July 27, 2013 § Leave a comment
“Mobile health (mHealth) is the provision of health services and information via mobile and wireless technologies. Within [many developing countries] the mobile phone has become ubiquitous, making mHealth applications an important tool with which to impact the health of [citizens]. When applied correctly, mHealth can make real contributions to improved health outcomes. mHealth has the potential to address and overcome (1) disparities in access to health services; (2) inadequacies of the health infrastructure within countries; (3) shortage of human resources for health; (4) high cost of accessing health; and (5) limitations in the availability of financial resources” (mHealth Compendium vo. 2). That said, like all interventions, mHealth interventions can have unforeseen side-effects that necessitate well-designed impact evaluation. For this reason, a new website designed in partnership with Johns Hopkins School of Public Health has been created to serve as the epicenter of mHealth evidence. mhealthevidence.org includes advanced search options for accessing evidence by topic, region, methods, or MESH term.
mHealth interventions really do have the potential to lengthen the stride of health services and providers in rural and disperse populations. A recent report by USAID contains twenty-seven case studies which document a range of mHealth applications being implemented mainly throughout Africa (because the report was compiled by the African Strategies for Health (ASH) contract), but also other regions. It includes examples of mHealth interventions ranging from behavior change, to data collection, finance, information dispersion, and service delivery. It’s worth a look-through. The use of mobile phones in health care surely has abundant room for growth, but considering that it’s a relatively new phenomenon1, the emphasis on evaluation and evidences is refreshing to see.
1mHealth interventions may have been around for a decade now, but it’s only been recently that so many individuals have had ready access to a mobile phone. Now if we could just get them the electricity to charge those phones….
2Here is an interesting website to find further mHealth interventions
July 10, 2013 § 1 Comment
I saw this on Upworthy and appreciated it. Adam Mordecai gives this preamble:
“Back in the day, for those of you younger folk, Dustin Hoffman made a movie called “Tootsie.” (iTunes.) It was a hilarious and touching movie about an actor who can’t get a gig, decides to become a woman to see if it helps, and scores a role on a soap opera. Hilarity ensued. But it was more than just a comedy. Here’s why.”
We so often judge the worth and interest of people by their appearance. It’s not always the wrong thing to do; often sight is a logical tool for implementing heuristics. But of course, like heuristics, sight can lead us astray. Astray from things and people that are good, and pleasant, and insightful, and in need, and inspiring, and hilarious, and poetic, and beautiful. Away from friends and opportunities to see the world (or our lives) more completely by adding the perspective of someone unlike us.
Is there a person you’ve neglected by appearance?
A lack of appearances is one of the many reasons that I enjoy The Listserve. The Listserve is an e-mail lottery. One person a day wins a chance to write to the growing list of subscribers (currently there are 23,275 subscribers) without strings or payments attached. I’ve only been on the Listserve for two weeks, but already I’ve been granted access to the lives, minds, memories, opinions, ambitions, dilemmas, discouragements, etc. of fascinating and inspiring strangers all over the world. (To say nothing of the three fabulous book recommendations!) I encourage you to join.
If you could speak to the world without the pressure of physical appearance, what would you say?
June 23, 2013 § Leave a comment
One in 7 homicides worldwide, and over one in 3 homicides in women specifically are perpetrated by an intimate partner. These were the findings of a new Lancet systematic review and World Health Organization report.
Considering these facts, I have little doubt that if intimate partner violence was a disease it would garner greater (both more and better) attention in our public conscience, mass media, and health research priorities. Yet without being a disease, intimate partner violence still acts as health burden and has serious health consequence prior to and including death.1 You might not think it’s disease, but it acts like one:
Disease: any harmful, depraved, or morbid condition, as of the mind or society (dictionary.com); The term disease broadly refers to any condition that impairs normal function, and is therefore associated with dysfunction of normal homeostasis (wikipedia)
We need to reframe our conception of intimate partner violence. It is a societal disease. Thinking about it in this way may garner greater public retaliation when the media treats it lightly or glorifies it. Perhaps as a disease intimate partner violence will also attract more members to organizations like this, and more observations like this (DISCLAIMER: this video contains strong language and subject matter).
With the proportion of female homicides by an intimate partner being six-times larger than that of males, it is reasonable that the news has largely focused on women as the victims. But we should not neglect the also shocking statistic that 1 in 7 homicides at large (i.e. of both men and women) are perpetrated by an intimate partner. This is a crime and a public health burden that clearly represents why we should not ask for whom the bell tolls.
1 Which is why the World Health Organization and the Lancet (a leading medical journal) funded and/or published the recent reports. Intimate partner violence, though we often may not think of it like this, is a health as much as a social issue.
June 19, 2013 § 1 Comment
My sense of humanity remains untouched. But my ability to assume that people have good intentions has definitely been hampered by all the things that I’ve seen. It does make me question humanity as a whole, and how, in spite of all of human kind’s achievements and advancements… barbaric acts of war continue to be implement and used, and how people actually believe that violence is a means to peace. – Kate Brooks, Photojournalist
It’s a reasonable quandary: the non-linear logic of healing conflict with violence. And yet it exists and allows violence persist. Perhaps this is because, aside from the manifold reasons that one might first become involved in a conflict1, eventually conflict can become a part of one’s identity. And although new information technologies (such as youtube, texting, twitter, and GIS) can prevent some acts of violence, these same technologies can also fail to alter the cultural norms and citizen identities that become entwined with and eventually entrench conflict over years. In fact, these technologies can engrain rather than excise such identities by allowing people to rally and polarize around them. In a recent post on A View from the Cave, Andrew Blum of the US Institute of Peace highlighted that there is more to the prevention of violence than the mere acquiring of information:
Atrocity prevention from the local to the international level is an intensely and inherently political process. Those working on atrocity prevention must find creative ways to confront illegitimate authority, disrupt the configuration of identities that contribute to violence, and craft new means to provide legitimate authority for those with the power to prevent atrocities.
The desire, in other words, for a simple solution to an entrenched conflict (physical or ideological) is likely frivolous. The conflict in Syria, for example, burns on and who knows precisely how or when it will end (though likely not soon). Thousands of families have been swept into this war(s) by the persuasion to catalyze change, defend their rights, seek revenge, or merely survive and keep their family safe. Whatever the case, this war and its causes have become a part of many people’s identity.
So what to do?
Surely one thing to do is to refrain from expressions of simple solution. But another is to maintain hope, because hope prospers an endurance to care for those innocently involved. The humanitarian needs evidenced in a conflict like Syria are certainly ‘complex’, but this complexity shouldn’t strike paralysis into aid organizations and the donors who support them.
Today it is estimated that 6.8 million (one in four) Syrians are in need of humanitarian assistance. By year end, there are expected to be 3.85 million Syrian refugees. That is approximately equivalent to the entire population of Oregon being displaced on foot with little to no provisions. In April of 2013, Syrian refugees had already increased the population of Lebanon by 10%.
“On 7 June, the UN and its partners launched the largest appeal for humanitarian funding in history: US$4.4 billion to help Syrian refugees and people in need inside of Syria, as well as $830 million to help the Jordanian and Lebanese governments cope with this crisis over the course of 2013. The appeal replaces an earlier appeal for $1.5 billion for aid operations in the first half of the year” (cite).
This need is effect of the conflict, and of the massacre, torture and other human rights violations that accompany it. Entangled though it may be with an intervention, we should not allow humanitarian aid to dry up as the number of those in need continues to surge. As one development blogger notes, “Donor fatigue is leading to less money available and causing relief agencies to look to non-traditional partners, like Coca Cola, for funding and support” (cite). Don’t think for a second that Coca Cola wouldn’t care if you, a potential customer, took the time tell them your approval of their donations.
The war in Syria is not likely to end soon or simply, but I can think of three simple actions that can be taken very soon. They will take one hour or less and will allow you to say that you’ve done something with regard to the millions of families affected by the Syrian war: (1) learn more, (2) give*, and (3) ask others (i.e. politicians or companies) to give via email, mail, or phone. The companies you buy from and the politicians that represent you care what your think about them and about what they do. Be a actor in the international community your are inherently a part of.
The Bell Tolls, this time (again) for Syria.
* Human Rights Watch, Doctors without Borders (read their mission), IRC, Save the Children, Islamic Relief Worldwide, OxFam, Red Cross/Red Crecent, etc.
1Imagine conflict springing up around you and your family; in your very city without your provocation. Can you predict what would you do to protect your family? I can’t.
2A thought question: does the fact that the Syrian civil war is happening in Syria (with a multitude of splinter rebel groups) inhibit your donating, even if that donation goes to reputable humanitarian group such as the International Red Cross? Listen here for a similar conversation:
June 19, 2013 § 1 Comment
In a recent report, study authors discussed the unintended effects of an mHealth (mobile phone) intervention designed by a team of researchers from Yale University, the NGO Interaction Poverty Lab, the Grameen Technology Center, and Google.
The abstract to this report reads [with some notation],
We evaluate[d] the impact of a health information intervention implemented through mobile phones [mHealth], using a clustered randomized control trial augmented by qualitative interviews. The intervention aimed to improve sexual health knowledge and shift individuals towards safer sexual behavior by providing reliable information about sexual health. The novel technology designed by Google and Grameen Technology Center provided automated searches of an advice database on topics requested by users via SMS. It was sponsored by MTN Uganda at no cost to users. Quantitative survey results allow us to reject the hypothesis that improving access to information would increase knowledge and shift behavior to less risky sexual activities. In fact, we found that the service…
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