Rural E-Health Infrastructure Development - E-Healthcare Systems and Wireless Communications - page 199

• Formal: regulatory and legal struc-

tures, property rights, insurance laws,
constitutions;

side of this project. The main scope of the economic
side is to answer the following question: What is
the best economic model or approach that can be
considered in order to achieve sustainability in a
humanitarian project?
As humanitarian projects are charitable activi-
ties, there is a general tendency to think they do
not need to make a profit and do not need to be a
business. Indeed, the vast majority of charity work
depends on donations. However, a better approach
would be to use donations over a definite period
to create operations that are sustainable within the
local community - effectively business embedded
within the local community and contributing to
the local economy. When the donations stop, such
operations are able to continue.
The challenge here is therefore to propose
a model, primarily in economic and business
senses, that would be valid for the target local
community. This is the very question that needs
to be redressed in theory before practice: How
can we setup an economic model that can sustain
long-term operations in developing countries?
What models are there, or may be there, is
what needs to be defined in this chapter. There
is no specific solution offered here, only a set of
options with defined pros and cons.

• Informal: customs, traditions, social val-

ues, and beliefs;

• Social networks and civil society

organizations.

All of these institutions are country- and time-
specific. Therefore, any economic interpretation
or intervention, even though based on the same
theory, can differ substantially across geographic
position and time span (Oliver, Mossialos &
Maynard, 2005). The intervention is based on
having the same key factors and institutions and
in conclusion the same model cannot be applied
throughout. This is the main reason why health
care research is not directed towards developing
countries. The best way of dealing with health
care modeling in these countries is to have a
general framework that can be easily adapted to
the internal/regional context. This framework will
result in the development of a business model in
three steps:

1. Value proposition: this will target the
segments of the market, the costumers and
will deal with marketing and operational
strategies.
2. Business model feasibility: technical de-
scription of the solutions and the feasibility
from a managerial point of view.
3. Complete business case.

8.1. Healthcare Evaluation Methods

There is a growing literature on the economic
evaluation of health care. This includes studies
conducted by economists, medical researchers,
clinicians and multidisciplinary teams. Typically,
the research goes under a number of labels such
as cost - effectiveness analysis (CEA), cost -
benefit analysis (CBA) and cost - utility analysis
(CUA). Therefore, there are a number of types of
measurements for both costs and consequences
in economic evaluation as can be seen in Table 1.
Cost analysis is just a partial form of eco-
nomic appraisal. As the name says it deals only
with the costs of health care which is just part of
a much complex analysis that is required.

The HTC project proposition is to follow such
a framework and try to achieve a business model
in emerging markets.
As it has been previously discussed, the main
purpose of the IEEE HTC initiative, and the
eHealth project in particular, is proof of concept.
Introducing technology expertise while doing hu-
manitarian projects is the essence of this initiative.
In this context, the aspect of health care eco-
nomics has a similar mandate to the technology