Leveraging on Digital Health to expand access to improved healthcare in Africa
Several efforts have been made worldwide to strengthen the health workforce (HWF). However, significant challenges still persist, particularly in Africa (Sub-Saharan countries).
For instance, a study conducted by the World Health Organisation (WHO) Africa Region from January 2018 to April 2019 under the theme: “The health workforce status in the WHO African Region: findings of a cross-sectional study” indicates a shortage and maldistribution of health workers in the WHO African Region.
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The shortage and maldistribution of health workers in the WHO African Region, the study further expands, remains a big challenge towards the attainment of universal access to health services in Africa.
The study was conducted to present the status of the HWF in 47 countries in Africa as a baseline in measuring countries’ progress in implementing the Global Strategy for HWF by 2030.
Following the findings of the study, which was published this year (2022), the WHO Africa Region has called for the need to substantially increase investment in the HWF in the Africa region.
This is because the shortage of health workers in Africa is undermining access to and provision of health services even though countries in the region have made efforts to bolster the workforce.
Key statistics
According to the WHO, there is approximately 3.6 million health workers across 47 countries in Africa. Out of the number, 37% of the health workers are nurses and midwives; 9% are medical doctors; 10% are laboratory personnel; 14% are community health workers; 14% are other health workers, and 12% are administrative and support staff.
WHO also puts the Africa Regional density of physicians, nurses, and midwives per 1000 population at 1.55, indicating that only four countries had densities of more than 4.45 physicians, nurses, and midwives per 1000 population.
Digital Health
Considering the huge disparities between doctor-patient ratios in Africa, which is affecting quality healthcare delivery in the region, it is necessary to adopt other interventions such as a digital health tools to bridge the gap and improve healthcare delivery outcomes in Africa, particularly in the Sub-Saharan Africa.
This is because digital health tools are fast becoming the hotcakes in the healthcare sector around the world, particularly in Europe, Americas and Asia due to the several advantages it professes.
Digital health basically refers to the use of information and communications technologies in medicine and other health professions to manage illnesses and health risks and to promote wellness.
Other experts also define digital health or digital healthcare as a multidisciplinary concept that includes concepts from an intersection between technology and healthcare. It thus incorporates software, hardware and services.
The digital health space has a broad scope and includes the use of mobile health, telehealth, wearable devices, health information technology, as well as telemedicine.
Digital Health has been envisioned to lower the cost of healthcare, improve access to healthcare; reduce any inefficiencies in the healthcare system; improve the quality of care; and provide more personalised health care for patients.
It is important to mention that digital health has the potential to prevent disease and lower healthcare costs, while helping patients monitor and manage chronic conditions. Similarly, it can also tailor medicine for individual patients.
What it means is that digital health technology can help health care providers to practice patient-centred care, ensure continuity of care and reduce waiting times by streamlining and improving the timeliness of access to health care users' data and information.
Some studies point to the fact that digital medicine allows patients to better track their own health and wellness. This is because the use of digital devices like the smartphone not only helps with communication, but these devices now have a huge number of apps that can help monitor one’s blood pressure, record blood sugars, ensure compliance with medications, and even track the amount of physical activity.
Practical uses
Even though the rate of usage of digital health tools in many African countries remain low, many people on the continent, particularly the young and educated youth are now turning to it.
During the early stages of the outbreak of the deadly COVID-19 pandemic, many countries in Africa, especially Ghana relied on digital health technologies to track patients and monitor patients’ conditions at home and health facilities. The Ghana Health Service also adopted digital health tools to share information on the COVID-19 pandemic as well as other emerging health conditions.
Currently, many health facilities in Ghana are using digital health tools to improve hospital’s administration and patients care.
Telecommunications companies in Ghana, including MTN, Vodafone Ghana, Tigo now Airtel-Tigo all use digital health tools to share timely information on healthy lifestyle tips, health news and key information about major health programmes in Ghana, including vaccinations and immunizations on diseases such as polio and yellow fever.
Speak Up Africa’s work
To further drum home the importance of digital health in improving access to healthcare in Africa, Speak Up Africa, a Dakar-based policy and advocacy tank, has launched the Francophone West Africa Digital Health Network, to increase awareness on the value-added of technology in healthcare as well as to engage all relevant stakeholders in that regard.
Even though Speak Up Africa’s digital health network operates in the French-speaking West African countries, the network, which is first in Africa, has a great potential to encourage the adoption of digital health in other countries in Africa.
In a foreword to the launch of the digital health network, published on Speak Up Africa’s website, highlights the essence of digital health in the following words: “Following the pandemic, the digitalisation of health systems is inevitable. The efficient and inclusive digitalisation of said system is crucial to reaching sustainable development goals across African nations and its people.”
The Chief Digital Advisor, Africa Centres for Disease Control and Prevention (Africa CDC), Mr Jean Philbert Nsengimana, for his part, believes that “the time for digital health has arrived” for Africa and that “We are called to use technology.”
He is of the view that with digitalised health systems, “we can save time and speed up research as exemplified by the worldwide record-breaking creation and procurement of COVID 19 vaccines.”
Also sharing her views on digital health during the launch of the Francophone West Africa Digital Health Networ, Madam Yacine Djibo, the Founder and Executive Director of Speak Up Africa, noted that the regional network will rely on the principles of health data governance, developed by Transform Health, to guide and inform countries in terms of data policy and legislation health.
“It is important to remember that technologies, and the resulting data cannot replace the human interactions and health services but rather accompany them, improve them. These tools should be aligned, integrated into country strategies,” she explained the complementary role digital health could offer to the orthodox medicine or healthcare delivery in Africa.
Critical contributions of digital health
In an interview, the Policy and Research Manager at Speak Up Africa, Mr Mouhamadou Dieng, said digital health is contributing to every step in the healthcare system.
For him, digital health presents opportunities to both health workers and beneficiaries, adding that the digital technologies have become so useful, particularly in the area of storage and easy accessibility of patients’ records (data).
He said the use of digital health in Africa remains low due to misinformation around it, leading to lack of trust on the part of beneficiaries.
Mr Dieng said some healthcare workers, including medical doctors still are not used to digital health tools, preferring their orthodox methods, saying “it’s a bit of problem adopting the new tool.”
He believes that one of the ways to encourage the adoption of digital health tools in Africa is for medical doctors and other health practitioners to let patients know and understand how they can use digital tools to improve health outcomes.
For him, one reason why many people are skeptical about the use of digital health on the continent, in particular is that they are not certain whether their data are safe and secured. It is important for healthcare service users to know how their records are stored and used.
Mr Dieng is of the view that many African countries have not developed strong data security systems to protect the information of users of digital health tools.
He said it was about time Africa owned her own cloud system to manage and protect the data of its citizenry, noting that “there is the need to develop data governance policies.”
He said for people to have a trust in the use of digital health tools, there was the need to give them that assurance that their data will not be used against them or for marketing purposes.
Internet usage
Mr Dieng also expressed concern that Internet provision remains a challenge in many parts of Africa, explaining that providing internet and helping people to get access to its use “can help to increase universal health coverage.”
For him, the Internet “has become a necessity in the world and Africa cannot be left out”, stressing that the continent has the needed human resource to both develop and scale up the use of digital health tools.
He was, however, quick to add that the use of digital health tools does not mean that people should shun the orthodox healthcare systems.
For Mr Dieng, digital health tools only provide complementary support to orthodox healthcare systems, however for more efficiency African governments need to be called to work to achieve health related targets of the Sustainable Development Goals.
Ms. Josephine Oppong-Yeboah is a health and gender advocate who believes that digital health tools could contribute greatly to the development of improved healthcare outcomes in Africa, particularly in West Africa.
Education
However, she wants governments in Africa to pay keen attention to data security as digital health tools is fast becoming attractive to many people on the continent.
“We need to pay attention to data collection, management and usage to avoid any potential misuse or negative manipulation of such sensitive data,” she noted.
Ms Oppong-Yeboah also called for more education on digital health tools to aid adoption and right usage, pointing out that once people get misinformed, it will take a lot of efforts to get such misconceptions erased, hence the need to start the education on digital health early to avoid any unforeseen propaganda.