Challenges and successes in making health care more accessible to rural communities in Waslala, Nicaragua using low-cost telecommunications

Two years ago, at the first IEEE Global Humanitarian Technology Conference, we presented a paper on the development of a tele-health project to provide a communication link to health care providers for the rural communities surrounding Waslala, a town located in the North Atlantic Autonomous region of Nicaragua. The system employed volunteer community health workers (CHWs) to transmit vital signs of their community members to a computer server using low-cost SMS telecommunications technology. At that time the project was still under development and four CHWs started to work on the project. Since then considerable progress has been made with many challenges overcome along the way. We now have fifty of the 92 communities covered by the program and expect to provide full coverage to this region by next year. We are also starting to consider other rural locations in Nicaragua to expand the project. This paper elaborates on the many challenges that have been faced and overcome on this project, the key partnerships that have been established to support the program, the impact of the project to date, and the plans for project expansion over the next year.