Peering into the Black Box

Abstract

This chapter begins with an overview of public health in developing regions. From this population-level perspective, we discuss the information challenges in each of the four domains of public health: research, education, health-care delivery, and disease surveillance. We introduce health-related use classes—categories of specific use cases—to provide a structured presentation of health and information communication technologies in developing regions. In this regard, we define and discuss the following six use classes: (a) surveillance and information gathering, (b) research, (c) provider to provider, (d) provider to patient,(e) education, and (f) logistics. Defining ICT broadly, we argue that the design or selection of technology requires consideration of the cost, ease of use, infrastructure, culture of ICT use, penetration of different ICTs, and population health profile. All of these factors vary among resource-scarce settings, and each factor can greatly impact the appropriate choice in any given setting. We discuss the following three types of assessment, each of which plays a crucial role in project evaluation: systems issues, usability, and health outcomes. Designing ICT for health applications in developing countries requires a deep understanding of various contextual factors, such as health and ICT infrastructure, disease burden, and sociocultural issues. With this in mind, and with some understanding of future trends in health and ICT utilization, we provide forward-looking recommendations for practitioners, researchers, funders, and policy makers.