general level of education, literacy, and numeracy is usually much lower than other health workers and their period of formal CHW training is often less than a year…

—

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

CITATION: Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings

Yannis K Valtis, Julie Rosenberg, Sudip Bhandari, Keri Wachter, Marie Teichman, Sophie Beauvais, Rebecca Weintraub

Valtis YK, et al. BMJ Glob Health 2016;1:e000041. doi:10.1136/bmjgh-2016-000041

http://gh.bmj.com/content/bmjgh/1/1/e000041.full.pdf

Correspondence to Dr Rebecca Weintraub: Rebecca@globalhealthdelivery.org

ABSTRACT

The rapidly changing landscape of medical knowledge and guidelines requires health professionals to have immediate access to current, reliable clinical resources. Access to evidence is instrumental in reducing diagnostic errors and generating better health outcomes. UpToDate, a leading evidence-based clinical resource is used extensively in the USA and other regions of the world and has been linked to lower mortality and length of stay in US hospitals. In 2009, the Global Health Delivery Project collaborated with UpToDate to provide free subscriptions to qualifying health workers in resource-limited settings. We evaluated the provision of UpToDate access to health workers by analysing their usage patterns. Since 2009, ~2000 individual physicians and healthcare institutions from 116 countries have received free access to UpToDate through our programme. During 2013–2014, users logged into UpToDate ~150 000 times; 61% of users logged in at least weekly; users in Africa were responsible for 54% of the total usage. Search patterns reflected local epidemiology with ‘clinical manifestations of malaria’ as the top search in Africa, and ‘management of hepatitis B’ as the top search in Asia. Our programme demonstrates that there are barriers to evidence-based clinical knowledge in resource-limited settings we can help remove. Some assumed barriers to its expansion (poor internet connectivity, lack of training and infrastructure) might pose less of a burden than subscription fees.

SELECTED EXTRACTS (selected by Neil PW)

‘according to WHO estimates, there are more than 100 000 physicians working in low-income countries; yet, only 1948 health workers applied for access to our programme.’

‘The relevance, or lack thereof, of EBCRs [Evidence based clinical reseources] in general, and UpToDate in particular, to LMIC clinical needs has not been evaluated: It is possible that UpToDate’s recommendations on clinical care are different from, and even in conflict with, local practice and guidelines. It is also possible that UpToDate recommends the use of diagnostic procedures and

therapeutic interventions that are unavailable in LMICs due to high cost or other constraints.’

‘It is clear that cost is one barrier to EBCRs that will need to be removed to realise the vision for evidence-based medicine for all. We are hopeful that the next steps towards this vision will be

bigger and broader and close the knowledge gap quickly.’

In an interview on Global Health Hub, the lead author puts forward an interesting hypothesis on the finding that topics such as heart failure, stroke, diabetes, and hypertension were extremely popular. One reason for this is of course the rising burden of NCDs. But another possible explanation is that existing guidance (and experience) on NCDs might not be widespread as compared with guidance on diseases that haave always been common, such as malaria. http://www.globalhealthhub.org/2016/06/13/access-to-information-literally-saves-lives-free-access-to-uptodate-in-lmics/

—

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

WONCA E-Update
Friday 17th June 2016

WONCA News – June 2016
The latest WONCA News is available via the WONCA website, packed with WONCA news, views and events.

World Family Doctor Day
Since its establishment by WONCA in 2010, World Family Doctor Day  – 19th May – has gained momentum each year and provides a wonderful opportunity to acknowledge the central role of family doctors in the delivery of personal, comprehensive and continuing health care for all people in every country. It is also a chance to celebrate the progress being made in recognizing the important role of family medicine in strengthening primary health care in each of our countries, and the special contributions that are made by wonderful individual family doctors all around the world.

This year there were more activities than ever, and WONCA News contains reports from many of our Member Organizations on how they celebrated this important day in our calendar.  There are many reports and messages, including a message from our President, Professor Michael Kidd.

Rural Roundup – Dr Rabia Afridi of Pakistan
Rural roundup always presents a fascinating picture of the lives of our colleagues working in rural and remote locations, but this month’s rural roundup from Pakistan is particularly fascinating.  The first of a two-part article, Dr Rabia Afridi describes her work in a Basic Health Unit (BHU) in CHAK 18, situated to the East of the Changa Manga forest in the Punjab province of Pakistan, where she has worked since 2014.  We urge you all to read this article from an incredible rural colleague.

From the CEO’s Desk
This month our CEO, Dr Garth Manning, reports on the latest Conference Planning Committee meeting held in Rio de Janeiro in April, and also reports on two fantastic events in Costa Rica – the Cumbre, or health summit, on 12th and 13th April and the first-ever Meso (central) American conference from 14th to 16th April. He highlights the changes to the WONCA website and also offers some advice on Zika virus in Latin America.

Global Jobs – WONCA jobs portal
WONCA has recently launched a jobs portal where you can find job listings for family doctors, locums, specialists, allied health professionals, medical support staff and academics from around the world.  You can also advertise a vacancy, and there are special rates for all WONCA members.  For more information go to www.globalfamilydoctor.com and click on the “Global Jobs” sidebar.

The new global mHealth compendium has come out, produced by USAID (see the note below), and the direct link is http://www.africanstrategies4health.org/uploads/1/3/5/3/13538666/2016_mhealth_31may16_final.pdf

It is the sixth edition, and expected to be the last. It is worth reading – the intro is a 10 page summary of eexperience (evidence, best tools, best resources, what you need to consider for sustainable scale). Then there case studies of the 10 most significant projects. They are:

– Airtel Insurance (health micro-insurance in 7 African countries)

– Aponjon (maternal health messaging in Bangladesh, part of MAMA)

– cStock (medical supply chain in Malawi)

– iCCM (mobile tool for health workers doing integrated community case management in Malawi)

– Kilkari (maternal health messaging via voice, train community health workers in India)

– mHERO (health worker SMS messaging for targeted care, in 6 countries mainly in West Africa)

– MomConnect (maternal health messaging fully in health system in South Africa)

– mSOS (disease surveillance reporting in Kenya)

– RapidSMS Rwanda (preventing maternal & child death in 1,000 days in Rwanda)

– U-Report (preventing adolescent AIDS through mobile counselling and polling in Uganda).

There is a lot to learn from here.

Best wishes,

Peter

HIFA profile: Peter Benjamin is SA director of HealthEnabled, South Africa. Professional interests: Digital health, mHealth, Empowerment through health information. Email address: peter AT healthenabled.org