Sub-Saharan Africa might soon be teaching the world about digital health, says Hassan Chaudhury, Digital Health & Data Specialist at the D.I.T.
It is often said that Africa has huge untapped resources. This is true but its greatest resources are actually its people and their dynamism, creativity and energy. Citizens and healthcare workers alike have stopped looking solely to their governments for all the answers and are starting to innovate in the face of remarkable adversity.
From 3D-printers and low-cost prosthetics in Kenya to drones in Malawitransporting blood for early infant diagnosis of HIV when the roads are flooded, we are witnessing a continental shift and the democratisation of digital health across sub-Saharan Africa.
So far, governments in sub-Saharan Africa haven’t prioritised the sorts of digital health initiatives that could begin to address persistent issues of the continent – underfunded health systems, the immense burden of disease including HIV and malaria, and the consistently high figure of maternal mortality and neonatal deaths, as well as the rise of non-communicable diseases. In addition, a digital divide exists with low digital literacy and difficulty in securing regulatory approvals. So how, then, could the region reach a position when it might be able to teach others about digital health?
In the search for cheap and accessible solutions that don’t rely on traditional infrastructure, people are essentially hacking the system, often taking advantage of the huge amount of discarded electronics waiting to be used. Take the story of the Vula mobile app. An ophthalmologist working in rural Swaziland witnessed how health workers struggled without specialist advice. So he invented a free mobile app to put primary healthcare workers directly in touch with on-call specialists who then receive good quality referrals, including photos and clinical details.
Or take the Ihangane Project dealing with HIV in rural Rwanda. They received donations ofequipment but had no grid electricity so they had to set up solar power. They then developed Rwanda’s first point-of-care digital health record – E-Heza – a low-cost solution which has dramatically improved maternal and child health outcomes.
A young inventor named Sanga Kathema took advantage of the wealth of discarded electronics available to create a low-cost wireless heart diagnostic system named IHMMS to offer an electrograph and digital stethoscope. There area huge range of similarly ingenious citizen or healthcare professional-led digital health projects in Africa.
This has even had an impact on governments in the region who have had to respond to the rising expectations of their populaces. The Democratic Republic of the Congo (DRC) is not known to be a digital pioneer, but it has faced repeated epidemics of Ebola and has begun to use digital strategies to garner real time data on the outbreaks. Citizens in Uganda were so fed up of travelling long distances to clinics only to find the medicine was out of stock that the Ugandan Government developed the mTracsystem. The digital groundswell means everyone involved has to raise their level.
Innovation from abroad
The region is also open and inviting to innovation in digital health from abroad, without the many barriers that often plague international trade. This means innovations that were conceived in developed countries are being adapted for use in Africa. Datix who produce patient safety and incident reporting software, has signed major deals in South Africa and Babylon are already in Rwanda for people to use on their phones. Customers register via their National ID number to qualify for the government subsidy. Unlike the UK, the platform doesn’t currently offer the AI triage. Instead, Rwandan nurses conduct the triage and then connect patients to Rwandan doctors.
This approach is important because more people in Africa have a mobile phone than access to electricity. While these were typically feature phones there has been a huge increase in smartphone adoption as internet penetration has improved. This means many of the innovations we see are mobile. For example in Ghana, mPedigree has mobile solutions to help identify counterfeit medication and in Nigeria Ubenwa developed a machine learning algorithm to provide instant diagnosis of birth asphyxia from the sound of an infant crying via a mobile app.
Universal health coverage (UHC) is an admirable objective as are the Sustainable Development Goals (SDGs), but the resourceful populations of sub-Saharan Africaare not waiting around. Instead, they are displaying ingenious, inventive and inspired thinking to circumvent their situations to realise their immense potential. They don’t have the historic advantages of developed nations, but they also don’t have the same baggage. They are teaching the world to be fearless, to be creative, to make the best of their circumstance and that the proverb really is true; necessity is the mother of invention.
In this sense they are already as innovative, if not more so, than the so-called developed nations. There is a lot for the world to learn from them.