The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations
The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations
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DOI：
10.1016/j.ijmedinf.2017.11.003
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发表时间：
2018-06-01
影响因子：
4.9
通讯作者：
Williams, Cynthia
中科院分区：
文献类型：
--
作者：
Asi, Yara M.;Williams, Cynthia
目的：千年发展目标的进展表明，持续的全球行动能够取得成功。尽管在卫生和教育方面取得了前所未有的成就，但10多亿人--其中许多人生活在受冲突影响的地区--无法从千年发展目标的成果中获益。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将所有年龄段的健康和福祉放在特定领域的优先事项，如孕产妇死亡率、传染病、心理健康和医疗保健劳动力。然而，如果不改变对受冲突影响地区的做法，世界上最脆弱的人有可能再次在全球发展中落在后面。我们必须进行有意义的讨论，讨论采用创新战略来应对脆弱、资源匮乏和往往偏远的环境中的卫生挑战。在本文中，我们将论证，为了实现SDG 3雄心勃勃的健康目标，数字医疗可以帮助弥合受冲突影响地区的医疗差距。方法：首先，我们描述受冲突影响环境中人口的健康需求，以及它们如何与SDG 3目标重叠。其次，我们讨论数字健康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们可能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的创新克服了物理障碍。此外，如果有效的教育和外联努力得到支持，可持续发展目标3的许多目标可以取得重大进展，而以移动保健和远程保健为形式的数字保健为这些举措提供了一个资源相对较少的平台。最后，缺乏数据收集，特别是在受冲突影响或其他方面脆弱的国家，是千年发展目标的主要限制之一。如果要衡量和评估可持续发展目标3的目标，就必须在数字卫生技术的支持下，加大对数据收集工作的投资。标准化的电子病历系统以及针对具体情况的数据仓储工作将有助于收集和管理准确的数据。利益相关者，如患者、提供者和非政府组织，必须积极合作，努力实现可持续发展目标3。数字健康可以帮助这些组织间的沟通努力。结论：可持续发展目标是复杂、雄心勃勃和全面的；即使在最稳定的环境中，实现每一个目标的完全完成也将是困难的，在受冲突影响的环境中，这一挑战要大得多。通过参与协作框架和使用适当的数字卫生工具，我们可以支持人道主义努力，以实现可持续发展目标3成果的持续进展。
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.