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We present discrete-event simulation models of the operations of primary health centres (PHCs) in the Indian context. Our PHC simulation models incorporate four types of patients seeking medical care: outpatients, inpatients, childbirth cases, and patients seeking antenatal care. A generic modelling approach was adopted to develop simulation models of PHC operations. This involved developing an archetype PHC simulation, which was then adapted to represent two other PHC configurations, differing in numbers of resources and types of services provided, encountered during PHC visits. A model representing a benchmark configuration conforming to government-mandated operational guidelines, with demand estimated from disease burden data and service times closer to international estimates (higher than observed), was also developed. Simulation outcomes for the three observed configurations indicate negligible patient waiting times and low resource utilisation values at observed patient demand estimates. However, simulation outcomes for the benchmark configuration indicated significantly higher resource utilisation. Simulation experiments to evaluate the effect of potential changes in operational patterns on reducing the utilisation of stressed resources for the benchmark case were performed. Our analysis also motivated the development of simple analytical approximations of the average utilisation of a server in a queueing system with characteristics similar to the PHC doctor/patient system. Our study represents the first step in an ongoing effort to establish the computational infrastructure required to analyse public health operations in India, and can provide researchers in other settings with hierarchical health systems a template for the development of simulation models of their primary healthcare facilities.
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The COVID-19 pandemic has highlighted the importance of in-silico epidemiological modelling in predicting the dynamics of infectious diseases to inform health policy and decision makers about suitable prevention and containment strategies. Work in this setting involves solving challenging inference and control problems in individual-based models of ever increasing complexity. Here we discuss recent breakthroughs in machine learning, specifically in simulation-based inference, and explore its potential as a novel venue for model calibration to support the design and evaluation of public health interventions. To further stimulate research, we are developing software interfaces that turn two cornerstone COVID-19 and malaria epidemiology models COVID-sim, (https://github.com/mrc-ide/covid-sim/) and OpenMalaria (https://github.com/SwissTPH/openmalaria) into probabilistic programs, enabling efficient interpretable Bayesian inference within those simulators.
Brief outline of Science Operations Centre activities for Gaia.
Without proper medication and vaccination for the COVID-19, many governments are using automated digital healthcare surveillance system to prevent and control the spread. There is not enough literature explaining the concerns and privacy issues; hence, we have briefly explained the topics in this paper. We focused on digital healthcare surveillance systems privacy concerns and different segments. Further research studies should be conducted in different sectors. This paper provides an overview based on the published articles, which are not focusing on the privacy issues that much. Artificial intelligence and 5G networks combine the advanced digital healthcare surveillance system; whereas Bluetooth-based contact tracing systems have fewer privacy concerns. More studies are required to find the appropriate digital healthcare surveillance system, which would be ideal for monitoring, controlling, and predicting the COVID-19 trajectory.
The health needs of those living in resource-limited settings are a vastly overlooked and understudied area in the intersection of machine learning (ML) and health care. While the use of ML in health care is more recently popularized over the last few years from the advancement of deep learning, low-and-middle income countries (LMICs) have already been undergoing a digital transformation of their own in health care over the last decade, leapfrogging milestones due to the adoption of mobile health (mHealth). With the introduction of new technologies, it is common to start afresh with a top-down approach, and implement these technologies in isolation, leading to lack of use and a waste of resources. In this paper, we outline the necessary considerations both from the perspective of current gaps in research, as well as from the lived experiences of health care professionals in resource-limited settings. We also outline briefly several key components of successful implementation and deployment of technologies within health systems in LMICs, including technical and cultural considerations in the development process relevant to the building of machine learning solutions. We then draw on these experiences to address where key opportunities for impact exist in resource-limited settings, and where AI/ML can provide the most benefit.
India accounts for 11% of maternal deaths globally where a woman dies in childbirth every fifteen minutes. Lack of access to preventive care information is a significant problem contributing to high maternal morbidity and mortality numbers, especially in low-income households. We work with ARMMAN, a non-profit based in India, to further the use of call-based information programs by early-on identifying women who might not engage on these programs that are proven to affect health parameters positively.We analyzed anonymized call-records of over 300,000 women registered in an awareness program created by ARMMAN that uses cellphone calls to regularly disseminate health related information. We built robust deep learning based models to predict short term and long term dropout risk from call logs and beneficiaries demographic information. Our model performs 13% better than competitive baselines for short-term forecasting and 7% better for long term forecasting. We also discuss the applicability of this method in the real world through a pilot validation that uses our method to perform targeted interventions.
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