Highlights of Published Papers in Global Esteemed Journals

ABSTRACT

Kilkari is an outbound service that makes weekly, stage-based, prerecorded calls about reproductive, maternal, neonatal, and child health directly to families’ mobile phones, starting from the second trimester of pregnancy and until the child is 1-year-old. Since its initiation in 2012–2013, Kilkari has scaled to 13 states across India. In this analysis article, we explored the subscriber’s journey from entry to programme to engagement with calls. Data sources included call data records and household survey data from the 2015 National Family Health Survey. In 2018, of the 13.6 million records received by MOTECH, the technology platform that powers Kilkari, 9.5 million (~70%) were rejected and 4.1 million new subscribers were created. Overall, 21% of pregnant women across 13 states were covered by the programme in 2018, with West Bengal and Himachal Pradesh reaching coverage of over 50%. Among new subscriptions in 2018, 63% were subscribed during pregnancy and 37% after childbirth. Of these, over 80% were ever reached by Kilkari calls, and 39% were retained in the programme. The main causes for the deactivation of subscribers from the system were low listenership and calls going unanswered for six continuous weeks. Globally, Kilkari is the largest maternal mobile messaging programme of its kind in terms of a number of subscribers but the coverage among pregnant women remains low. While call reach appears to be on the higher side, subscriber retention is low; this highlights broader challenges with providing mobile health services at scale across India.

ABSTRACT

The field of artificial intelligence (AI) has evolved considerably in the last 60 years. While there are now many AI applications that have been deployed in high-income country contexts, use in resource-poor settings remains relatively nascent. With a few notable exceptions, there are limited examples of AI being used in such settings. However, there are signs that this is changing. Several high-profile meetings have been convened in recent years to discuss the development and deployment of AI applications to reduce poverty and deliver a broad range of critical public services. We provide a general overview of AI and how it can be used to improve health outcomes in resource-poor settings. We also describe some of the current ethical debates around patient safety and privacy. Despite current challenges, AI holds tremendous promise for transforming the provision of healthcare services in resource-poor settings. Many health system hurdles in such settings could be overcome with the use of AI and other complementary emerging technologies. Further research and investments in the development of AI tools tailored to resource-poor settings will accelerate realizing of the full potential of AI for improving global health.

Source: The British Medical Journal. Available from: https://doi.org/10.1136/bmjgh-2018-000798.

ABSTRACT

Ethical questions related to health, health care, and public health cover topics as diverse as moral issues around reproduction, state obligations in the provision of health care services, and appropriate measures to control infectious diseases. Scholars and healthcare professionals have debated ethical questions related to health and healthcare since the earliest days of medicine. Recent formal efforts to articulate international standards of ethics applicable to health and health care can be traced to the Nuremberg trials of 1947, during which the horrors of Nazi medical experiments came to light.

The principles that emerged from those trials, known as the Nuremberg Code, are broadly applicable to many types of health-related research involving human participants, including clinical trials. The growing breadth and complexity of contemporary health challenges have produced a range of difficult questions that cannot always be adequately addressed by relying exclusively on existing policies, guidelines, or codes of conduct. Debates over access to new and expensive pharmaceuticals and medical technologies, as well as increasing awareness of the gross health disparities that exist both within and between countries, have called attention to the need for an ethics of health policy and practice.

Source: World Health Organization, 2024. Available from: https://www.who.int/health-topics/ethics-and-health#tab=tab_1.