Measuring the health outcomes of an e-health communication project in rural Nicaragua

Background: Access to health care in rural Nicaragua is very limited and it is particularly difficult to access for those living in the rugged, mountainous region of north-central Nicaragua. Surrounding the town of Waslala are some 85 rural communities with about 35,000 inhabitants. The most challenging barrier to receiving health care treatment is the distance and terrain over which a patient is required to travel to see a health care provider. The roads are unpaved and many of the communities are reached either by horseback or on foot. If there is an emergent situation, a resident must travel miles to seek health care. During the rainy season the communities may be inaccessible for extended periods of time. Description: During the summer of 2010 nursing, engineering and business students will be involved in the designing and implementation of a project to overcome this barrier by providing real-time communication between three rural communities and health care providers in the town of Waslala using cell phone technology and solar energy. The community contacts are volunteer health workers who have minimal training (perhaps no more than first-aid training) and virtually no access to medical supplies. Using this technology, the lay health worker may call or text to a licensed health care provider who would review the information and advise the health worker about whether or not the patient requires further health intervention. For example, if blood pressure parameters are too high or if there is a serious injury, the health worker will be instructed on how to safely manage the problem. Lessons Learned: Identifying clinical effectiveness has been problematic in developing countries due to lack of diagnostic accuracy, incomplete record keeping, and poor patient follow-up. Student nursing's role includes identifying the needs of the lay health workers, assisting in the development of electronic patient records, and identifying health outcome measures. Recommendations: Of interest is assessing the impact or the clinical effectiveness of this project. This presentation will identify the health data and outcomes identified as part of the nursing role in this project.