Healthcare in Africa is a huge problem. Where progress is being made in Asia and Latin America, Africa remains far behind. That does not have to be this way. ICT also breaks through and almost everybody has a mobile phone. The eCareAccess predecessor has achieved radically innovative and sustainable eHealth projects with a strong impact. Another example is India. The situation was difficult, but the development began. It even generated top hospitals like the Apollo Hospital and new concepts about cheap and efficient medical care. eCareAccess wants to contribute to the radical renewal of healthcare in Africa. ICT is the lever. And “Affordable quality care for all” is the goal.
This document provides the background of eCareAccess. It is basic information for a brainstorm about the further elaboration of the activities of eCareAccess. We appreciate you think along. It is a puzzle that we can solve together only.
The state of health care
Healthcare remains a problem in Africa. Many examples can be given, but this quote is illustrative.
In this world, 1.2 billion people still live in extreme poverty. One third of them lives in sub-Saharan Africa. An indicator is child mortality. This has fallen 41 percent since 1990, but still about 10,000 children die every day. A child younger than 5 years has 16 times more risk in Africa than in developed countries.
Progress in improving the health system is slow. The number of private clinics increases to the benefit of those with purchasing power. There is a shortage of qualified doctors and drug supply often inadequate. Generally, the organizational and institutional problems are overwhelming. Many experts have been there and gave advice. It turned out difficult to lift the health system to a higher level. Besides problems with the quality of health care, the access to health care is also very uneven. Disadvantaged rural areas and urban poverty have as a result that the poorer communities suffer most from poor health service.
A new direction towards a solution
What is most noticeable in Africa, is that everyone has a mobile phone and uses it extensively. For many Africans mobile phones have an important place in everyday life. This is due to the poor physical and institutional infrastructure. A mobile phone eases communication and transactions (purchases, water bills, electricity, insurance, etc.). Services and payments have become much more transparent. In addition, there is no ICT ‘legacy’ problems and bigger steps can be made. This development accelerates. In Africa, a new generation grows up, better educated, better informed about todays’ world, and eager for change.
Healthcare without ICT is unthinkable in Europe and it is considered a major source of innovation in health care. While in Europe, ICT improves health care with a few percent per year, it can do so with tens of percentages in Africa. The use of eHealth seemed a luxury for healthcare in Africa 10 years ago. Recently, a number of pilot projects have shown that this can make a significant contribution to better and above all more accessible and affordable care. Examples to which eCareAccess members have contributed are:
Doctors from several Mali hospitals agree to send X-rays electronically to a hospital where a team is formed to diagnose. A simple technical solution is devised and implemented together to convert the analogue images into digital. They practice it, agree on the mutual settlement and it works. It is already running well and without external support since 2011. 8 hospitals in remote rural areas are connected to the radiology department of central hospital in Bamako. 86 doctors are involved and the number of cases varies from 700 to 1100 per year.
A number of Tanzanian hospitals have introduced an electronic system for patient registration, patient records and logistic support. Nurses and doctors get an extra reward if they use the system properly. Hospital income increases by 30% and ultimately one can manage on the basis of information and report correctly. The eHealth system is maintained locally. Because the benefits exceed the costs, other investments can also be made at the hospital, at least if managed well.
In Zimbabwe, one goes further by linking the hospital system to an eVoucher. The target group – poor future mothers – get a voucher for the pregnancy, birth and aftercare. Cash hand money is paid per mobile phone. The whole system is paperless including reporting to the health authorities and reporting the health statistics. It operates since end 2015 in the cities of Harare and Bulawayo.