Information technology and telemedicine in sub-Saharan Africa

doi:10.1136/bmj.321.7259.465

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Economical solutions are available to support health care in remote areas

Hamish S F Fraser, instructor in medicine (hamish@medg.lcs.mit.edu),
St John D McGrath, co-director

Children's Hospital Informatics Program and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
International training program in medical informatics, New England Medical Center, Box 041, 75a Washington Street, Boston, MA 02111, USA

Many developing countries have an acute shortage of doctors, particularly specialists. Sub-Saharan Africa has, on average, fewer than 10 doctors per 100 000 people, and 14 countries do not have a single radiologist.1 The specialists and services that are available are concentrated in cities. Workers in rural health care, who serve most of the population, are isolated from specialist support and up to date information by poor roads, scarce and expensive telephones, and a lack of library facilities.2 Can information technology offer solutions? If so, what technologies are likely to be most effective and economical?

The internet is making inroads into Africa: whereas three years ago only 12 countries in Africa had internet access, it is now available, at least in the capital city, in 53 out of 54 African countries.3 Free online resources include journals,4 research databases, and training courses.5

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