The 5 health inequalities that digital technology can fill
- As the world continues to tackle health inequalities, digital technologies have immense potential to contribute;
- Five factors of health inequality in particular can benefit from digital technologies;
- Greater leadership from all sectors can increase the use of digital technologies for good, but must also take into account the potential for increasing inequalities.
Health inequity does not have a single cause; it is the amalgamation of structural and procedural dimensions that benefit some and marginalize others. It will take a concerted and collaborative effort to address these determinants of health, but over the past 10 years we have found an important tool for this work: digital technologies.
10 years ago, if a health worker in Tanzania needed to know how many doses of vaccine she had given or how many her clinic had left, she would have to go to seven different paper registers, cross-check them and check them against each other. others. . As a result, tracking inventory levels and changes in demand could mean 8-10 hours of data management each month. With inconsistent stock levels, one in 14 children who came for a vaccine could leave the clinic without one.
Digital tools then automated the processes it carried out by hand. An electronic tablet-based vaccination register connected to a logistics management information system replaced the seven paper registers and automatically updated her inventory data each time she recorded a vaccination in the clinic. A data dashboard, designed by an advisory group of health workers and managers, puts inventory level data at your fingertips. It wasn’t perfect, but when inventory data was made visible on these digital systems, the incidences of out-of-stock decreased by around 70%.
The digital transformation of health systems is not about the “killer app” that will forever solve health inequalities; it is the systemic, often invisible, means whose digital tools and approaches support individuals and health systems in their efforts to dismantle inequalities.
Here are five drivers of health inequity that digital technologies can help address:
1. Inequitable access to reliable and reliable health information
At the individual level, misinformation, misinformation, and lack of information all pose barriers to a person’s ability to pursue their health. At the systems level, a lack of high-quality and timely information can lead to wasted resources, ineffective health interventions, or even widen the health equity gap. Digital tools and approaches have a huge role to play in meeting the need for reliable and reliable health information.
Messaging platforms, for example, democratize access to health information by connecting communities to trusted and trusted sources. This review found that text reminders improved adherence to anti-HIV drugs in several studies. Another review suggests that short messaging services have increased antenatal delivery visits and skilled delivery assistance. The Visualize No Malaria initiative demonstrates the power of data in the hands of health workers, who can respond more proactively and reactively to malaria epidemics because they have up-to-date data at their fingertips.
2. Inequitable access to medical expertise
It is estimated that 18 million additional health workers are needed to achieve universal health coverage by 2030. This global health workforce shortage is not shared equally among communities and without sufficient health workers, care individuals suffer. Digital tools and approaches can extend the reach and skills of the existing workforce and provide new ways to fill this gap.
For example, artificial intelligence (AI)-enabled decision support tools can extend medical expertise to regions facing a shortage of healthcare workers. Babyl’s AI-based systems demonstrated safety parity with direct doctor visits, while ThinkMD reports high satisfaction among healthcare workers with decision support tools that he has deployed. In Myanmar and India, an AI tool called qXR can diagnose tuberculosis faster than traditional methods.
3. Inequitable access to medical products and other interventions:
The availability of essential medical products (drugs, vaccines, diagnostics, devices, etc.) has a huge influence on the quality of care. As we saw during the COVID-19 pandemic, when countries and communities do not have equitable access to something as simple as medical oxygen, the implications are far-reaching. Digital tools and approaches can streamline supply chains and provide better data to anticipate and resolve supply shortages when they arise.
For example, electronic logistics management information systems (eLMIS) help ensure that appropriate and safe medicines are available and in stock for those who need them. In Tanzania and India, the use of an electronic logistics management information system has reduced cases of vaccine stockouts and recent modeling efforts suggest that these reductions can translate to significant lives saved.
4. Inequitable representation in public health systems and services
Information systems and the data they collect often do not fairly represent populations, for example, underestimating members of vulnerable communities or not collecting the right data to diagnose inequalities in the health system. When data is not representative and inclusive, the analysis and use of that data will be inherently inequitable. When wisely designed, digital technologies can improve representation in health system data and increase access to health services for people otherwise disenfranchised to care.
The USAID-funded Healthy Markets initiative at PATH, for example, reaches LGBTQI + people in Vietnam through secure, peer-run online forums and chatbots. Using existing platforms such as Facebook, Blued, and TikTok, people at risk or otherwise marginalized can connect to up-to-date health information and essential health services such as pre-exposure prophylaxis. In this case, digital tools help the health system reach people they might not otherwise have reached and connect people who might not have identified a way to access it. essential health services that feel safe and comfortable.
5. Inequitable coverage of catastrophic medical expenses
Each year, 950 million people devote at least 10% or more of their family budget to health expenses, and 100 million people are plunged into extreme poverty. Health insurance and government financial plans are important protections for individuals, but are often unavailable in unbanked or otherwise marginalized communities. As part of broader efforts to achieve universal health coverage, digital financial services can lay the groundwork for accessible and transparent insurance schemes that prevent medical spending that causes poverty.
Transformational change can reside in the evolution of systems and infrastructure, shifting our vision of health systems from the paper-based vaccine registry to AI-powered dashboards. Digital technologies affect all parts of health systems and we cannot overlook their potential to tackle inequalities.
Leadership from public, private and funding organizations can contribute to this ongoing transformation. We must continue to gather evidence of impact on health, expanding the community of global citizens working on digital health and protecting the promise of digital technologies from existing inequalities. Although not everyone has access to the internet or a mobile phone, we can work together to create a more equitable health system and close the digital divide in health care.