IntroductioneHealth solutions that use internet and related technologies to deliver and enhance health services and information are emerging as novel approaches to support healthcare delivery in sub-Saharan Africa. Using digital technology in this way can support cost-effectiveness of care delivery and extend the reach of services to remote locations. Despite the burgeoning literature on eHealth approaches, little is known about the effectiveness of eHealth tools for improving the quality and efficiency of health systems functions or client outcomes in resource-limited countries. eHealth tools including satellite communications are currently being implemented at scale, to extend health services to rural areas of Nigeria, in Ondo and Kano States and the Federal Capital Territory. This paper shares the protocol for a 2-year project (‘EXTEND’) that aims to evaluate the impact of eHealth tools on health system functions and health outcomes.Methodology and analysisThis multisite, mixed-method evaluation includes a non-randomised, cluster trial design. The study comprises three phases—baseline, midline and endline evaluations—that involve: (1) process evaluation of video training and digitisation of health data interventions; (2) evaluation of contextual influences on the implementation of interventions; and (3) impact evaluation of results of the project. A convergent mixed-method model will be adopted to allow integration of quantitative and qualitative findings to achieve study objectives. Multiple quantitative and qualitative datasets will be repeatedly analysed and triangulated to facilitate better understanding of impact of eHealth tools on health worker knowledge, quality and efficiency of health systems and client outcomes.Ethics and disseminationEthics approvals were obtained from the University of Leeds and three States’ Ministries of Health in Nigeria. All data collected for this study will be anonymised and reports will not contain information that could identify respondents. Study findings will be presented to Ministries of Health at scientific conferences and published in peer-reviewed journals.Trial registration numberISRCTN32105372; Pre-results.
SUMMARYMulti-protocol label switching (MPLS) is a promising technology that is quickly gathering momentum as a solution for delivering quality of service (QoS) on IP-based terrestrial networks. It is then appropriate to wonder how this technology could a!ect the next generation satellite networks (from at least an interoperability standpoint) and if satellite network designers should implement MPLS on their space segment (and if yes, how?). These are the main questions that this paper is addressing.We will show how MPLS can be used on top of any layer 2 technology on the space segment, to provide IP QoS. In particular we will discuss MPLS over ATM over satellite where MPLS is essentially used to control and manage an on-board ATM switch fabric. Problems with MPLS and solutions will be presented. As the digital video broadcast (DVB) standard is becoming popular to be used on both the forward and return link, the di!erent methods to carry IP over DVB will also be discussed.
The paper summarises the work on wireless networks inside the COST 257 project, entitled "Impact of new services on the architecture and performance of broadband networks" and chaired by Prof. Tran-Gia of the Technical University of Wiirzburg (Germany). This project was established for 4 years (1996)(1997)(1998)(1999)(2000) and collected the researchers from 16 European countries represented by 32 organisations. Its topics are modelling, performance, network planning and analysis of present and future wireless systems.
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