BasicInternet:Technological transition and Health Support - WHO

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BasicInternet:Technological transition and Health Support - WHO

Title Technological transition and Health Support - WHO
Place Phone
Date, Time 2020/03/16, 1530-1610
Contact Person Josef.Noll
Participants Josef.Noll, Rüdiger Krech
related to Project BasicInternet, DigI
this page was created by Special:FormEdit/Meeting, and can be edited by Special:FormEdit/Meeting/BasicInternet:Technological transition and Health Support - WHO
Category:Meeting


Main take away

During the phone conference we addressed the following topics

  • Knowledge and behaviour change
  • Community involvement
  • Governance at Urban Level
  • Indicators for Health governance
  • Technological Transition - and impact on health strategies

Knowledge and behaviour change

  • common understanding that involving schools and providing digital health at school is an excellent way to change behaviour of parents and societies
  • though, how to introduce the digital health package at schools is more complex, and needs involvement of decision makers

Community involvement

  • core in community involvement is to include the decision makers, as there is the need on adapting the decision processes and establish good governance for health.
  • Evidence for community involvement as a positive contribution is not commonly accepted

Governance at Urban Level

  • WHO has started a project on Governance at urban level, in order to see how ownership for health education can be better grounded in the local governments

Indicators for Health governance

  • Though the goal of providing digital access and a health information package at every primary health facility is commonly agreed, the way to get there is not that straight forward
  • every new indicator, e.g. number of connected primary health stations, has a cost budget, typically 100k - 1MEUR/indicator
  • Thus, we need to ensure that the indicators are meaningful and have a clear cost-benefit, especially as compared to other health indicators
  • Methods to establish indicators need to be scientifically proven, and the results need to be reproducible

Technological Transition- and impact on health strategies

  • Health is a seismograph of the society was a common starting point, given the challenges of countries like NO and DE in answering to the COVID-19 pandemic outbreak.
  • What we see is that technological transition and innovation is much faster than what people are able to adapt
  • Thus, we have the need to regulate innovations and technology development to contribute on better health and better wellbeing. The two dimensions are a) to adopt innovations to answer health challenges, and b) to establish a regulatory framework for the outcome of the innovations.
  • Examples being discussed were 5GforAll, 6G, big data and data ownership. Societal Security, which is the core topic Prof. Noll's research, has addressed means to overcome the Digital Divide, addressing especially Internet Lite, the freemium model for access.

We concluded that we need to discuss more, based on the summary of the activities by UiO and the Basic Internet Foundation.

Through our work with UNICEF on Digital Public Goods and ITU on Digital Transformation Centres it becomes more clear that every country needs a National Knowledge Portal (see discussion later on), which will also answer the crisis on Infodemic https://www.afro.who.int/news/inoculating-against-infodemic-africa

Background information

About UiO and the Basic Internet Foundation

This part is extended such that it can be shared directly with relevant shareholders.
University of Oslo has established the Centre for Global Healthto focus on coordination of health aspects in a global perspective. Several departments of UiO are contributing, a.o. the Department of Informatics with the Health Information System Platform (HISP, DHIS2.org) and the Department of Technology Systems (ITS) with the focus on Energy & Information provision to local communities.

In order to reach the targets for SDG 3 and SDG 4, digital inclusion and societal empowerment is a key area. The University of Oslo (UiO) and Kjeller Innovation have established the Basic Internet Foundation (BasicInternet.org), to foster solely on connecting the unconnected. The Foundation has established the the concept Internet Lite for All, the free access to information for everyone. furthermore, the Foundation

  • has the vision to improve the life of every human through free access to information on the Internet
  • promotes and provides the Freemium model for access
  • builds Information spots with free access to information, and premium access to broadband services.

Basic Internet Foundation enforces the need to empower the society by fostering trust, and ensuring how this trust as a value proposition is achieved. This value proposition has all to do with the digital participation by the people.

Recognition of the Work

The Government of Norway (Research Council of Norway, Norad and MfA) supports the work of the Foundation through the Non-discriminating Access for Digital Inclusion (DigI project), involving 11 partners from 9 countries. As part of the DigI project, the consortium has connected 10 villages in Tanzania (see DigI:Villages) and established the basis for local communities building information spots.

The provision of digital health information through publicly available information spots in remote villages has shown tremendous success. Increase of 60% for Cysticercosis (from 16% to 75%), and 30% for Tuberculosis (from 64% to 94%) - see: https://its-Presentation by Christine Holst at the Breakfast Seminar in Oslo on free access to digital public goods

The work of the Foundation was recognised by the United Nations' High-Level Panel on Digital Cooperation, and was cited as an example by the Norwegian Parliament Report Digital transformasjon og utviklingspolitikken (Stortinget Meld. St. 11, 2019–2020). See further details at DigI:Publications.

 PresenterPresentation File
Mexico National Knowledge Portal for Digital Inclusion 2020/03/09Josef NollClick to Open

As explained in the presentation, the Foundation has achieved the following

Figure 4: Basic Internet Infrastructure with Local Information Spot, high level overview (left) and detailed view of components of the Information Spot (right)


National Knowledge Portal for each country

Two major aspects are addressed through a National Knowledge Portal, being

  • What is a National Knowledge Portal, and what content should reside on the Knowledge Portal
  • How to enable free access of everyone in the society

Content on the National Knowledge Portal

Please see the Video by Digital Skills Foundation on the National Knowledge Portal- https://owncloud.basicinternet.org/index.php/s/TCH1zu9G5iL63qp

Figure 3: Basic Internet Mission, as original (left) and AMP version (right)

With regards to content creation on the portal, we had a longer discussion, touching into:

  • What kind of content: Information for education, health, entrepreneurship and innovation, as well as governmental information are the obvious kinds of content to be provided through the knowledge portal. Best praxis: The government invites for content, including ministries, academics and private companies. As an example, the Digital Public Goods established by UNICEF could be made available through the knowledge portal
  • Ownership of content: the government should set up the guidelines, and should ask the citizens and the local communities for their needs, such that the goal of empowering the society is reached.
  • The Foundation suggests to establish a split architecture, between lightweight content (text and pictures) and heavy content such as videos. In order to effectively use the connectivity, heavy content should be provided through local points of presence.

The question of network neutrality on the Knowledge Portal emphasised the need to "filter after the content type and not after the content". In our definition of Internet Lite we split the content after content types, e.g. text & pictures are provided through the Internet, while video and streaming content is provided locally. There is a need to define the set of protocols to characterise the lightweight content, with AMP being a protocolthat already satisfies the needs. See Figure 3 as an example, showing the normal and the AMP version of a Web page side-by-side:

Connectivity and Access

Figure 3: Prof. Noll presenting the Information Spot (antenna and local Wifi) during the African Innovation Week 2019

The main driver for a National Knowledge Portal is the provision of valuable services to every member of the society. People with a good economy will have a mobile broadband subscription, and thus the ability to search for information on the Internet. People in rural areas, as well as under-privileged people often don't have mobile broadband network coverage. And even though they might have coverage, they don't have a mobile broadband subscription to access the Internet. Girls and women are most-often hit especially hard by the digital divide. Boys have toys, and in rural areas, where 30% of males own a smartphone, only about 1% of the women have a smartphone. A similar gender divide exists for the mobile broadband subscription, with substantially less women have a data package. Thus, the digital divide is also a gender divide - and current business models have not answered how to overcome the divide.

The driver for Information Spots is addressing the business needs in providing both connectivity and access, as well as a much better Quality of Service. The Freemium Model for access provides free access to the National Knowledge portal and other lightweight information, and premium access to streaming and other bandwidth-demanding content. Numbers presented by Opera Softwarefor their Opera Mini browser demonstrate that you can either provide a person with 10 min of video, or 10 months of information. The data volume is the same. Experiences by the Basic Internet Foundation show that one user watching video, supports 300 user accessing Internet Lite.

The envisaged split architecture for the National Knowledge Portal, with heavy content being provided through a local point of presence, will typically use 2-3% of the bandwidth of a mobile network. The costs for this bandwidth can be accounted in different ways:

  • as part of the license conditions for mobile operators, 3% of the bandwidth need to be given for access of the National Knowledge Platform,
  • as refund from the regional development fund, where the operators are paid for the net costs of providing the Giga Bytes (GB) from the Information spots, or
  • as deduction of contribution to the license fees.

Given en example, each information spot uses 3-5 GB per month on Internet Lite. Given 1000 information spots, that makes in average 4000 GB/month. The net costs for an operator, as reported by Spryutte et al., were 8.5 €/GB as EU average, and down to e.g. 0.9 €/GB for Sweden in 2016[1]. Thus, given the stead decrease in costs, 4000 GB/month will be around 4000 €/month for 1000 information spots, thus down to 4€/month for a single school/village/health station.

As discussed with the national regulatory in Tanzania during the Seminar on school connectivity in rural areas in Feb2020, an OPEX cost of 20 USD/month is acceptable. Thus, the suggested wholesale model answers the need for affordable Internet connectivity. Furthermore, given the local presence of the heavy content, the Quality of Service will be a lot better, as local streaming is on Wifi and does not need to share the rather thin mobile network bandwidth.

References

  1. J Spruytte et al., International roaming in the EU, University of Gent, 2017 -https://biblio.ugent.be/publication/8545542/file/8545544.pdf