Whether they are collating data on disease, monitoring health trends, combating misinformation or facilitating cooperation between medical centres, African eHealth initiatives are leading the way towards higher standards of living and health on the Continent. With eLearning Africa 2013 set to subject eHealth to a detailed examination, the news service explored a few initiatives that offer a promising prognosis for Africa’s health sector.
By Matthew Labrooy
eHealth is becoming more relevant to regional needs in Africa by addressing local issues associated with the paucity of medical centres in rural areas. However, there is uncertainty as to whether the current eHealth model will be as effective on a larger scale. A recent study found that the major challenges for eHealth in Africa are:
“The complexity of ensuring interoperability and integration of information systems and securing privacy of information… [and finding] sustainable financing required for large-scale use of mobile phone technology in resource-limited settings.” (1)
Nevertheless, it is clear that eHealth initiatives are urgently required, as found in a second report into the effectiveness of such mobile initiatives:
“Many of these deadly conditions are relatively simple to treat, prevent or contain… For HIV patients, simple weekly text reminders have consistently shown higher adherence amongst the patients.”(2)
In addition, the report found that SMS reminders sent to health centres to monitor stock levels have shown positive results in reducing the risk of malaria, TB and HIV medication shortages.
Indeed, initiatives involving mobile phones such as m4RH, eMOCHA and Text to Change have shown encouraging results and the potential for scalability.
Mobile for reproductive health (m4RH) is a simple low-cost information sharing tool that allows users to access information on contraception and reproductive health through a text messaging service. The m4RH system also provides service delivery information so users can locate local clinics that can provide information and services specific to their needs.
The service has the added benefit of correcting misinformation about the use of contraception, ensuring correct use and encouraging uptake. The initiative is still in a testing stage, but since its inception in 2010 m4RH has reached over 70,000 users in Kenya and Tanzania.
The electronic Mobile Open-source Comprehensive Health Application (eMOCHA) is a smartphone app designed to assist health programs in resource-limited settings and improve provider communication and education, as well as patient care. Active since 2010 and currently in use by the government of Uganda, eMOCHA uses video, audio, touchscreen quizzes, GPS and SMS to collect and analyse large amounts of health-related data.
Text to Change, like eMOCHA, is a platform for collecting health data and information; however, it approaches the task in a decidedly low-tech – smartphone not required – and interactive way, often through incentive-based SMS quizzes, personalised medicine reminder programs and self-assessment.
The Text to Change mobile platform has been successfully used to quiz users on their knowledge of general health, provide information on local clinics and refer users to prevention and treatment facilities.
The tool has been active since late 2008 and has issued more than 8,400,000 text messages containing vital health information on HIV/AIDS, maternal health and nutrition.
While mHealth solutions are gaining traction, crowdsourcing projects are proving to be important tools for diagnosing complex cases. Projects such as MEDTING allow health workers worldwide to share health trends and crowdsource diagnostic advice and expertise. On a smaller scale, telemedicine and information sharing between medical centres in Africa are being used successfully by health workers in distant rural communities where specialists are not available locally.
Other eHealth programmes such as eLearning@ttcih are focusing on addressing the shortage of skilled health workers, one of the biggest challenges faced by health systems. eLearning@ttcih, a collaboration between the Novartis Foundation for Sustainable Development (NFSD), the Swiss Tropical and Public Health Institute and the Tanzanian Training Center for International Health, functions as an eLearning hub for improving the quality of health education and training and thus increasing the number of trained health workers in Tanzania.
The effectiveness and scalability of eHealth initiatives will be examined by experts and practitioners at eLearning Africa 2013. For more information, please see www.elearning-africa.com.