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Research Roundup

August 2024: Digital Tools Transforming Humanitarian Aid

Issue 14, August 2024

Poster for World Humanitarian Day

 

In celebration of World Humanitarian Day on August 19th, this month's Digital Health Research Roundup focuses on the potential of digital tools for improving humanitarian health interventions. Dr. Aral Sürmeli explores how digital health innovations intersect with broader humanitarian efforts through tools such as crisis mapping, telemedicine in conflict zones, and enhanced healthcare delivery in emergencies.

Guest Editor's Remarks:

The climate crisis and ongoing conflicts are increasing the global demand for humanitarian assistance, intensifying the challenges of resource scarcity in crisis-affected regions. In such settings, limited financial and human resources often hinder effective healthcare delivery. Digital health technologies have emerged as a promising solution, offering scalable and cost-effective alternatives that require fewer human resources compared to existing methods. While there is substantial evidence supporting the potential of these tools, further research is needed to assess their long-term impact and scalability before they can become the gold standard of care in humanitarian response standards.

Various studies have highlighted the utility of tools originally designed for non-humanitarian contexts. For instance, mobile health applications developed for stable, low-resource environments may be adapted for rapid communication in crisis situations. Similarly, blockchain technology, often associated with cryptocurrencies, shows promise for providing secure and efficient logistics tracking systems. 

This article roundup reviews recent studies across several key dimensions of digital health in humanitarian settings: artificial intelligence and predictive analytics, blockchain technology, crisis mapping, mobile health applications, and telehealth. The selected studies investigate various aspects of humanitarian response and data-informed decision-making in environments characterized by low data quality and urgent needs.
 

Digital Tools for Humanitarian Aid

CGDHI key takeaways and comments on the research articles hand-picked by our guest editor:

Opportunities in AI and predictive analytics for humanitarian action

A. Beduschi et al, Harnessing the Potential of Artificial Intelligence for Humanitarian Action: Opportunities and Risks, International Review of the Red Cross, 2022

This article investigates the potential of artificial intelligence (AI) technologies in the humanitarian sector, emphasizing deployment opportunities and risks, and discussing how they can be used for conflict and crisis support.

Key Takeaways:

  1. AI has the potential to enable a shift from reactive to anticipatory humanitarian action, allowing for better preparedness, response, and recovery efforts. Examples include predictive analytics for forecasting natural disasters and displacement, and AI-supported disaster mapping for rapid emergency response.
  2. AI deployment in humanitarian contexts poses risks such as algorithmic bias and data privacy concerns. Poor data quality and biased algorithms can lead to unfair outcomes, potentially exacerbating vulnerabilities and inequalities.
  3. Implementing AI in humanitarian action requires careful consideration of context-specific challenges, including data quality, accessibility, and the risk of over-reliance on technology.
  4. To leverage AI responsibly, humanitarian actors must prioritize the "do no harm" principle, ensuring risk assessments, data protection, and transparency in AI system implementation.

Comment from the Center for Global Digital Health Innovation: The article's strength lies in its balanced approach, addressing both the transformative potential and the inherent risks of AI technologies. It underscores the critical importance of addressing algorithmic bias and ensuring data privacy to protect vulnerable populations. However, the study could benefit from more practical examples of AI deployment in real-world humanitarian contexts to illustrate the discussed concepts. Future research should focus on developing robust frameworks for ethical AI use, incorporating community engagement and exploring the long-term impacts of AI-driven interventions on affected populations.

Digital cash transfers and blockchain in operations management

K. Hunt et al, Blockchain in Humanitarian Operations Management: A Review of Research and Practice, Socio-Economic Planning Sciences, 2022

This review systematically examines the current literature on the application of blockchain technology in humanitarian operations management, covering the theoretical advantages and practical deployments of blockchain in this field.

Key Takeaways:

  1. Blockchain technology offers enhanced security and auditability, making it valuable for transparent and efficient humanitarian operations, including secure data sharing and transparent supply chains.
  2. Blockchain can provide robust solutions for identity management and data protection, ensuring the secure and efficient distribution of aid to refugees and disaster victims. It also improves operational efficiency in humanitarian supply chains, reduces fraud, and enhances collaboration among various stakeholders through transparent and traceable transactions.
  3. Blockchain supports efficient communication and coordination in disaster management, promoting trust and collaboration among relief agencies and ensuring reliable crisis information sharing.

Comment from the Center for Global Digital Health Innovation: This comprehensive review by Hunt et al. offers insights into the potential and challenges of blockchain technology in humanitarian operations management. Its strength lies in its systematic categorization and analysis of existing literature, providing a clear understanding of the current state-of-the-art use of blockchain and identifying future research directions. However, the study highlights a significant gap in empirical evidence supporting the effectiveness of blockchain in real-world humanitarian settings. To bridge this gap, future research should focus on developing and testing blockchain-based frameworks in field settings, addressing scalability and integration challenges, and conducting cost-benefit analyses to justify investments. 

Crisis mapping in complex emergencies

J. Ziemke et al, Crisis Mapping and Crowdsourcing in Complex Emergencies, Oxford Research Encyclopedia of Politics, 2021

This article provides an overview of crisis mapping, charting its inception and evolution, while highlighting the significant role of crowdsourcing in the humanitarian response. It also explores the technological advancements that have enabled the deployment of crisis mapping tools, examining their security and political implications.

Key Takeaways:

  1. The field of crisis mapping has evolved rapidly due to technological advancements such as satellite imagery, GPS, and machine learning. These technologies have transformed crisis mapping from a human-powered effort to a more automated and efficient process.
  2. Crowdsourcing plays a crucial role in crisis mapping by leveraging the collective intelligence of volunteers to gather, filter, and visualize data in real time. 
  3. The article highlights the risks associated with crisis mapping, including issues of data privacy, the potential for misinformation, and the need for effective verification processes to ensure the accuracy of crowdsourced data.
  4. The future of crisis mapping will be shaped by improvements in data collection and analysis technologies, such as low-cost drones and enhanced machine learning techniques, which will further enhance our capability to respond to complex emergencies.

Comment from the Center for Global Digital Health Innovation: The strength of this study lies in its detailed account of the technological and collaborative efforts that have shaped the field. The emphasis on crowdsourcing underscores the value of community engagement in disaster response and how it can triangulate other data sources. However, the article could benefit from a more in-depth analysis of the ethical considerations and long-term sustainability of crisis mapping. Future research should explore the integration of crisis mapping with existing humanitarian response frameworks and approaches for  addressing data privacy and misinformation challenges.

Mobile apps/ chatbots for NCDs in humanitarian settings

S. Doocy et al, Pilot Testing and Implementation of a mHealth Tool for Non-communicable Diseases in a Humanitarian SettingPLoS Currents, 2017

This study evaluates the implementation and effectiveness of a mobile, patient-controlled, electronic health record (PCHR) for managing non-communicable diseases (NCDs) among Syrian refugees and host communities in Lebanon. It highlights the often-overlooked advantage of PCHRs in facilitating record portability across facilities in areas with fluid population movement.

Key Takeaways:

  1. The use of the mHealth application led to a significantly greater proportion of patients recording BMI and blood pressure in the mHealth system compared to traditional paper based medical records, indicating an improvement in data collection.
  2. Provider reactions to the application varied; some viewed it as extra work or time-consuming, while others saw it as beneficial, noting improved patient understanding of lifestyle behaviors, medications, and increased patient satisfaction.
  3. Satisfaction with clinic visits improved significantly during the implementation of the mHealth application, but despite the positive outcomes, provider adoption of the mHealth application was low, with only 21.7% of consultations utilizing the application. 

Comment from the Center for Global Digital Health Innovation: This study underscores the potential of mHealth tools to enhance the continuity and quality of care for NCDs in humanitarian settings. The improvements in data recording and patient satisfaction highlight the value of integrating digital solutions into healthcare delivery. However, the low uptake by providers indicates a critical challenge that must be addressed. Doocy and coauthors emphasize the necessity of aligning new interventions with existing practices to avoid duplication and enhance usability. Future research should focus on identifying and mitigating organizational and provider-side barriers such as multiple reporting requirements for the adoption of such applications. Provider and consumer feedback mechanisms could further identify ways to optimize the benefits of such tools in similar settings.

Telehealth in conflicts

P. Parkes et al, Telemedicine Interventions in Six Conflict-affected Countries in the WHO Eastern Mediterranean Region: A Systematic Review, Conflict and Health, 2022

This review explores telemedicine interventions in six conflict-affected countries within the WHO Eastern Mediterranean region, assessing their implementation, efficacy, and the barriers encountered. 

Key Takeaways:

  1. Telemedicine interventions reviewed include both store-and-forward and real-time technologies used across various specialties such as radiology, histopathology, mental health, and intensive care. Most interventions were implemented by humanitarian or academic organizations.
  2. Significant barriers to telemedicine in conflict settings included limited internet bandwidth, lack of technical equipment, funding limitations, and reliance on volunteer providers. The review also noted the lack of studies exploring key issues of confidentiality, ethical standards, and local healthcare worker and patient acceptability.
  3. Few interventions had built-in evaluation strategies or reported on outcomes systematically. The ad hoc nature of many projects and lack of sustained investment posed challenges to quality and sustainability.

Comment from the Center for Global Digital Health Innovation: The article provides a thorough review of telemedicine interventions in conflict-affected regions, shedding light on both the potential and the challenges of such technologies in these settings. The study's comprehensive scope and identification of key barriers are commendable. However, the lack of evaluation strategies and detailed exploration of ethical and data privacy issues (e.g., the potential of blockchain) are notable gaps. Future research should focus on developing standardized protocols for evaluating telemedicine interventions in these settings, while exploring sustainable funding models. More empirical evidence is also needed to understand the long-term impact of telemedicine on healthcare outcomes in conflict-affected regions.

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Meet Our Guest Editor 

Dr. Aral

Aral Sürmeli, MD, MPH, DrPH(c), is a global health professional with extensive experience in humanitarian aid, refugee care, and digital health interventions. He co-founded and leads HERA Digital Health and the Medical Rescue Association of Turkey, providing mobile health services globally. Dr. Sürmeli’s work, supported by Grand Challenges Canada, USAID, and the European Investment Bank, focuses on transforming research into practical applications for vulnerable populations. He is currently pursuing his DrPH program at Johns Hopkins Bloomberg School of Public Health, focusing on innovative technologies in humanitarian crises.