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Can digital intervention and adoption of information communication technology (ICT) tools save 300,000 TB patients from dying every year?

Health minister Ghulam Nabi Azad said recently that the United Progressive Alliance (UPA) has in its two terms in office taken initiatives to revamp two key sectors—health and education. Although public health is a state subject, the central government has made significant investments in developing health infrastructure and services delivery through the National Rural Health Mission (NRHM). Under NRHM alone, more than 96,000 crore has been provided for revamping rural healthcare. Further, the government is committed to raising spending on health during the 12th Plan (2012-17), and strengthening service delivery to ensure an accessible and affordable healthcare system. More than 10,000 experts are empanelled across the country to spread awareness about health issues and until now more than 15,000 editions of awareness programmes have been telecast.

This thrust is significant and necessary, because 70% of the population lives in rural areas and 37.2% are below the poverty line. What is interesting is to see health infrastructure through the lens of information communication technology (ICT) tools. Are we spending all the money in brick and mortar infrastructure, or human resources, or just in hardware? Are we adequately integrating the high-tech possibilities of digital media and technologies like mobiles, telecom, radio, FM, Wi-Fi and video conferencing?

Let us take the tuberculosis (TB) challenge in India, home to 2.2 million cases out of 8.7 million globally, as an example. TB continues to kill more than 300,000 Indians every year. With 17% of the global population, India carries 26% of the global TB burden. How digital interventions have been able to complement efforts to control TB is something one can take note of and explore—that is, how we can use ICT and digital tools to tackle health issues efficiently and effectively.

The Revised National TB Control Programme (RNTCP) has launched Nikshay, a website for tracking and recording TB cases. Effective from May 2012, it has been made mandatory for all healthcare providers to report every TB case to the local health authorities. Getting the right amount of information at the right time is vital to making India TB-free, health experts say. Fifty percent of TB cases in India are treated by private agencies, which places a great deal of responsibility on them to share the information they have for centralized monitoring.

In the meantime, mobile phone technology is turning out to be a boon for the health sector. In fact, health is one sector in which mobile and telecom options have proven extremely effective. For example, even for universalized reporting of TB cases, the mobile could be an integral tool which can be used by all stakeholders including private agencies to report each TB case and other information. And Nikshay could be that centralized repository and processor of data that could produce intelligence for action.

Further, training frontline health workers, especially in rural India, to capture TB cases on mobile phones on a regular basis can provide useful observations and analysis of the disease and strengthen the reporting mechanisms. Because of the labour-intensive nature of TB treatment, a mobile-based monitoring and tracking mechanism is expected to enable DOTS (directly observed treatment, short course) providers to monitor their patients on treatment adherence. For instance, DOTS treatment requires a regime of taking pills on alternate days—an SMS will help remind patients of the treatment days to ensure they stay the course.

Osama Manzar is founder-director of Digital Empowerment Foundation and chairman of the Manthan Award. He is member of a working group on internet proliferation and governance at the ministry of communications and information technology. Follow him on twitter @osamamanzar.

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