Everything needs to be referenced

1)​ Current situation in Public Health (less doctors, less beds, divide between rural &
urban) and What specific problems are there in the current public health setup?-
Shreya
2)​ What steps have been taken to improve public health in India (can take about
policy changes and new interventions, and how the impact hasn't been great so
far, dont talk about tech here)- Vraj
3)​ How can AI/ Tech come in and tackle to improve public health?- Ayush
4)​ What barriers are stopping India’s public health from improving? (talk about how
tech penetration is difficult)- Gaurav
5)​ Give potential solutions to tackle the problem of tech penetration in public health-
Krisha
6)​ To support the above sentence, show the case studies of developing countries
testifying our solutions.- Vraj

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Steps have been taken to improve public health
in India-Vraj
The Government has formulated the National Health Policy, 2017, which aims at attainment of
the highest possible level of good health and well-being, through a preventive and promotive
health care orientation in all developmental policies, and universal access to good quality health
care services without anyone having to face financial hardship as a consequence.

The Government has devised various new initiatives on health sector which inter-alia includes:

●​ Introduction of new vaccines

●​ Mission Indradhanush
●​ NHM Free Drug and Diagnostics Initiatives
●​ Setting up of New AIIMS Institutions
●​ PradhanMantri National Dialysis Services Programme
●​ The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
●​ Senior Citizen Health Insurance Scheme (SCHIS)
●​ Biomedical Equipment Management & Maintenance Program (BMMP)
●​ MAA- Mother's Absolute Affection Programme
●​ Kayakalp initiative
●​ Health and wellness centres to provide comprehensive primary healthcare.
●​ Scheme for strengthening of Drug Regulatory system in the country
●​ National Quality Assurance Programme, under which, Quality Standards for District
Hospitals, Community Health Centres, Primary Health Centres and Urban Primary
Health Centres have been formulated.
●​ New Mental Health Policy 2014 envisions promoting mental health, by providing
accessible, affordable and quality health and social care to all persons with mental
illness.

Under Ayushman Bharat-Health and Wellness Centres (AB-HWC) initiative, launched by

Government of India in the year 2018, 1.5 lakh Sub-Health Centres (SHCs) / Primary Health
Centres, both in rural/urban areas, are being upgraded into HWCs for the betterment of local
public health care.

Packages provided under AB-HWC in rural/urban HWCs.

●​ Care in Pregnancy and Child Birth.

●​ Neonatal and Infant health care services.
●​ Childhood and Adolescent health care services.
●​ Family planning, contraceptive services and other reproductive health care services.
●​ Management of communicable diseases: National Health programmes.

IMPACT of the steps taken to improve public health

 ●​ Public health expenditure remains at 1.28% of GDP (2022), far below the target of 2.5%
by 2025, leading to inadequate infrastructure and workforce​.
●​ India faces a shortfall of over 600,000 doctors and 2 million nurses, with rural areas
especially underserved​
●​ Targets to reduce NCD-related premature mortality by 25% by 2025 are lagging;
diseases like diabetes and hypertension affect 15% and 30% of adults, respectively
●​ Stunting among children under five reduced only marginally to 35.5% in 2022, far from
the 25% target​
●​ Only 59% of children are fully immunized despite enhanced programs like Mission
Indradhanush.
●​ Male sterilization remains at 5%, well below the target of 30%, showing weak population
control measures​
●​ Digitization initiatives, such as a national electronic health database, have not reached
significant scale due to technical and infrastructure hurdles.
●​ Tribal health metrics lag; 70% of health workers concentrate in urban areas despite the
rural population being 65%.

Sources-
●​ https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1744363
●​ https://pib.gov.in/Pressreleaseshare.aspx?PRID=1519328
●​ https://joghep.scholasticahq.com/article/34300-recent-initiatives-for-transforming-
healthcare-in-india-a-political-economy-of-health-framework-analysis
 ●​ https://mohfw.gov.in/sites/default/files/9147562941489753121.pdf

How AI and Technology Can Transform Public

Health - Ayush
Advances in Artificial Intelligence (AI) and technology are revolutionizing public health,
presenting unprecedented opportunities to improve healthcare delivery, outcomes, and
efficiency. This section explores the transformative potential of AI and technology in tackling
public health challenges.

1. Revolutionizing Disease Diagnosis and Treatment

AI has set new standards in the accuracy and speed of disease diagnosis and treatment,
significantly impacting public health.

Diagnostic Accuracy: AI tools

in pathology have
demonstrated exceptional
performance, achieving
diagnostic accuracies of
99%-100% for certain
cancers such as skin
melanoma and thymoma. In
radiology, AIdriven models
analyzing chest X-rays for
pneumonia classification
achieved a 92.9%
sensitivity, outperforming
human radiologists.​
Scalability in Screening:
Scalability in Screening: AI-powered tools are transforming healthcare in resource-limited
regions. For instance, in Zambia—a country where approximately 60% of the population lives
below the poverty line and there is roughly one ophthalmologist per 556,000 people—AI
systems for diabetic retinopathy have demonstrated clinically acceptable performance, with an
area under the curve (AUC) of 0.973, sensitivity of 92.25%, and specificity of 89.04%. This
showcases how technology can ​
effectively bridge critical healthcare gaps despite significant challenges. Source: 1, 2, 3.​
Exponential Growth in AI-Enabled Medical Devices: Referring to Fig. 1, the number of
FDA-approved AI and machine learning-enabled medical devices has grown exponentially, with
over 120 devices approved by 2022, compared to fewer than 10 before 2015. Radiology
accounts for nearly 70% of these devices, while fields such as cardiology, pathology, and
ophthalmology also demonstrate significant adoption. This rapid growth reflects the healthcare
industry’s increasing reliance on AI to enhance diagnostic precision and treatment across
multiple disciplines. Such adoption ensures that public health is better equipped to tackle
diagnostic challenges on a larger scale.​
Improving Chronic Disease Management: AI platforms predicting patient risks and providing
personalized interventions have reduced hospital readmissions by 25%-30%, offering scalable
solutions for managing chronic illnesses.

2. Bridging Healthcare Access Through Telemedicine

Telemedicine, empowered by AI, is addressing geographic and infrastructural disparities in
healthcare.​
​
Impact in LowAccess Regions: In India, where 68% of the population resides in rural areas but
only 37% have inpatient services within a 5 km radius, telemedicine is bridging gaps.​
Internet Penetration and Adoption: With 52% of Indians accessing the internet in 2022 and rural
areas accounting for 399 million users, the potential for digital healthcare solutions continues to
grow.​
Global Telemedicine Expansion: The adoption of telemedicine during the COVID19 pandemic
highlighted its effectiveness in maintaining healthcare continuity while reducing costs and
physical barriers.

3. AI for Mental Health: Early Detection and Scalable Care

AI is transforming mental health care by providing accessible and effective solutions for early
detection and management.

Behavioral Analytics: AIpowered applications analyzing language and social behavior achieved
high accuracy in detecting mental health conditions such as depression and anxiety.​
Addressing Urban-Rural Disparities: Urban users are four times more likely to engage with mental
health apps compared to rural users, highlighting the need for targeted strategies to bridge this
gap.

4. Enhancing Public Health Surveillance and Disease Forecasting

AI's predictive capabilities are reshaping public health strategies by enabling proactive and data
driven decision making.

Disease Prediction: Machine learning models analyzing diverse datasets (e.g., health records,
social media) have proven effective in forecasting epidemics. In Nigeria, AI systems reduced
response times to outbreaks like Ebola by 40%, ensuring timely interventions.​
Resource Optimization: AI malaria prediction models optimize resource allocation for over 225
million annual cases, showcasing the potential of AI to tackle high burden diseases.
5. Addressing Inequities in Healthcare Access
Technology plays a pivotal role in bridging disparities between high and low income regions as
well as urban and rural areas.

Urban-Rural Divide: Urban residents are three times more likely to use digital health platforms
compared to their rural counterparts. Rural engagement with healthcare provider apps
increased by only 5.7% over the past year.​
Low-Income Nations: Low Income countries, constrained by limited budgets and infrastructure,
lag in technology adoption. Targeted AI solutions, such as low cost diagnostic tools, can
significantly bridge this gap.

6. Streamlining Healthcare Operations

AI optimizes healthcare operations, enhancing efficiency and reducing costs.

Operational Impact: In U.S. hospitals, AI reduced adverse events like cardiac arrests by 35%,
while early sepsis detection decreased mortality rates by 20%.​
Resource Allocation: AIenabled predictive analytics helped optimize patient admissions and
resource utilization, reducing costs by 10%-15%.​
Supply Chain Innovations: In Rwanda, AIpowered drones halved delivery times for medical
supplies, improving healthcare delivery in remote areas.

7. Advancing Personalized Medicine

AI's ability to process vast datasets enables precise and individualized healthcare.

Genomic Applications: Platforms like LifeQ leverage genomic data to provide tailored care for
chronic diseases, benefiting thousands of patients annually.​
Sleep Studies: AI wearables analyzing sleep patterns identified disorders such as insomnia and
sleep apnea early, offering actionable insights for improved wellbeing.

What barriers are stopping India’s public health

from improving? - Gaurav

Barriers to telemedicine reported by the patients were lack of awareness of the existing
telemedicine services until recently (75.9%), lack of Digital understanding and literacy (55.2%)
and poor network connection (82.8%) which they felt impelled them to prefer physical in person
consultation over telemedicine services at the facility. (Table 2) Difficult terrain and the
distance they have to walk to access to the facility were also identified as barriers to adoption
(51.7%). The majority of the staff reported a lack of adequate telemedicine training (70%),
resistance to change, lack of a positive attitude towards telemedicine (80%) and a high
workload (60%). Technical Shortage of human resources and low education levels and digital
literacy of the local population and technical issues like network connectivity (80%), were the
major reasons for the underutilisation of telemedicine services in their area

https://www.researchgate.net/publication/368642068_CHALLENGES_IN_IMPLEMENTING_DI
GITAL_HEALTH_SERVICES_IN_RURAL_INDIA

Infrastructure

More reliable internet connectivity and electricity supply in certain areas is needed for
telemedicine and other digital health interventions.

https://www.knowledgeridge.com/expert-views/digital-healthcare-in-rural-india?utm_source=chat
gpt.com

Digital Literacy and Adoption

Limited digital literacy and technological skills among some rural populations can hinder the
uptake of digital health solutions.
Data Security and Privacy

Robust measures are needed to ensure the security and privacy of sensitive patient data in the
digital realm. In this regard, the Government of India passed The Digital Personal Data
Protection Act (DPDPA) in August 2023. DPDPA assigns restrictions and obligations to
organizations that process personal data, including sensitive patient data

Telemedicine raises several unanswered questions, such as:

●​ What is its impact on patient outcomes and healthcare costs, especially in remote
subspecialty consultations?
●​ How should physician licensing work when they can practice globally from their office?
●​ What level of supervision is needed for ancillary personnel—is a video conference
enough, or should a physician be on-site?
●​ How should telemedicine services and remote procedures be reimbursed?
●​ Can workflows be redesigned to handle multiple cases at once using telepresence?

Source :- A. Moghadas, M. Jamshidi and M. Shaderam, "Telemedicine in healthcare

system," 2008 World Automation Congress, Waikoloa, HI, USA, 2008, pp. 1-6.
keywords: {Telemedicine;Medical services;Bandwidth;Telephony;Costs;ANSI
standards;Standards development;Standards organizations;Patient
monitoring;Airplanes;telemedicine;health care;health system},

Challenges of AI in Healthcare (Cancer Diagnosis)

1.​ Regulatory Framework Limitations:

 ○​ Current regulations are tailored for static, traditional software, not dynamic AI
systems.
○​ AI's learning potential must often be "locked" to comply with regulations,
preventing continuous improvement and leading to outdated predictions.
○​ Frameworks have not fully adapted to AI's evolving nature in healthcare
applications.
2.​ Bias in Training Data:
○​ Training datasets often lack diversity, resulting in biased predictions.
○​ Models trained on predominantly Caucasian data may underperform for ethnic
groups like African Americans or Asians.
3.​ Potential Harm to Patients:
○​ Inadequate or outdated data can cause incorrect diagnoses.
○​ AI models struggle to indicate uncertainty or acknowledge biases in their
predictions, particularly for underrepresented populations.
4.​ Challenges in Data Diversity:
○​ Certain diseases, such as skin cancer, are more prevalent in specific groups,
complicating the collection of diverse datasets.
○​ A lack of mechanisms for models to indicate uncertainty when predictions are
based on skewed or incomplete data.
5.​ Ethical and Development Responsibilities:
○​ Developers face significant challenges in ensuring AI systems are unbiased and
representative of diverse populations.

https://youtu.be/uvqDTbusdUU?si=kCNLCs3_5dbHyIDT

Krisha - Give potential solutions to tackle the problem of tech

penetration in public health
1. Enhancing IT Infrastructure

●​ Expanding Internet Connectivity: BharatNet has connected 2,14,679 Gram

Panchayats with 6,92,082 km of Optical Fiber Cable, supported by Rs. 39,825 crore in
investments. This enables last-mile connectivity to schools, hospitals, and anganwadis,
fostering digital integration in public health and bridging the urban-rural digital divide.
●​ Upgrading Healthcare Facilities: Equipping primary health centers with telemedicine
platforms, affordable devices, and electronic health record (EHR) systems can
enhance care delivery. Despite the Ayushman Bharat Digital Mission creating over 34
crore health accounts, public EHR adoption remains low, highlighting the need for
affordable and scalable solutions to integrate IT into healthcare effectively.

2. Promoting Financial Accessibility

●​ Subsidies and Grants: Providing financial aid to public health institutions for acquiring
and maintaining digital tools, ensuring affordability and accessibility.
 ●​ Public-Private Partnerships (PPPs): Leveraging collaborations between the
government and private sector to co-finance IT infrastructure and technological
deployment. Successful examples include the Apollo Hospitals Group's health IT
initiatives.
●​ Cost-Effective Solutions: Encouraging the use of open-source platforms like DHIS2
and locally developed health tools to reduce implementation costs while increasing
digital access.

3. Building Capacity and Digital Literacy

●​ Training Healthcare Workers: Conducting workshops and online modules to enhance

healthcare professionals' proficiency in telemedicine and EHR systems. Programs like
"Digital Saksharta Abhiyan" can serve as a blueprint.
●​ Community Education: Launching mass awareness campaigns to educate the public
on digital health benefits and providing basic digital literacy programs, particularly in rural
areas.
●​ Telehealth Training Modules: Developing structured training for healthcare providers to
improve telemedicine practices and diagnostics.

4. Ensuring Data Privacy and Security

●​ Strengthening Policies: Establishing strict data protection frameworks, such as those

outlined in the Personal Data Protection Bill, 2019, to safeguard patient information.
●​ Secure Platforms: Investing in encrypted platforms for digital health tools to enhance
user trust and prevent cyber threats.
●​ Capacity Building in Cybersecurity: Training IT staff at healthcare facilities on
advanced measures like penetration testing and real-time threat detection.

5. Innovative and Inclusive Technologies

●​ Multilingual Platforms: Designing digital health tools in regional languages to cater to

India's diverse population. For instance, the eSanjeevani teleconsultation platform
supports multiple languages.
●​ Offline Capabilities: Developing applications that operate offline, synchronizing data
when internet connectivity is restored.
●​ Wearable and Portable Devices: Using low-cost diagnostic tools like glucometers
and wearable health trackers to improve healthcare access in underserved regions.

6. Policy and Governance Support

●​ National Digital Health Ecosystem: Strengthening the National Digital Health

Mission (NDHM), which has already issued over 71 crore ABHA numbers and
registered over 5 lakh healthcare professionals, to streamline public health IT
adoption.
●​ Tax Incentives: Offering financial benefits to healthcare facilities adopting digital health
technologies, similar to incentives under the IT Act for telemedicine services.
 ●​ Monitoring and Evaluation: Implementing robust assessment mechanisms to gauge
the impact of digital initiatives and recalibrate strategies as needed.

7. Fostering Collaboration

●​ Stakeholder Engagement: Involving governments, non-profits, tech companies, and

academic institutions to co-develop scalable and context-specific health tech solutions.
●​ Community Participation: Engaging local communities in the design and execution of
digital health tools to ensure cultural relevance and usability.

8. Leveraging Emerging Technologies

●​ Artificial Intelligence (AI): Using AI for predictive analytics in disease outbreaks,

improving early warning systems, and optimizing resource allocation. AI platforms like
PATH's automated disease surveillance tools can serve as models.
●​ Blockchain: Ensuring secure, transparent, and tamper-proof health record
management, reducing administrative fraud in health claims.
●​ Drones: Deploying drones for medicine delivery in inaccessible areas, inspired by
successful models like Zipline in Rwanda.

9. Standardization of Data Collection and Management

The lack of unified protocols creates challenges in integrating IoT and big data into public
health.

●​ Universal Standards: Collaborate with global bodies (e.g., IEEE) to establish protocols
for data exchange and formats.
●​ Real-time Data Cleaning: Integrate automated tools to resolve missing or inconsistent
data issues.
●​ Distributed Computing Platforms: Use tools like Apache Spark for efficient data
storage and analysis.

10. Strengthening Privacy and Security Frameworks

Robust security frameworks are essential for building trust in public health technologies.

●​ Lightweight Encryption: Develop IoT-compatible encryption to secure sensitive data on

energy-constrained devices.
●​ Blockchain Integration: Utilize blockchain for tamper-proof data transactions.
●​ Localized Data Regulations: Advocate for health-specific governance laws in nations
without comprehensive frameworks.

11. Managing Data Volume and Variety

Efficiently handling large and diverse datasets is critical.

 ●​ Distributed Processing: Use tools like Apache Spark for large-scale data analytics.
●​ Real-time Data Streaming: Leverage platforms like Apache Kafka to manage
continuous data influx.
●​ Scalable Storage: Adopt secure cloud solutions to accommodate growing data needs

To support the above sentence, case studies of

developing countries testifying our solutions.-
Vraj
The widespread adoption of artificial intelligence (AI) technology globally has brought significant
changes to various sectors. AI-assisted algorithms have notably improved decision-making,
operational efficiency, and productivity, especially in healthcare and medicine. However, in low
and middle-income countries (LMICs), particularly in sub-Saharan Africa (SSA), the integration
of medical AI has faced delays and challenges, slowing its acceptance and implementation in
medical interventions.

Challenges to the application of medical AI in SSA

Despite the enabling factors to potentially implement successful AI-powered algorithms in the
clinical settings of SSA, several challenges impede their acceptance and implementation.

●​ Data unavailability
●​ Data security issues
●​ Resource constraints
●​ Regulatory hurdles
●​ Poor access to internet connectivity
●​ Poor acceptance and perceptions
●​ Digital illiteracy

Current application of medical AI in sub-Saharan Africa

●​ AI-powered applications have impacted several specialties of medical imaging, such as
brain imaging, cancer, chest imaging, and cardiology (Houssein et al., 2021; Martin-Isla
et al., 2020; Zhang et al., 2020). However, the focus has always been on high-resource
settings.
●​ Several AI-assisted clinician decision-making and diagnostic algorithms have been
proposed, evaluated, and implemented in SSA for diagnosing and managing various
infectious diseases.
●​ In addition, medical AI has been applied in the assessment of cancers, renal diseases,
metabolic derangements, retinopathies, injuries, and among others.In Zambia, an AI
model made up of two convolutional neural networks (VGGNet architecture and a
 residual neural network architecture) using deep learning was evaluated for diagnosing
diabetic retinopathy (Bellemo et al., 2019)

Recommendations for the application of medical AI in medical

laboratories in SSA
To allow for the effective integration of medical AI into laboratory practices in SSA, several
strategic policies must be implemented. To begin with, comprehensive education and training
programs should be established to equip medical laboratory professionals with the necessary
knowledge and skills in AI. The training institutions in SSA should develop relevant curricula and
training programs to equip medical laboratory professionals with AI skills.

Impact of AI implementation in sub-saharan africa-

Diagnostics and Disease Prediction:

●​ AI-powered malaria prediction models optimize resource allocation for over 225 million
malaria cases annually.
●​ In South Africa, AI-based tuberculosis detection from chest X-rays improves diagnostic
speed and accuracy for over 87,000 cases annually.

Telemedicine and Remote Care:

 ●​ Platforms like M-Tiba in Kenya support tens of thousands of patients annually with
remote monitoring and consultation.
●​ Babylon AI chatbots in Rwanda assist millions of consultations, reducing the burden on
healthcare workers.

Treatment and Personalized Medicine:

●​ Genomic analysis by platforms like LifeQ in South Africa enables personalized care for
thousands of patients with chronic diseases.
●​ AI systems for early cervical cancer detection in Kenya increase detection rates by 30%.

Logistics and Supply Chain:

●​ Zipline drones in Rwanda reduce medical supply delivery times by 50%, impacting
healthcare for millions in rural areas.

Public Health Surveillance:

●​ AI-driven systems in Nigeria (EpiAFRIC) enable early detection of infectious diseases,

reducing response time by 40% for outbreaks like Ebola and malaria

Conclusion
Medical AI can revolutionize the practice of medical laboratory science in the SSA. Several
studies have proven that AI can be integrated into the medical space in SSA. Despite the
proven importance and advantages of incorporating AI in laboratory practice, many hurdles
need to be overcome before the integration can be complete. Education and competency
training, ethical consideration, the generation of local data, and investments in infrastructure and
technology must be achieved before the successful implementation of medical AI in laboratory
practice in SSA.

SOURCES-

●​ (https://www.researchgate.net/publication/381924549_Impact_and_Challenges_of_A
rtificial_Intelligence_Integration_in_the_African_Health_Sector_A_Review)
●​ https://tmr.scione.com/newfiles/tmr.scione.com/144/144-TMR_1.pdf
●​ https://ceimia.org/wp-content/uploads/2024/07/state-of-ai-in-healthcare-sub-saharan-afri
ca.pdf​