Monday, 16 January 2012

Asia #SocEntChat on #innovatehealth: Summary & Excerpts

Ashoka Changemakers and the Robert Wood Johnson Foundation’s Pioneer Portfolio together have launched a competition titled 'Innovations For Health: Solutions That Cross Borders' to seek health care solutions from anywhere in the world that have the potential to be applied in other countries to improve health and health care systems.
Ashoka Changemakers hosted the Asia #SocEntchat on Jan 10, 2012 for its Asia twitter community to discuss replicable healthcare models and views on what kinds of health care challenges are shared by communities around the world, in the realm of Innovation for Health competition.  The 2-hour session was attended by more than 100 participants and gathered above 400 tweets from India, Pakistan, Sri Lanka, Indonesia, HongKong, Israel, Nigeria, Finland, UK and many other countries.  Robert Wood Johnson Foundation’s Pioneer Portfolio co-moderated parts of the session. Major participation for this online event came from India and Indonesia.

Here are some excerpts from the discussions:

Q 1. What are the examples of public health issues that the Asia communities face?

- Access to qualitative and quantitative medical and healthcare facilities in remote rural areas is a challenge. In remote villages people die of TB, Appendicitis, and food poisoning. Filaria identified in 13 districts of 7 endemic states, - AP, Bihar, Kerala, Orissa, TN, UP, WB, covering about 41 million people. In the last five years, Japanese Encephalitis caused by flavivirus group has acquired serious magnitude in 11 states.
- Common Health issues discussed were infant mortality, tuberculosis control and control of diseases caused due to mosquito bites.
- One of the common public health issues is level of awareness and sanitation in remote rural areas.
-  Yet another public health hazard is disposal of hospital waste that poses threat to general masses.    Contaminated cotton is often used for ear buds. Small pathological containers are often used as packing container for spices by roadside vendors.
- Implementation of Government’s medical aid for general masses is not very effective and is full of layers of corruption. Except for Polio Eradication, other government schemes on healthcare has not been successful (There are iodine, vitamin A related government schemes also, never saw in action). There is a Govt TB treatment program, but poor villagers from remote areas are made to pay for it.
- Many unregulated healthcare providers present huge challenges especially in remote areas for low income group population. Many government doctors are engaged in private practice and lower-ranking staff are engaged in the racket of injecting saline injections and charging patients for it.
- Punjab province has one of most extensive health infrastructure.

- Pakistan is currently facing issues like quality, accessibility & coverage of services especially MNCH services. Some new public health problems like Dengue has also been observed.
- Pakistan is still battling with polio. UNICEF is undertaking a study to find fact and cause.

- Public health issues in Indonesia include accessing public health facility, reproductive health and sanitation.
- Indonesia has a high rate of malnutrition due to improper nourishment of children.

-  The problem of access and quality is rampant in Nigeria but rural areas are the worse hit.
-  In must rural areas in Nigeria, hospitals are without electricity, water, mattresses, bedsheet and other needs.
- Changemakers are faced with huge corruption, politicizing health schemes and lack of funds.

Q 2. What are some obstacles to the scaling/expansion of viable solutions to other countries/regions?

- Lack of coordination between various implementation organisations, especially between donor & government.
- Scaling or expansion also largely depends on the country's public health policy.  
- Lack of proper documentation and dearth of coordinating platform for sharing information.
- Inadequate public-private engagement or partnerships.
- One of the big challenges to expansion is availability of skilled human resource.
- Socio-economic inequality has been a crucial obstacle in health care in India

Q 3. What is the role of social entrepreneurs in improving health processes? Are there some examples of such initiatives?

 -  Apollo recently launched the telemedicine service. It has health insurance that costs 2.5 US cents/day for a family of 5, for a village in Andhra Pradesh of 50,000 people.
- The main focus of Cancer buster community in Indonesia is providing balance information about cancer for child patients and their parents & assisting those who suffered.
- Gram Vikas (which literally means 'Village Development') is an organization that has been working since 1979, to bring about sustainable improvement in the quality of life including use and management of natural resources.
- Mr. Durojaiye launched his company after noticing that even though 20 million people lived in Lagos, there were very few public toilets, thus creating a health hazard. His mobile toilets are now built locally with local materials.
- One of the key health focuses of NGOs in rural Morocco is to reduce newborns death and congenital disability. 
-  Barefoot College, started by Bunker Roy in 1972, has made innumerable school dropouts in villages into “barefoot” doctors
- Dr. Govindappa Venkataswamy and Thulasiraj D Ravilla established Aravind Eye Hospital in 1976. It has treated more than 2.3 million outpatients and carried out more than 2, 70,000 operations in 2006-07, most of them free.
- Narayana Hrudayalaya Institute of Medical Sciences & its network of hospitals run by Devi Shetty perform 20 free surgeries a day.
- Successful models can only have the maximum effect when Govt and Social Entrepreneurs work to complement each other.
- Collaborative approach has been adopted by people in South Halmahera, Indonesia to eradicate malaria.

Q 4. Are there health innovations you have seen around the world that you would like to see in your country?

-  Better e-systems in South African state hospitals that improves efficiency of hospital administration.
- Cambodian rural areas have health counsellors on motorbikes for tuberculosis (mobile DOTS).
-  Preventing low birth weight with chewing gum done by Baylor College of Medicine in Houston, Texas. The team hopes to roll out chewing gum or gummy snacks containing polyols to try to reduce early births in Malawi.
-  Stopping HIV transmission with a vacuum pack @ Duke University from Durham, N.C
-  Mobile heart monitoring and data gathering @ Save the Children Federation from Westport, Connecticut.
- Isha Foundation's Mobile Health Clinics tours surrounding villages.
- An innovative alternative to forceps @ The World Health Organization in Geneva, Switzerland. The devices is a film-like polyethylene like open plastic bag wrapped around the head of the baby, sealed to help extraction during complications. WHO says Odon could be safer and easier than forceps, and would require lesser training.
- Diagnosing with paper stamps @Diagnostics for All, Inc. from Cambridge, Massachussets. Diagnostics for all created 2 postage stamp-sized paper tools to detect anaemia, hypertensive disorders for high-risk pregnancy.
- Ashoka Fellow Anna Alisjahbana has also created vacuum foot pump for birthing (Frontiers for Health Indonesia).
- Telemedicine is also gaining wide popularity.
- Coupled with mobile health units, telediagnostics could be a great solution for rural areas.
- In Pune (India ), Project for sweepers named, START YOUR BACKWARD COUNTING BACTERIA- HERE WE COME.

Q 5. For someone starting health initiative in your country, would you have some advice?

-  Mobile applications are useful only when there is high penetration and use of the applications.
- Newly trained midwives are providing basic healthcare to over 20,000 mothers and children monthly in 5 districts in Afghanistan.
- A woman health officer has motivated sweeper community of Kalyani (Kolkata) to shun open defecation & start using toilets. These sweepers now use theatre to spread awareness and motivate fellow-sweepers to maintain good hygiene and sanitation.
- The Yeshasvini Cooperative Farmers Health Scheme is a young but successful microinsurance scheme in Karnataka.
- Stagnant water is the agent for spreading many diseases. Planting LOTUS in such regions helps to remove stagnant water.
- PlayAble believe that INCLUSIVE SPORTS has an amazing power to create awareness.
- In the Maoist belt of Orissa, where doctors fear to venture, an NGO named ASHA serves a deprived community with healthcare solutions.
- A community radio initiative in Bihar enables locals to voice their problems and raises awareness on mother/child health.
- SHALOM Delhi is an HIV/AIDS project, providing care and support to people living with HIV/AIDS (PLWHAs) in and around Delhi. Their Transgender Project Aims to bring healing and care to eunuchs through care, nutritional & medical support and health education.

Useful Resources: 

@Feature | Blockchangemakers Enter Innovation for Health competition at
@Feature | BlockCHMInnovations Check out our Highlights Report from 2011 which shows new innovations and key trends from around the world!
@meryemefaris @CHMInnovations @changemakers More promising innovations can be found in our free online database!
@EnnoventSEbot #socentchat The World Bank encourages funding dev projects through social entrepreneurship.... - 3:15 PM Jan 10th, 2012
@Feature | Blockudayusuf Check our website : <-- @changemakers #socentchat, we focused on motivate patients and parents who suffered cancer -2:44 PM Jan 10th, 2012

Quotable tweets:

@Feature | Blocklahwahleh RT @statweestics: #socentchat is getting popular, +1200% the last hour : -2:33 PM Jan 10th, 2012
@Feature | Block ableinlife Listen to the people and communities first! Find out what they really need and not what the government thinks they need! #socentchat -3:34 PM Jan 10th, 2012
@Feature | Block AkilaCharagi Mobile applications are useful only when there is high penetration and use of the apps. Can poor people afford the mob apps? #SocEntChat -3:48 PM Jan 10th, 2012
@Feature | BlockHinaHazrat Please look into the health of EUNUCHS, they are even not allowed to enter hospitals- talking in broad sense! #socentchat -3:49 PM Jan 10th, 2012
@Feature | BlockHinaHazrat HEAVEN ON EARTH is a project which is working on EUNUCH in Pakistan!
@Feature | BlockHinaHazrat Next time, Jennifer Ali will be joining us, she is the leading Health Change Agent in Pakistan! #socentchat - 4:10 PM (IST), Jan 10th, 2012
Feature | Block@CHMInnovations We have found that a health market place with many unregulated healthcare providers presents huge challenges #globalhealth #SocEntChat -2:14 PM Jan 10th, 2012
Feature | Block@CHMInnovations Thanks for the great #innovatehealth chat! Well worth getting up in the middle of the night. Now back to bed! #SocEntChat - 4:10 PM (IST), Jan 10th, 2012
@Feature | Block pioneerrwjf Thanks 2 those who participated in @changemakers #SocEntChat! Learn about #innovatehealth solutions that cross borders - 4:10 PM (IST), Jan 10th, 2012

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