eHealth and innovation in women's and children's health: A baseline review

CONTEXT

Action for women’s and children’s health is a global imperative, reflected in Millennium Development Goals

(MDGs) 4 and 5, which seek to reduce maternal and infant deaths by 2015 (1). This joint report by the World

Health Organization (WHO) and the International Telecommunication Union (ITU) demonstrates the vital role

that information and communication technologies (ICTs), and particularly eHealth 1 , play in helping achieve

those targets. It demonstrates how, every day, innovations in eHealth are saving the lives of women and

their children in some of the most vulnerable populations around the world.

The United Nations’ Secretary-General’s Global Strategy for Women’s and Children’s Health (2) was launched

in 2010 to accelerate action on the MDGs through a better process for global reporting, oversight and

accountability for women’s and children’s health. This led to the creation of the United Nations Commission

on Information and Accountability (CoIA) (3) and an accountability framework for monitoring, review and

action, focused on the 75 countries which together have 98% of the world’s maternal and child mortality.

The framework links accountability for resources to the results, outcomes and impacts they produce.

REPORTING RESULTS

Information plays a critical role in supporting implementation of the ten recommendations on resource

tracking and oversight of results and resources, nationally and globally. ICTs and eHealth applications are

central to these functions.

An independent Expert Review Group (iERG), established by WHO in 2012, reports to the UN Secretary-

General on progress and results in implementing the recommendations. To inform that effort, WHO’s Global

Observatory for eHealth (GOe) launched a survey to collect and analyse data on progress being made in

the uptake of eHealth in developing countries – particularly for the benefit of women’s and children’s health.

This is the report of the WHO GOe survey, to which 64 of the 75 CoIA countries responded. Over 300 eHealth

and maternal and child health experts contributed their specialist knowledge to the survey. WHO and ITU

then joined forces to analyse the findings and present them here.

QUIET REVOLUTION

Communication over the Internet and mobile phone has become commonplace and a nearly indispensable

part of daily life for much of the world’s population. Remarkable technological advances have taken us from

the bulky personal computer to the laptop, smart-phones and wearable devices. These ICTs are instruments

of change – transforming the way people live, work and interact. They are supporting health authorities and

health-care professionals through eHealth, by helping citizens everywhere to live longer and healthier lives.

A theme of this report is how these instruments of change are part of a “quiet revolution” in which many far-

reaching health-related changes are now taking place.

Numerous countries are already using mobile phones to improve health. The Internet is expanding rapidly

and with it access to essential health information and advice. Governments are finding new avenues,

including official websites and social media, to provide more information to their populations, and to promote

women’s and children’s health programmes. They are steadily moving towards ICT-based integrated health

information systems, and adopting eHealth policies and strategies, guided by the joint WHO/ITU National

eHealth Strategy Toolkit.

These trends are set to continue in the coming years and to have profound effects on people at all levels. At

the family level, pregnant women and mothers are becoming better informed on healthy pregnancy, safe

delivery and improved infant and child protection. At national and community levels, official registrations

of births, deaths and causes of death are gradually improving. Registering a child’s birth is the first step in

realizing its right to health through the continuum of care.

FINDINGS AND RECOMMENDATIONS

Some of the report’s most encouraging findings and recommendations include: 94% of countries have a

national policy or strategy for women’s and children’s health; and over 90% are monitoring most of the key

indicators on women’s and children’s health. Sixty-nine per cent have implemented, at least partially, an

electronic information system to register births, deaths, and causes of death. Fifty-six per cent of countries

report that eHealth is supporting major women’s and children’s health initiatives.

While progress is being made, there is much more to be done to improve inter-sectoral collaboration and

promotion of eHealth. This report highlights the many difficulties that stand in the way of eHealth adoption

with the aim of overcoming them. These challenges can include lack of government commitment in some

cases, lack of skilled health professionals and expertise in others, and lack of funding and infrastructure

almost everywhere.

The report makes a number of recommendations. Among the most important are for countries to promote

inter-sectoral collaboration in their efforts, to include electronic data collection as part of an integrated plan

for implementing eHealth services for women’s and children’s health, and to adopt eHealth programmes

for reproductive, maternal, newborn and child health (RMNCH). They are also urged to develop eHealth

policies and strategies and to act on barriers that impede progress.

The recommendations are intended to help countries build on the work already done – much of it

impressive – and find ways to accelerate the pace at which they can further improve the health of every

woman and every child.