| Summary: | Microcomputer support for health care delivery is a relatively new concept in developing countries, despite serious shortages of human expertise. In this light, the concept of microcomputer-based decision support for patient management at the rural health centre level in The Gambia is discussed and developed. Possible methodologies are devised and evaluated, taking into account constraints imposed both by feasibility of hardware for the rural African setting and by appropriate software techniques. Clinical data were collected for a pilot system, which was implemented using a Bayesian methodology, and assessed, with encouraging results. Further sources of data were then considered in order to generalise the pilot system into a prototype, which was implemented on a portable solar-powered microcomputer. The evaluation of this prototype system, and the difficulties involved in undertaking rigorous evaluations of this type of decision aid, are described and discussed. Whilst it is not proven that major health benefits would arise from the widespread introduction of such systems, the results of this preliminary study suggest that this type of approach merits further consideration and development.
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