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Enhancing healthcare delivery in low and middle income countries : a systems approach
Dissertation   Open access

Enhancing healthcare delivery in low and middle income countries : a systems approach

Joseph Mwanza
Doctor of Philosophy (PHD), University of Johannesburg
2024
Handle:
https://hdl.handle.net/10210/513709

Abstract

Medical care - Developing countries Medical technology - Developing countries Wireless communication systems in medical care.
Collectively, low-and middle-income countries face the grim prospect of being the reason why global Universal Health Coverage goals might not be achieved. A range of adverse factors including constraints in infrastructure and inadequate medical equipment, a critical shortage of skilled workforce, as well as limited financial resources, all combine to create a formidable set of challenges that prevent low-resourced healthcare facilities from achieving the set objectives. An accessible, easily implementable and cost-effective solution is required if these health systems are to be put back on track to delivering accessible and effective healthcare to their populations. Digital technologies may have the potential to provide the toolkit required to address this challenge. In this study, we develop a hospital digital twin for monitoring the status and performance of a healthcare institution in real time, based on sensor input and Internet-of-Medical-Things devices, and we interrogate its potential role in aiding low- and middle-income countries attain Universal Health Coverage. The digital tool is co-designed with relevant stakeholders in order to ensure the desired attributes are achieved. We build intelligence into the digital twin through optimisation algorithms and heuristics that give the digital twin capability for intuitive decision-making. Business intelligence tools are applied to enable performance measurement for the facility and to determine effectiveness of the digital twin on operations of the healthcare facility. Results from the study suggest that digital twin technology may be able to give output that improves the quality of decision-making in healthcare management. The study reveals that deeper levels of integration may be achieved across healthcare institutions’ various systems in a cost-effective manner through the use of industrial and systems engineering tools and techniques. In both development and deployment of the tool, emphasis is on real-time monitoring, robust data-driven optimisation and intelligent decision-support. The digital twin proves useful in managing operations and optimising resource utilisation within health facilities in resource-limited settings. Accordingly, it is expected that deployment of the developed digital twin model within healthcare institutions in low-resource settings will lead to higher service levels and better resources management. Keywords: Business Process Mapping, Digital Twin, Discrete Event Simulation, Hospital, Modelling, Optimisation
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