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Tele-Medicine

MOZAMBIQUE INTEGRATED NATIONAL TELEMEDICINE NETWORK

TELEMEDICINE :

Telemedicine is viewed as an important form of advanced information and telecommunications technology that can deliver high quality and cost effective healthcare, as well as health education, to underserved rural and disadvantaged communities. It is seen as a leapfrog technology that can help solve the problem of a rural-urban disparity in medical resources, as well as an important capacity building tool in the fight against HIV infections, Tuberculosis and other life threatening epidemics such as Malaria and Cholera

Telemedicine can be broadly defined as the use of information and telecommunications technologies to provide medical information and services at a distance.  The ability of telemedicine to facilitate medical care irrespective of distance and availability of personnel on site makes it attractive to both the public and private health sectors.  Telemedicine allows better utilisation of scarce medical personnel and resources.  It also has the potential of improving access to, and quality of, medical care at lower cost.  In particular, telemedicine may be seen as a valuable tool for providing much needed medical services to underserved rural areas.  It promises to enhance continued medical education of our young doctors, nurses and other health care practitioners in rural areas, both in training and in established practice. Telemedicine is one form of advanced technology that may be part of the solution to a number of health care and education problems in Mozambique.

Although telemedicine is often conceived in terms of dynamic interactive high bandwidth real-time video consultations, the Store and       Forward, non-real time, low bandwidth applications are potentially       clinically effective. The latter transmits static images or audio and       video clips over low bandwidth links, typically overnight, for review by       health care practitioners the following day. To deliver the proposed       solution, the computers and digital cameras will be used to capture       patient data and transmit it over internet to doctors, specialist and       healthcare managers in Hospital Central de Maputo. In the ITNT project the computer assisted communications will be used in       all its three components i.e. textual data transfer, audio and visual       communications

The Network will utilize the following Telemedicine applications and formats:

Store and Forward

  • Server based Intranet/Internet stored locally or remotely
  • Video tapes
  • CD ROM

Closed TV Channel Broadcasting

  • Real-time or Recorded Broadcasts of Lectures and Seminars
  • Classes interact by phone only

Video-conferencing (VC) Real-time video interaction

  • Lectures and seminars
  • Case studies
  • Clinical Grand Rounds
    All Hospitals, Clinics and Tele-medic Containers will have Broadband Connectivity mostly provided by wireless technology and fixed fibre optic lines. All will utilize mostly wireless connectivity.

CSIP utilized previous studies, its own research and facilities to establish, adapt and extend the ITNT to its full potential. Tribute must be paid to Empresa Moçambicana de Seguros, (EMOSE), the SAEB Consulting Group and Reunert Defence Logistics (SA), for its work to recognize the value of Satellite Technology as a capacity building tool of the National Strategic Plan to Fight HIV/AIDS in Mozambique.

The main aim of the ITNT is the provision of an integrated total medical service to all the people of MOZAMBIQUE, even in the remotest areas by providing permanent all round access, via satellite communications technology to the best available medical knowledge and treatment.

Concurrent with this medical service, ITNT will promote HIV/AIDS, Tuberculosis, Malaria and Cholera (when and where appropriate) public awareness and education in schools, build primary healthcare capacity and improve health education of healthcare providers.

The network will provide underserved communities access to quality health care expertise and medical training that is available at the MAPUTO CENTRAL HOSPITAL, Eduardo Mondlane University and other advanced Medical Centers in Mozambique, Southern Africa and Internationally.

Providing facilities in presently underserviced areas by way of Tele-Med Containers (TMC’s)
TMC’s are modified 20 foot ISO shipping containers, equipped with equipped with fax, phones, computers, internet and TV access, video-conferencing, Tele-education screen and Wireless Communications.
The TMC’s will be deployed in rural schools and clinics where they will be used as a tool for capacity building in health and educational services.
The TMC’s are ideally suited for these purposes as they are :

  • easily and economically available on the market
  • easily transportable, which will facilitate deployment to remote areas.
  • ensure protection and security of equipment inside.
  • are suitable for "assembly line" conversion.

 

The programmes of the ITNT

will support and extend the core programmes of the Mozambican National Strategic Plan to Fight HIV/AIDS which are to:

  • Incorporate the HIV/AIDS, sexual and reproductive health education in Mozambican schools; 
  • Carry out education and information campaigns on STDs (Sexually Transmitted Diseases) and HIV/AIDS to rural and remote communities:
  • Prevent new HIV infections and promote Distribution of condoms;
  • Promote voluntary counselling and testing.
  • Facilitate and Monitor STD’s and HIV/AIDS Treatment;
  • Facilitate Home Based Care to people living with HIV/AIDS
  • Manage Quality Assurance of blood transfusion services.
  • Counselling, Psychosocial Services and Spiritual support. 
  • Syndromic Management of Sexually Transmitted Infections. 
  • General Health Care. 
  • Appropriate immunizations. 
  • Nutritional support. 
  • Post-exposure Prophylaxis. 
  • Palliative Care
  • Incorporation of HIV/AIDS, sexual and reproductive health education in Mozambican schools; 
  • Carry out education and information campaigns on STDs (Sexually Transmitted Diseases) and HIV/AIDS to rural and remote communities:
    • To provide health education, medical supervision and expert medical opinion for health practitioners in the remote country areas
    • To improve access to cost-effective and quality healthcare by patients in remote areas of the country
    • To coordinate capacity building for public health management, health research, education and training of nursing students, medical students and other health professionals
    • To improve planning and management methods with emphasis on the development of information, planning and financial management tools for primary level health services.
  • To expand access to computers and the internet for the rural population and expand knowledge of computers through educational systems in the Mozambican population
  • promote public awareness of Tuberculosis as the most common opportunistic infection in people living with HIV/AIDS to limit and lower the risk of Tuberculosis infection, especially in the workplace by :
  • The highest levels of management and union leadership to actively support appropriate education programs about both TB and HIV and to provide these programs to all employees. Providing sound information is essential in overcoming unreasonable anxiety.
  • The  Workplace policy that is based on scientific and epidemiological evidence, for example, that most workplaces pose low risk for TB transmission, and that people with latent TB infection pose no risk of transmission as long as the bacterium remains latent.
  • Employees with active TB to immediately seek medical treatment and not to return to the workplace until cleared by health care professionals when they have questions concerning their health.
  •  Contact the local health department for assistance in the event of a possible or confirmed case of active TB in the workforce.
  • No special workplace action is necessary for employees with latent TB infection, although such persons may benefit from preventative therapy.
  • Workplace policy regarding returning to work for employees with active TB to be based on individual medical clearance by competent health professionals. Employees with active TB will be allowed to come back to work once they present evidence of adherence to ongoing drug therapy and when judged to be non-infectious as established by bacteriologic response to therapy, by competent medical personnel.
  • Workplace policies and practices to protect the confidentiality
  • Employees’ medical and health information.
  • By Education Programmes deal with specific issues that need to be addressed including proper care of employees who are infected, protection of confidentiality, adequate protection of non-infected employees
  • promote general healthcare, inter alia by programmes :
  • dealing extensively but in socially appropriate with primary health care  geared towards target groups such as women and children, in a campaign to reverse the current growth of the HIV/AIDS pandemic, and greater efforts in the fight against endemic diseases such as malaria, cholera, diarrhoea, tuberculosis and leprosy.
  •    universal primary education, rapidly expanding to secondary education, informal education, and technical-vocational training on all the objectives relating to primary healthcare, hygiene, combating HIV/AIDS through schools.
  • initiatives in related areas linked to health, such as the provision of water (infrastructure) and food security (agriculture).

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