MICA: BIOS - Assessing the potential of wearable digital biosensors for health system strengthening in LMICs.

非传染性疾病，包括心脏病、癌症、慢性呼吸系统疾病和糖尿病，在许多发展中国家日益成为重要的健康问题。例如，2012年的一项全球调查发现，在全球5280万人的死亡中，有3450万人死于非传染性疾病，其中近75%发生在发展中国家。这些疾病导致的大多数过早死亡是可以通过改变生活方式来预防的，比如增加体力活动、戒烟、减少饮酒和吃更健康的食物。然而，在世界范围内，公共卫生当局促进更健康的习惯从而改善生活的能力仍然不足。此外，在资源匮乏的国家，由于缺乏资源和信息系统薄弱，人们往往无法准确了解非传染性疾病的负担和相关风险因素的流行情况。例如，最近对全球健康调查趋势的审查发现，100个国家没有关于胆固醇的人口数据，也没有国家的血压数据。因此，卫生当局缺乏必要的信息来制定应对这些挑战的政策和方案。开发用于健康监测的新的可穿戴技术，如智能手表和智能手环，是一项很有前途的技术创新，具有支持预防和控制非传染性疾病方案的巨大潜力。在高收入国家无线医疗设备商业成功和健身跟踪器迅速普及的推动下，该领域的进步导致了越来越复杂的硬件和软件，可以捕获广泛的生物统计数据，包括呼吸、血氧饱和度、心率、血压、皮肤温度等。与此同时，发展中国家的无线网络有了很大的扩展，可以提供必要的基础设施，使数据能够从用户传输到卫生信息系统。因此，可以引入可穿戴健康系统，对可预防疾病的风险因素及其在人口群体中的分布进行定期调查，为制定政策将这些风险降至最低的卫生当局提供重要信息。可穿戴健康系统还可以根据个人进展向用户传递信息，帮助他们实现健康目标并降低风险。然而，尽管有这些承诺，可穿戴式健康监测器的公共健康潜力仍然没有得到开发，因为到目前为止还没有研究探索这种设备如何支持卫生政策和计划。该项目旨在对这一潜力进行初步评估，为更全面的多国研究奠定基础。将在柬埔寨开展研究活动，在那里将部署一个原型装置进行实地评估。这是一个示范案例国家，迄今为止，大多数研究和预防都集中在传染病上，而非传染性疾病尽管日益重要，但受到的关注和支持要少得多。在这方面，引入可穿戴设备可有助于加强预防方案和监测人口健康。意识到引进一项新技术是一个复杂的过程，我们将探索可能或多或少有助于采纳拟议创新的各种体制、社会经济和技术因素，并特别注意个别用户的反应。

Non-communicable diseases, including heart diseases, cancers, chronic respiratory diseases, and diabetes, are increasingly important health concerns in many developing countries. In 2012, for example, a global survey found that non-communicable diseases accounted for 34.5 million deaths of the 52.8 million deaths worldwide, and nearly 75% of those occurred in developing countries. Most premature deaths from these diseases are preventable through changes in lifestyle, such as increasing physical activity, quitting smoking, reducing the consumption of alcohol, and eating healthier food. However, capacities of public health authorities to promote healthier habits and thus improve lives are still inadequate worldwide. In poor-resourced countries, moreover, the burden of non-communicable diseases and the prevalence of associated risk factors is often not known with precision due to the lack of resources and weak information systems. For example, recent reviews of global trends in health surveys found that population data on cholesterol were not available in 100 countries, and no data on blood pressure were obtained for 64 countries. As a result, health authorities lack essential information to develop policy and programmes to address these challenges.The development of new wearable technologies for health monitoring, such as smartwatches and smartbands, is a promising technological innovation with great potential to support programmes for the prevention and control of non-communicable diseases. Boosted by commercial success of wireless medical devices and the rapid uptake of fitness trackers in high-income countries, advances in this sector have led to increasingly sophisticated hardware and software which can capture a wide range of biometric data, including respiration, oxygen saturation, heart rate, blood pressure, skin temperature, and more. In parallel, there has been a great expansion of wireless networks in developing countries, which can provide the necessary infrastructure to enable data transfer from users to health information systems. Thus, wearable health systems could be introduced to conduct regular surveys on risk factors for preventable diseases and their distribution across population groups, providing important information to health authorities who develop policy to minimise these risks. Wearable health systems can also be used to deliver messages to the users based on individual progress, helping them to achieve health targets and reduce risks. Despite these promises, however, the public health potential of wearable health monitors remains untapped, as no studies to date have explored ways in which such devices could support health policy and programmes. This project aims to conduct a preliminary evaluation of this potential, laying the foundation of a more comprehensive multi-country study. Research activities will be conducted in Cambodia, where a prototype device will be deployed for field evaluation. This is an exemplary case country in which most research and prevention to date have focused on infectious diseases, while non-communicable diseases have received much less attention and support despite their increasing importance. In this context, the introduction of wearable devices could be useful for strengthening preventive programmes and monitoring of population health. Aware that the introduction of a novel technology is a complex process, we will explore the full range of institutional, socio-economic and technical factors that may be more or less conducive to the uptake of the proposed innovation, with particular attention to the response of individual users.