Ugandan Participatory Poverty Assessment reports have identified ill-health as the leading cause and consequence of poverty in Uganda, with priority given to improve preventive health care and commodities for basic curative care. The project initiators include the Uganda Communications Commission (UCC), the Ministry of Health and the Ministry of ICT who approached SPIDER to provide expertise and technical support to improve health service delivery in the rural communities of Uganda using Information and Communication Technology (ICT). Recruitment of educated medical practitioners is difficult in the rural areas as the higher wages and living conditions of Kampala and larger towns are more appealing. Hence ICT can be utilized to improve current workflow processes in community health units and bring needed healthcare services to the point of need.

The overall goal of the project is to improve the information flow from the community to the district and the regional levels of the health care system. This should empower rural healthcare communities, for better health outcomes for the rural population in Uganda using information and communication technology (ICT)‏.

Technical expertise from Sweden will be provided by the Biomedical Engineering Department at Karolinska University Hospital (Karolinska), Karolinska Institutet and the Royal Institute of Technology, as well as Ericsson AB (Research Dept. in Sweden, local offices in South Africa and Uganda).

There are several on-going activities in the project including software development reported in the latest progress report.

The following applications are under development:

HIV Application: HIV+ Patients that reach the stage of requiring daily ARV medication can sometimes develop complications from the treatment administered. Many of these complications result in preventable deaths. Patients are required to visit the HIV clinics frequently to receive drugs. The same clinics perform tests on patients to determine the response to the treatment, virus levels, the CD4 count and the measure of hemoglobin. This information is stored in paper format. Up to 80% of patients die because there is a lack of expertise to judge when to change the drug treatment if complications and side effects have develop. The system being developed is a visual tool for the doctor to see what stage the patient is in, what side effects they have towards drug treatment etc. A doctor can in a short amount of time, without looking at hundreds of papers or asking nurses, look at that information on a patient from the digital records and make the decision to change drug treatment. An important point is that the doctor does not have to be where the patient is located. A doctor with login rights located in Kampala can offer consultation to patients in other parts of the country, input this information which any local nurse or doctor administering care should be able to pick up when they log in to obtain client information. To ensure sustainability, a central system at the Ministry of Health is being installed. The regional health care units can access data from this server via an Internet connection.

Electronic Out-Patient system: Goal: to improve the out-patient care system currently in place. Transfer patients’ records to a digital system that should be able to provide the history of treatment to a patient. For example, the health center should be able to bring up data about the recurrence of malaria in a patient. If the patient reappears with similar symptoms the nurse should be able to track the last time the patient was treated for malaria. This helps to identify ways of preventing or reducing the reinfection. It also reduces the amount of data required for registration without losing quality.

The Electronic Health Record System is important for generating: - Accurate client traceable records. - Data that allows tracking of indicators at all levels - Monitoring for prevention and control of diseases of epidemic potential

Child Health Application: There is a need for better vaccination management in rural areas. The clinical decision support system will generate a care program for any child registered at any clinic. When vaccination or routine check-up is imminent a message from the system is sent to the community health worker’s phone, who visits the parents to remind them of vaccination. These are the community health workers who received mobile phones in 2009 in Ruhira Village, Isingiro District.