The statistics remain grim; nearly half of the world’s population still lacks access to essential health services, and each year at least 100 million people are pushed into poverty in the attempt to pay for access to these services.
Those figures should be an anomaly, but are the stark reality – and the fact remains that many of the people who fail to get much-needed access to care live in Africa. Emerging economies typically bear the brunt of a lack of access because of gaps in the availability of services and citizens battling to afford even the most basic healthcare.
The challenge of having such a high number of the continent’s people unable to access even basic healthcare, which is a fundamental human right is increasingly being offset by the introduction of solutions borne from rapid technological advancement – innovations that are removing traditional barriers to access.
One such innovation is telehealth – or telemedicine – which is the remote diagnosis and treatment of patients through the use of telecommunications and digital technology such as mobile devices and computers.
Telehealth as a viable solution in the quest for access to care
Telehealth has quickly gained itself a reputation as an effective solution to help achieve the goal of universal health coverage. The industry has grown exponentially and it is predicted that it will be worth approximately $89 million globally by 2023.
This growth can largely be attributed to telehealth’s benefits, which have been widely felt wherever it has been adopted. By enabling healthcare professionals to diagnose and treat patients without needing to see them face-to-face, telehealth effectively helps lower the costs of delivering healthcare services.
Telehealth also has the potential to overcome shortages of healthcare professionals by increasing access to specialists in bigger and more well-equipped medical centres, hospitals and academic institutions. This has far-reaching consequences in places such as Africa, where patients often have to walk long distances or catch multiple forms of transport before they even get the chance to join a long queue to see a medical professional – a reality I have often witnessed myself. I believe telehealth is a big step in the right direction of overcoming this challenge and I am heartened by the encouraging signs of its uptake in Africa.
All telehealth requires is access to a mobile device and internet connection, which has proved to be a massive area of growth in Africa.
Mobile has helped Africa leapfrog many of the challenges the continent faces – ranging from accessing financial services to education – so it comes as little surprise that subscriber penetration reached 444 million in 2017 and is expected to hit 634 million by 2025.
More than just being mobile, though, African citizens are making the move to smartphones and mobile broadband: from 250 million people with smartphones and 38 percent of all connections being mobile broadband at the end of 2017, this will accelerate to 690 million smartphones and mobile broadband connections sitting at 87 percent by 2025.
These millions with smartphones and mobile broadband connections are able to access life-changing – and life-saving – services, such as telehealth solutions.
Creating opportunities for access to healthcare is at the forefront of my vision and innovations like telehealth excite me. This shift has led to a proliferation of platforms and apps that open up access to care.
There are multiple kinds of apps that allow people to talk to or text doctors, get daily health tips and find out what their symptoms can mean, or which help people living with specific illnesses – such as diabetes – manage their disease. And these apps have widely proven to not only improve access to care, but also to ultimately improve the patient experience.
In fact, our latest Future Health Index (FHI) research has shown that a third of South African healthcare professionals say that their patients’ experience has been positively impacted by telehealth in the past five years. It has also indicated that 38% of South Africans are open to remote consultations for non-urgent care – showing the potential of telehealth as a tool to provide care.
Targeting poor and underserved communities
There are additional examples of telehealth solutions that have been implemented specifically to improve access and provide healthcare services to the poor and those living in remote, rural areas.
In Kenya, for instance, 450 healthcare providers have partnered with M-TIBA, a mobile service that allows people to send, spend and save money specifically for healthcare, to provide mobile ultrasounds for over 100 000 patients.
Kenya also launched its national telemedicine initiative for the poor and marginalised in rural areas in 2015. The initiative helps patients and healthcare providers in rural areas to use video conferencing to interact with experts at the country’s biggest referral hospital, Kenyatta National Hospital. This not only helps with diagnosis and treatment, but also with training and research.
In South Africa, the Impilo Initiative also helps give access to care in rural areas, but focuses specifically on women and girls and providing pre- and post-natal care. Established in 2018, it equips community health workers with smartphones and tablets to facilitate virtual doctor’s appointments.
Although there are no formal statistics on hand to reflect exactly how many patients these two initiatives have positively impacted, I have seen enough telehealth solutions in action to know that they make a tangible difference in the lives of the people that need it most.
Philips too, for example, has numerous telehealth solutions that we have piloted in Kenya that we can see are making a real difference in underserved communities. The Philips Foundation, for instance, is supporting a number of projects that explore the use of mobile ultrasound technology at primary care level to enhance availability of affordable services in the underserved communities and remote areas of Kenya.
One such project is called “Mimba Yangu”, in collaboration with the Centre of Excellence in Women and Child Health of the Aga Khan University, which is currently looking into the feasibility, impact and costs of quality antenatal care and examining if ultrasounds before 24 weeks of pregnancy, as recommended by the World Health Organisation (WHO), will result in better health outcomes for mothers and babies.
Together with Amref International University, the Philips Foundation is also testing the viability of ultrasound in the business models of midwives. These projects look, in particular, at our Lumify and Philips Mobile Obstetrics Monitoring (MOM) solutions.
The Lumify uses a smartphone-based mobile app and portable ultrasound to help both healthcare professionals and mothers. Medical professionals are able to deliver care wherever it is needed even in the most remote locations, while mothers are able to see clear and high-quality images of their unborn babies. This means that patients can be treated at the point-of-care with a greater chance of success because of faster and more accurate diagnosis and treatment. We pride ourselves on this innovation as we work towards reducing mother and child mortality rates on the continent.
The Philips Mobile Obstetrics Monitoring (MOM) solution, meanwhile, is a scalable telehealth platform that allows midwives to remotely monitor patients from hospitals or home through data collected from physical examinations and then shared to the centralised MOM server. This data can then be used to determine if a pregnancy is high-risk so that immediate care can be provided.
MOM has been used successfully in Indonesia – which, like most African countries, is an emerging market. I personally witnessed its efficacy as the pilot was run during my time as the Head of the Philips consumer business in Indonesia. In this pilot study, detection of very high-risk pregnancies increased threefold and zero maternal deaths were recorded. There was also a 99 percent reduction in anaemia from the first to the third trimester through enhanced patient management. These results are testament to the impactful difference our innovations are making.
It’s clear then that telehealth presents a clear opportunity for Africa, where nearly 700 women die of pregnancy-related causes every day. Research by the WHOhas shown that at least two thirds of mothers and children can be saved with cost-effective interventions and solutions like the Lumify and MOM – making it critical to introduce them to these countries to avoid preventable deaths.
These examples clearly show the immense potential of telehealth to drive widespread access to essential healthcare services – making it critical for healthcare providers to continue to implement these solutions at scale to give citizens across the African continent the healthcare they deserve.
Article by Jasper Westerink, CEO Philips Africa