Digital Health is the use of Information and Communication technologies (ICT) to treat and serve the communities, evolving the usual way patients and healthcare providers interact traditionally and lessen the burden of healthcare providers at the same time. It could potentially transform healthcare so that an accurate care is delivered more robustly and patients can access therapeutics from wherever they are, rather than having to physically attend a healthcare facility.
Pakistan Institute of Living & Learning (PILL) is striving through innovation and becoming a standout leader in the field of digital health to culturally adapt evidence based psychosocial interventions.
The use of innovative technological tools and communication techniques using wireless services (use of mobile phones, tablets, others) in delivering and enhancing health and mental health interventions called as digital health, emerged back in 2000 and has been globally pervasive now.
The context of this rapid technology ubiquity is the belief that digital technologies (including web-based delivery, online engagement platforms, video-conferencing, and use of cellular technology) has substantial potential of improving the quality of health intervention even in tough geographical terrains targeting vulnerable populations in a cost-effective manner. In particular, innovative technologies offer hope for the cross-cultural and widespread dissemination of evidence-based interventions.
Some of the significant digitally delivered evidence-based programs by PILL include:
Effectiveness of Telehealth to Support Postnatal Depressed Mothers – TeleMotherCare
Telehealth – ‘Tele’ means distance and Telehealth refers to health care provided at – and from distance; including signs and symptoms monitoring and management. This ‘TeleMotherCare’ is individualized support that is facilitated by a telehealth program using high-end telephone technology that can extend the reach of experts, prevent the worsening of mental health symptoms or concerns, and provide peace of mind to mothers in a challenging yet exciting time of their lives.
The telephone delivered program was supplemented by the provision of Learning through Play Plus pictorial calendars to the mothers having children aged up to 3 years. This interactive calendar encompassed eight successive stages of child development from birth to 3 years, with illustrations of parent-child play and other activities that promote parental involvement, learning, and attachment. In each stage, five key areas of child development were depicted: sense of self, relationships, understanding, and communication. Information about each area was written in simple, low-literacy language, with accompanying pictures that act as visual cues.
mHealth to reduce maternal depression and improve child health – ‘TechMotherCare’
The aim of this project was to develop and assess the phone-based intervention, containing problem-solving and child development related psycho-education to function as a self-help intervention that can reduce maternal depression and improve child health in low middle income countries like Pakistan. The main objective of TechMotherCare was to increase the access to psychological care for mothers who have children of age from birth to thirty months, consistent with their values.
The Pakistan Institute of Living and Learning team was awarded the Grand Challenges Canada (GCC) grant for developing a simple, cost-effective, and highly interactive mobile application ‘TechMotherCare’ with Global Systems for Mobile (GSM) high-end connectivity to monitor developing signs and symptoms of depressed mothers having children (0-3 years) during the delivery of psychological treatment.. Cognitive Behavioral Therapy based intelligent text messages automatically sent to mothers` phones that were based on their responses at particular timing via two-way SMS technology. These messages were further compounded by ‘Learning Through Play’ based pictorial calendar technique which helps to illustrate eight successive stages of child development promoting parental involvement, learning, and attachment.
The TechMotherCare revolutionizes improvement of mental health signs and symptoms by being able to changing negative thinking, collaboration with the family, and guided discovery (gently probe for the family’s health beliefs and to stimulate alternative ideas).
This study further entailed a supportive element, ‘Interpersonal Psycho-Therapy’ which acted as an educational catalyst, a parenting element, and an interpersonal relationship element. This primarily focused on helping mothers to feel supported, empowered and confident enough about their parenting abilities, which can directly influence a reduction in depressive symptoms as well as the resolution of interpersonal conflicts. We approached more than 370 depressed mothers and addressed their postnatal depression as well as made them empowered in their mother`s role.
