Department of Health Management and Informatics, College of Health and Public Affairs, University of Central Florida, Orlando, FL, United States.
Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, United States.
Int J Med Inform. 2018 Jun;114:114-120. doi: 10.1016/j.ijmedinf.2017.11.003. Epub 2017 Nov 6.
PURPOSE: The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas. METHODS: First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments, and discuss potential policy solutions. DISCUSSION: Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of the MDGs. Greater investment in data collection efforts, supported by digital health technologies, is necessary if SDG 3 targets are to be measured and progress assessed. Standardized EMR systems as well as context-specific data warehousing efforts will assist in collecting and managing accurate data. Stakeholders such as patients, providers, and NGOs, must be proactive and collaborative in their efforts for continuous progress toward SDG 3. Digital health can assist in these inter-organizational communication efforts. CONCLUSION: The SDGS are complex, ambitious, and comprehensive; even in the most stable environments, achieving full completion towards every goal will be difficult, and in conflict-affected environments, this challenge is much greater. By engaging in a collaborative framework and using the appropriate digital health tools, we can support humanitarian efforts to realize sustained progress in SDG 3 outcomes.
目的:千年发展目标(MDGs)的进展表明,持续的全球行动可以取得成功。尽管在卫生和教育方面取得了前所未有的成就,但仍有超过 10 亿人,其中许多人在受冲突影响的地区,无法从 MDG 成果中受益。最近制定的可持续发展目标(SDGs)比其前身更加雄心勃勃。SDG 3 优先考虑所有年龄段的健康和福祉,具体领域包括孕产妇死亡率、传染病、心理健康和医疗保健人员。然而,如果不改变用于受冲突影响地区的方法,世界上最脆弱的人群可能会再次在全球发展中落后。我们必须就采用创新战略解决脆弱、资源匮乏且通常偏远地区的卫生挑战进行有意义的讨论。在本文中,我们将论证,为了实现 SDG 3 的宏伟健康目标,数字医疗可以帮助弥合受冲突影响地区的医疗保健差距。
方法:首先,我们描述了受冲突影响环境中的人群的健康需求,以及这些需求如何与 SDG 3 目标重叠。其次,我们讨论了数字医疗如何满足受冲突影响地区的独特需求。最后,我们评估了在脆弱环境中部署数字技术的各种挑战,并讨论了潜在的政策解决方案。
讨论:受冲突影响地区的人可能会受益于数字医疗工具的扩散性质。使用蜂窝技术或基于云的解决方案可以克服物理障碍。此外,如果有效的教育和外展工作得到支持,SDG 3 的许多目标都可能取得重大进展,而以移动医疗和远程医疗形式出现的数字医疗为这些举措提供了相对低资源的平台。最后,缺乏数据收集,特别是在受冲突影响或其他脆弱国家,是千年发展目标的主要限制之一。如果要衡量和评估 SDG 3 目标的进展,就需要通过数字健康技术来加大对数据收集工作的投资。标准化的电子病历系统以及特定于上下文的数据仓库工作将有助于收集和管理准确的数据。患者、提供者和非政府组织等利益相关者必须在实现 SDG 3 方面积极主动,协作。数字医疗可以协助这些组织间的沟通努力。
结论:SDGS 是复杂、雄心勃勃和全面的;即使在最稳定的环境中,要全面完成每一个目标都将是困难的,而在受冲突影响的环境中,这一挑战更大。通过参与协作框架并使用适当的数字健康工具,我们可以支持人道主义努力,以实现 SDG 3 成果的持续进展。
Int J Environ Res Public Health. 2020-2-7
Vertex. 2018-11
Int J Health Policy Manag. 2020-7-1
Oxf Open Digit Health. 2025-1-8
Oxf Open Digit Health. 2024-7-23