icegov2012 proceedings

Chart 1 [40] GHANA – Total Telephone Subscription
The growth in penetration and use of mobile phones presents
unprecedented opportunities to communicate with rural audiences,
and may soon be the largest media opportunity in rural Ghana,
especially for enhancing healthcare delivery.
[50] informed in personal communication with the author that “as
at the last count on March 2nd, 2012 the National Communication
Authority (NCA) had registered over 25 million SIM cards and
assuming 20 percent double or triple SIM registrations, we are
likely to have over 80% of Ghanaians owning phones including
citizens in the rural areas. This phenomenon has obviously made
communication across the country very efficient and brought great
relief to rural folks,” he added.
Ghana’s health sector reforms were guided by five principles:
integration, decentralization, partnerships, ownership, and
common financing. During the process of decentralization,
decision making authority and management of health care services
was transferred from the national level to the regional and district
levels [23]. With the unprecedented opportunities offered by
mobile phones to communicate with rural audiences, Ghana’s
Health Sector reforms made room for the maximum use of ICTs.
The Ghana Health Service (GHS) intends to coordinate and
mainstream all m-Health projects in Ghana to derive the
maximum benefit for the people, ensure sustainability and
ownership after the pilots by the current implementing
organizations for the project to survive beyond the donor-funded
period.
4.1.1 Health Sector Strategies in Ghana
Poor people often lack access to services, because of physical and
financial barriers, lack of information, unavailability of care, and
other factors [9].
[14] adds, “Although developed-world newsflashes tell us that
the whole world is “wired” and that people in the farthest reaches
globally are able to surf the ’net, the reality is that the poorest of
the poor do not have access to even the most basic of health
information.
A recent analysis showed that young women from the poorest
households in 12 low and middle income countries were more
likely to enter in early marriages, to have given birth at an early
age, and to be less likely to be using maternal health services [54].
It must be noted that the response to exploitation of ICTs in the
health sector in Ghana has been only modest, what with continued
low bandwidth problems causing a digital divide between the
health headquarters in the capital and the various regions. The
promise of mobile technology is what could speed up the
transformation process- recognized by that part of the sector ICT
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Policy and Strategy’s plan of work which states the wish to,”
improve efficiency of health delivery by improving both
management and technical efficiency of the sector through
reliable information dissemination systems and by supporting the
decision –making process through the prompt availability of
information for all decision-makers” [24].
The Mobile Technology for Community Health (MoTeCH)
initiative recognized Ghana Government’s desire according to its
ICT Policy to, “improve ICT infrastructure in the health sector by
networking all health facilities and by providing adequate ICT
tools and service delivery management.’’, albeit on a smaller pilot
scale as a beginning. In 2007, strategies and priorities were
articulated [21] within the context of Government’s development
agenda as spelt out in the GPRS and of the three priority areas for
transforming Ghana into a Middle Income Country by 2015
include, Private Sector Development, Good Governance and
Human Resource Development. The Ghana Reproductive Health
Strategic Plan (2007-2011) includes six high-level objectives
under its Safe Motherhood Policy, the first of which is to “reduce
maternal morbidity and mortality.”
In the author’s consultation with Ghana’s Head of Monitoring and
Evaluation Department of the Ministry of Health Dr. A. Ofosu, he
emphasized that ‘the use of mobile devices in the health sector in
Ghana, has been increasing over the past five years. There are
various pilot projects in Ghana where mobile devices are being
used to; collect health data, facilitate Telemedicine, provide health
messages to clients, follow-up children and women to reduce
drop-out from service, manage logistics to reduce stock-outs,
conduct Health Surveys and conduct facilitative supervision.’
The mobile devices in use range from Pocket digital Assistants to
simple phones and smart phones. Some of the initial pilots, using
mobile devices, used pocket digital assistants, due to the low
telephone network coverage. With the increase in availability of
mobile communication service providers, phones of varying
complexity have become the choice tool for use in various fields
in health. Mobile technology holds immense potential for
addressing health delivery bottlenecks. Indeed mobile devices will
become as important as the stethoscope in the years ahead, Dr.
Ofosu added.
4.1.1.1 The Mobile Technologies for Community
Health (MoTeCH) Initiative
Improved maternal health, as is well known, is a major indicator
for development and global initiatives to intensify policy
intervention for maternal mortality began with the Safe
Motherhood Initiative in 1987, a response to growing recognition
that primary health-care programmes in many developing
countries were not adequately focused on maternal health [10]. In
an article by Rosemary Ardayfio titled ‘Improved Maternal
Health. An Indicator of Development,’ reference was made to
health delivery in the Northern Region ‘which is beset with
several challenges including poor road networks, lack of
electricity and inadequate community health workers’ [3].
[1] in a paper, also discussing obstacles challenging maternal
health in Ghana, listed them as limited geographical access by
some clients, limited human resources; ageing midwives, and their
numbers, inadequate funding, inadequate collaboration among