Digital health – an enabler for better health in Africa

In healthcare systems, digital health solutions have the potential to facilitate substantial developments in the quality and delivery of services. For instance, with the COVID-19 pandemic, healthcare delivery has deviated from regular face-to-face methods to remotely accessed methods [1]. Digital health is a broad term that includes the use of information and communication technology, such as software applications, mobile phones, and wearable devices, to support peoples’ health and their quality of life [2]. The World Health Organization (WHO) emphasises that digital health is essential in achieving universal health coverage as “it extends the scope, transparency and accessibility of health services and health information, widening the population base capable of accessing the available health services and offering innovation and efficiency gains in the provision of health care” [3]. For that reason, our thinking needs to shift from a focus on the technology itself to how we bring about the changes needed to deliver more efficient and effective care for patients.

Patients’ Online Access to Health Information

The internet is often used by patients to search for health-related information and educate themselves on signs and symptoms they could be currently experiencing. Educational websites where patients can learn more about their health, and may be able to remotely access healthcare practitioners have been on the rise. With rural and hard to reach areas still unreached with connectivity, there remains a large potential to further mobilize the power of the internet to improve health on the African continet [6].

Self-Management and Online Treatments

For most people with chronic health conditions, self-management is vital. A study was conducted whereby patients’ use of a chatbot to support self-management of young adults and adults with sickle cell disease, a genetic blood disorder that causes several comorbidities that can be acute, chronic, and potentially deadly [7]. It was concluded that further research was needed to focus on understanding the user practises, needs and participation better.

Telemedicine/Online Consultations

This is rapidly gaining popularity however questions are being raised whether it is possible to provide quality care through these online consultations. A study was conducted concluding that telemedicine is a practical alternative for providing care and works well in rural areas [8]. In addition, it states that telemedicine can reduce barriers in accessing mental healthcare such as anxiety, stigma and addiction guilt surrounding a person when meeting a healthcare professional.

Digital health solutions will lower the cost of investment needed to improve infrastructure and enhance progress towards universal health coverage. Moreover, digital health has potential benefits including improving access to health care and health information for people in remote hard-to-reach areas amidst pandemics without imposing the threat of exposure to infection, improved knowledge leading to better productivity of the health workforce, and increased uptake of health service[5]. The most common digital health solutions on the African continent include mobile telephony (mHealth), telehealth and eLearning. For instance, social media platforms have also been widely utilized by the WHO and Ministries of Health to create awareness on accurate health information during the Covid-19 pandemic [4]. In addition, at 74% and 21.8% respectively, mobile phone and internet penetration in Africa is lower than the global average but sufficient for scale up of digital health on the continent [5]. To explain, countries in Africa are utilizing digital health and scaling up the health innovation ladder. For instance, in Zambia, South Africa and The Gambia computer aided detection of tuberculosis by chest x-ray is being used [5]. Moreover, in Tanzania, digital ultrasound using telemedicine solutions is being utilized[5]. In addition, Smartphone-powered, cloud-enabled portable electrocardiograph (ECG) are used in Uganda and Malawi [5]. Also, Rapid Diagnostic Tests (RDT) integrated into cloud-based mHealth Smart reader system are in use in Kenya, Tanzania and Ghana [5].

The call for more public-private partnerships

More partnerships between the public sector and private sector are required. This is for the public sector to manage the digital health ecosystem, encouraging the integration of effective start-ups more effectively into formal systems and regulating those that could cause harm and spread misinformation.

To conclude, countries across the world, including low- and middle-income countries (LMICs), have now become more open to embrace digital health solutions. Moreover, African countries should acknowledge digital health solutions as a vital part of national strategies for advancing the resilience of health systems. To do this, we must integrate private and public digital health systems to mobilize the present trend in digital health engagement. Digital health solutions can provide a practical path to improving service delivery. It is our efforts now which will determine Africa’s future.

Vodacom Group CEO Shameel Joosub says: “In many ways, the pandemic has also opened our eyes to new possibilities in the healthcare space. Our ability to deliver on the promise of digital solutions at scale presents enormous opportunity – not only when it comes to the reach of healthcare services, but also to dramatically improved health outcomes at decreased costs.”

References

[1] D. Ting, L. Carin, V. Dzau and T. Wong, “Digital technology and COVID-19”, Nature Medicine, vol. 26, no. 4, pp. 459-461, 2020. Available: 10.1038/s41591-020-0824-5.

[2] S. Henni, S. Maurud, K. Fuglerud and A. Moen, “The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review”, BMC Public Health, vol. 22, no. 1, 2022. Available: 10.1186/s12889-021-12393-1.

[3] “From innovation to implementation – eHealth in the WHO European Region (2016)”, Euro.who.int, 2022. [Online]. Available: https://www.euro. who.int/en/publications/abstracts/from-innovation-to-implementation-ehealth-in-the-who-european-region-2016. [Accessed: 27- Apr- 2022].

[4] L. Hwenda, “Africa Can Improve Future Health Systems Resilience by Complementing Gaps in Physical Infrastructure with Digital Health Solutions”, https://africanarguments.org/, 2022. [Online]. Available: https://africanarguments.org/2020/11/africa-can-improve-future-health- systems-resilience-by-complementing-gaps-in-physical-infrastructure-with-digital-health-solutions/. [Accessed: 04- May- 2022].

[5] O. Olu et al., “How Can Digital Health Technologies Contribute to Sustainable Attainment of Universal Health Coverage in Africa? A Perspective”, Frontiers in Public Health, vol. 7, 2019. Available: 10.3389/fpubh.2019.00341.

[6] N. Oldenburg, K. Horvath, J. Van’t Hof, J. Misialek and A. Hirsch, “Promoting Aspirin Use for Cardiovascular Disease Prevention Among an Adult Internet-Using Population: A Pilot Study”, Frontiers in Public Health, vol. 9, 2021. Available: 10.3389/fpubh.2021.500296.

[7] D. Issom, M. Hardy-Dessources, M. Romana, G. Hartvigsen and C. Lovis, “Toward a Conversational Agent to Support the Self-Management of Adults and Young Adults With Sickle Cell Disease: Usability and Usefulness Study”, Frontiers in Digital Health, vol. 3, 2021. Available: 10.3389/ fdgth.2021.600333.

[8] T. Cole et al., “Patient Satisfaction with Medications for Opioid Use Disorder Treatment via Telemedicine: Brief Literature Review and Development of a New Assessment”, Frontiers in Public Health, vol. 8, 2021. Available: 10.3389/fpubh.2020.557275.