1.17 Uganda: Uganda’s Approach to Implementing Broadband Connectivity in Underserved Areas
0Uganda Communications Commission (UCC) established the Rural Communications Development Fund (RCDF) to stimulate provision of telecommunications services in the rural and underserved areas. The RCDF is therefore acts as a mechanism for leveraging investments in communications infrastructure and services in rural underserved areas of the country. This was recognition of the fact that although the sector had been liberalized and opened to competition some parts of the country which were non-commercially viable would not attract private capital for investment in infrastructure and services.
The RCDF main objectives include to provide access to basic communication services within a reasonable distance; ensure effective investment in rural communications development and to promote ICT usage in Uganda.
Uganda’s Universal Access Policy (2010) is developed within the premise of the global development agenda, the Millennium Development Goals (MDGs), to which Uganda is one of the signatories; and its country-specific National Development Plan (2010) that was originally linked to the national vision called Vision 2025. The policy is also developed building on the previous universal access policy (2001) and within the framework of Uganda’s ICT policy and telecommunications policy.
One of the main reasons why the Internet has not spread to the rural areas are the cost of access, insufficient bandwidth and power issues and more important for the rural communities, illiteracy and the absence of relevant local content in vernacular. The new policy therefore has the main objective of ensuring provision of broadband connectivity and supporting the development of local content. However, the main impediment for the ICT sector in Uganda today is the lack of broadband infrastructure network meant to accelerate access and use of the Internet in particular and ICTs in general. This is especially because of the heavy capital requirements that cannot be left to the private sector alone and thus requiring special intervention from government.
Uganda government has embarked on supporting the interconnection of all higher local governments’ capitals and major towns with a national data backbone infrastructure so as to enable provision of wide array cost effective ICT services to the users. This expected to facilitate the establishment of institutional data access points with initial focus on vocational, tertiary and secondary educational institutions, and government health units for levels IV and III.
Broadband connectivity will be provided for selected sub-counties to connect to the high speed National Backbone Infrastructure. The connection is considered as a ‘last mile’ solution for the sub-counties. To this end, a detailed study to determine the most cost effective technological solutions (wireless, cable) that could be implemented for each location is underway. Additionally, the study will help in identifying the districts that will not be covered by the national backbone infrastructure. The backhaul links will then be deployed to link such sub-counties to the identified districts.
The initial proposal is to outsource the design and implementation of the proposed access network to competent telecommunications service providers. The project once implemented is intended at lowering the price of bandwidth paid by the consumers while providing high quality and a wide variety of broadband services. The project will also entail providing computers and capacity building or training programmes to the end users such as schools, health centres and local governments.
1.17.3 Expected Benefits
E-government: The project will help in collecting information from lower local governments upwards to the central government. The information will be part and parcel of the national demographics and other socio-economic related statistics.
E-education: The project will facilitate e-learning and already this is gaining popularity in the country. For example major local universities are having satellite campuses in upcountry locations in which long distance and online education are now being offered.
E-health: The project will facilitate data and voice flow from the rural communities to the health centre onwards to the district hospitals and regional referral hospitals and finally to the national referral hospital. The reverse flow will happen. Additional traffic is expected between the Ministry of Health head office and the district offices and also between the ministry and the health centres.
Internet penetration, access and usage in Uganda is still very low and is estimated at (5%) users of the total population. This is also largely confined to urban commercial centres owing to commercial considerations by the private service providers. Although Uganda’s previous policy had supported the installation of Internet points of presence in all the underserved districts, the internet bandwidth speeds and quality of service issues (outages) has been of major concern by the end users.
Therefore the new policy objective is expected improve broadband uptake in selected underserved areas. This is envisaged offer lessons and experiences for developing a national broadband policy and subsequent rollout strategies for the country. Therefore ITU-D Study Group meetings offers Uganda an opportunity to gain experiences on how other countries are addressing this developmental concern.
0Currently in Uzbekistan a wide range of socially significant reforms are carried out. There are the administrative reform, education and health care reforms, etc. Much attention is also paid to the development of information technologies – informatization of state agencies and set up the ground for future e-Government in the near future.
To speed up the introduction, use and further development of computer information systems, the program of computerization and ICT development in 2002 – 2010 has been adopted by the Government of Uzbekistan. The program was designed to create conditions that will allow Uzbekistan to achieve a higher level of ICT penetration in all spheres of life, including public administration and social activities.
1.18.1 HMIS in Uzbekistan
Integrated Health Management Information System means a multi-tiered system consisting of software and hardware in departments and divisions of the Ministry of Health, medical institutions, laboratories, sanitary-epidemiological surveillance departments, research institutes and universities as well as in departments/units of medical statistics. The development of the Health Management Information System should be based on the use of Internet technologies and integration of all available information resources into a single corporate network of the Ministry of Health.
The Ministry of Health approved the concept of HMIS (Decree №99, March 31, 2009) after detailed considerations and evaluations. It was selected a star type architecture of HMIS with the Data Center located in Tashkent based on open integration-communication platform. The structure of HMIS is presented in Figure 18. The decision to select the centralized architecture was well justified at this moment because the environment is not well prepared for computerization and it is needed some control. The Healthcare Integrated Platform is the common telecommunication and information infrastructure and it is a backbone of HMIS. It will be built component-wise, mutually connecting all entities into powerful common infrastructure. Of course, each entity has its own Local Area Network (LAN). This approach also allows adding or subtracting any component as appropriate and needed. It is important to stress that one of the main advantage of such architecture is scalability.
The all organizations belong to the Ministry of Health will transmit their information according to the agreed protocol directly to the Data Processing Center which is the repository of all information of the Ministry. The Data Center will be connected with all information systems and databases such as “Management and planning of human resources of health care system”, “Monitoring of infectious diseases”, “Basic register of blood donors and persons not permitted to donate”, “E-passport of health facilities”, etc.
Figure 18: Architecture of HMIS in Uzbekistan
Openness and standard pursuance of selected HMIS architecture enables interconnection of any other kind of register or database that healthcare service process requires. Furthermore, central system management reduces administrative costs.
The Data Center will get raw data without any intermediate levels and process it into required format, presentation or report. Data Processing Center (DPC) of Ministry of Health, which will be the heart of the HMIS should also include a Service Center and Call Handling, which is a standard feature of any data center. The access to the information will be restricted and regulated.
The advantages of this architecture are the following:
Direct transmission of primary information in the database eliminates the possibility of modifying the original raw data.
Instant display information in real time by any criteria.
A single data repository eliminates duplication.
Paperless process will bring some saving.
Only the owner of raw data has a right to make correction of his presentation.
Manager will get a chance to view the situation at any time.
Quick search of any information related any region & Sampling only interest criteria.
Universal access via the Internet (Intranet) in the presence of access rights.
Complete elimination of middlemen, who collect and aggregate data.
High level of security.
Opportunity to get quickly any analytical or statistical reports.
1.18.2 Activities Undertaken by the Ministry of Health
In line with the approved HMIS concept and according to available resources, the Ministry of Health is providing the number of servers and computers to organizations in order to connect them to corporative information network.
The Ministry of Health decided to establish a database and distribution of computer equipment based on the concept adopted, with phasing for connection of each organization to the corporate network of the Ministry. The introduction of some e-Health services is considering as well.
The main objective of e-Health services is to provide expert medical help to the people situated in rural and remote areas where highly qualified and experienced doctors are not available. Improvements in all aspects of information and telecommunication technologies are enabling health and healthcare organizations to share information electronically across previously impossible distances and borders, and bring clinical practice and administrations alike to the healthcare staff in any location. New technologies are emerging and rapidly maturing. In some cases even faster than users can absorb and integrate them.
The introduction of the telecardiology monitoring service (and other e-Health services) will give the opportunity to provide quick and highly needed service at a distance for many patients suffering from cardio-vascular and other chronic diseases.