AFRO-NETS: DELIVERING HEALTH INFORMATION THROUGH TECHNOLOGY

http://www.afronets.org/

The electronic conference for the 'African Networks for Health Research & Development' (AFRO-NETS) was established in 1997 to facilitate exchange of information among different networks active in health research for development in Anglophone Africa, and to facilitate collaboration in the fields of capacity building, planning, and research. Since then, the AFRO-NETS discussion group has grown to 1300 subscribers in 74 countries and now includes a web site. Topics for discussion include: advocacy for health research and development; priority setting; capacity building; resource mobilisation; evaluation; dissemination of results; utilisation of research findings; networking; use of information technology for the health sector; announcement of meetings, training courses and other events of interest to subscribers; and HIV-AIDS issues.

AFRO-NETS is sponsored by SATELLIFE (http://www.healthnet.org/), an organisation that aims to improve health in the world's poorest nations through the innovative use of information technology and AFRO-NETS is seen as an important tool for enhancing collaboration among health professionals. Information services director Dr. Leela McCullough says that AFRO-NETS was launched to meet the need for ongoing communication among several research networks in Eastern and Southern Africa. Electronic communication, using basic email, presented a viable solution.

McCullough says simple email messaging in the electronic forum offers an opportunity for health professionals in Africa and other parts of the world to engage in open discussion on important issues. “ICT can assist in the creation of communities of practice and contribute to overcoming information poverty and professional isolation,” she says, using as an example the case of a young physician in Ghana who applied for various scholarships that he had seen announced on the discussion group. “He was able to secure funding to go abroad and further his studies in public health and then return to his country to continue serving his community,” says McCullough.

On the future of the use of information technology for the health sector in developing countries, McCullough says building strong health care delivery systems in developing countries requires reliable data and knowledge management tools. Policy makers, planners, program and resource managers, and health care providers, need up-to-date and reliable information to make informed decisions on a daily basis. The range of information and communication technologies, from radio, CD-ROM, email, Web access, digital satellites, cell phones and handheld devices can play a major role in supporting information access. SATELLIFE has also been testing the efficacy of the handheld computer or personal digital assistant (PDA) as a tool for data collection and information dissemination in Africa. McCullough says: “There is no single best solution - one needs to think creatively and fluidly about using a variety of technologies to meet various needs.”

An example of the kind of debate that takes place on the AFRO-NETS discussion list was over the release of a study published in the October issue of the Royal Society of Medicines' International Journal of STDs (Sexually Transmitted Diseases) and AIDS. The article challenged conventional wisdom on the relative importance of different means of transmission of HIV/AIDS, implying that Africa's HIV/AIDS crisis may be fuelled as much or more by unsafe medical practices as by unsafe sex. The authors of the research said that the evidence available from an exhaustive review of research did not support the standard assumption that over 90 percent of HIV/AIDS in African adults was from heterosexual intercourse. Instead, they argued that the data available was not adequate to make good estimates of the relative importance of means of transmission, and that the likely proportion of transmission through unsafe medical procedures, including injections, transfusions, and other contact with infected blood, was being grossly under-estimated.

The posting, originally distributed by Africa Action, led to a flurry of responses. Peter Burgess from http://www.atcnet.org, wrote that it had become “glaringly” apparent that the incidence of HIV-AIDS in Africa could not be explained simply by sexual behavior. Others were surprised that the subject was even considered new, arguing that hospital acquired infection was a known subject that included diseases such as hepatitis and HIV-AIDS. John Kiwaanuka Ssemakula, CEO of Medilinks (www.medilinks.org), wrote: “Could this be the missing link that could explain the rapid spread of HIV/AIDS in Africa when compared to other parts of the world?”

He said the debate around sexual behaviour had been a controversial aspect of the HIV/AIDS debate since the epidemic rose to prominence, with the commonly accepted view being that the high rates of sexual partner change in Africa were one of the main reasons for the rapid spread of HIV/AIDS. “The implications of this finding if true are enormous. It will have a considerable impact on the way the HIV/AIDS epidemic is being tackled in the future and I commend the authors for highlighting this very important point.” But Satellife Medical Director Malcolm Bryant said he feared that branding every health care worker on the continent as being guilty of fuelling the epidemic showed a lack of understanding of the reality of Africa, and immediately demonized many hundreds of thousands of dedicated health care workers.
He said his experience indicated that trained trained health care workers were not the problem and that he would estimate that unlicensed and illegal injections greatly exceeded the number of injections given by all the health care staff. “Let us investigate this issue promptly, let us correct any problems we find, let us advocate at the highest levels for adequate resources in our health care systems, but please let us not start with the assumption that our greatest resource (the people who deliver health care services in exceptionally difficult situations) is negligent or delinquent.”

The AFRO-NETS web site is a useful resource for anyone interested in health in Africa. Users will find an archive section going back to January 1997, which makes it easy to access past debates about health on the African continent. It is possible to search the archive or access a list of discussions that took place in any given month. A search function enables users to search the entire web site, or sections of the site. There is also a page detailing forthcoming events, while another page makes available a range of larger documents based on health issues in Africa.

ENDS