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  • Articles (2,091)
  • Strategies for EHRs have changed over the years

    Back in the 1990s, EHRs were seen as large-scale clinical databases bringing data from clinical information systems and providing patient data needed for clinical tasks. Their role in public health was acknowledged, but seldom fulfilled. Since then, their role’s extended to become an essential source of data for health analytics, information for patients and a link to numerous mHealth services. EHRs are now as important to public health as they are to clinical practices.

    Many African countries missed out on the initial phase of EHRs. They’re still lagging behind. The WHO global eHealth survey shows Africa’s national EHRs adoption at some 11%, with about 18% of hospitals using them. Investment in some related systems for EHRs is also at 7%, compared to about 24% globally. 

    Alongside these findings, Africa’s mHealth investments pulling well ahead.  Approaching 60% across a range of mHealth features, Africa’s mHealth offers a valuable route into its EHRs.

    mHealth investment alone doesn’t help to deal with the challenges of EHRs. Complex informatics, such as semantic interoperability and architecture, connectivity constraints, increasing cyber-security risks, eHealth skills and establishing sustainable costs and finance all combine to make EHRs challenging for Africa. There’s plenty of good practices that have accumulated since the 1990s to guide Africa’s programmes.

    There’s also evidence of bad practices that Africa’s health systems should avoid. Knowledge of these are extremely valuable. Examples are rushing EHRs through on an unrealistic, short timeline, not understanding or managing risks, not having rigorous business cases and not engaging regularly with the main stakeholders from the start of formulating strategies for EHRs. Avoiding these are prerequisites for success, but doesn’t guarantee it.

  • Which’s best, national or regional eHealth platforms?

    India’s Union Government has a national eHospital platform. A report in The New Indian Express (NIE) says Kerala State wants its own. It’s a perspective that can be reflected in Africa’s health systems. Which approach is most appropriate?

    In Kerala, only two hospitals from Kerala - Malabar Cancer Centre in Thalassery and Vaidyaratnam P S Varier Ayurveda College Hospital in Kottakkal have enrolled in the national Online Registration System (ORS). It links hospitals across India to facilitate online appointments for patients by authenticating either through Aadhaar or a mobile number. Aadhaar provides each person with a unique, random 12-digit number issued by the Unique Identification Authority of India (UIDAI). 

    Hospitals can also use the e-Hospital platform to provide online services to patients. They include online outpatient appointments, viewing their laboratory reports and the status of blood availability in blood banks. The main objective’s to have an appointment system at government hospitals to avoid long queues that inconvenience patients when they register.

    NIE says Kerala State officers haven’t provided a precise reason for opting for its own platform. It is reported as referring to its own eHealth as state-of-the-art, implying it’s a better solution.

    The decisions raise important eHealth issues. If local eHealth’s better than a national service, why give it up. It’s not only Kerala or India where this issue surfaces. It’s been a challenge for many countries. Effective convergence strategies that build on existing good practice are excellent ideas. They’re not easy to achieve.

    Some of Africa’s health systems may face similar challenges as they move from legacy systems. Change can offer new benefits, but it can sometimes bring additional costs.

  • mHealth’s MDCS needs better cyber-security

    While mHealth’s been successful in developing countries, many initiatives fail to address security and privacy issues. Leonardo Iwaya’s at Karlstad University’s Faculty of Health, Science and Technology. His thesis, Secure and Privacy-aware Data Collection and Processing in Mobile Health Systems, starts from this perspective and describes solution. 

    He sets a context where mHealth often operates in a setting of no specific legislation for privacy and data protection in developing countries. Africa’s health systems exhibit equivalent limitations. His work has several components:

    • A comprehensive literature review of Brazil’s mHealth
    • Design of a security framework, SecourHealth, for Mobile Data Collection Systems (MDCS)
    • Design of a MDCS to improve public health using geographic Information (GeoHealth)
    • Design of Privacy Impact Assessment (PIA) template for MDCS
    • Study of ontology-based obfuscation and anonymisation functions for health data. 

    These offer Africa’s health systems a route into Information security and privacy that are paramount for high quality healthcare. They also protect healthcare professionals and other workers by creating a secure and explicit working environment for their clinical and working practices.

    Iwaya’s objective’s to enhance knowledge of the design of mHealth’s security and privacy technologies, especially the MDCS. These extend across data collection, reporting and replacing paper-based approaches for health surveys and surveillance. It’s a good place to start from to improve mHealth’s general and cyber-security.

  • EAC plans to address its healthcare workforce shortfall

    Most countries in Africa struggle with a shortage of healthcare resources, including skilled staff. The East African Community (EAC) states are no different. The region has a serious shortage of qualified medical specialists, a recent minister's report shows, and reported in allAfrica.

    The report says the region currently has less than 44.5 physicians, nurses and midwives per 10,000 people, WHO say 44.5’s the minimum needed to attain the health-related Sustainable Development Goals (SDG).

    A health workforce of adequate size and skills is critical to achieving the population health goals. Countries at all levels of socio-economic development face challenges in educating, training, deploying, retaining their health workforces.

    Consequnetly, EAC member states struggle to provide quality healthcare without addressing the issue of training of human resources for health. "Our efforts to achieve SDG 3 on good health and wellbeing and in particular the universal health coverage is very much dependent on how we address existing human resources for health challenges," said Ugandan Minister of State for Health, Dr Sarah Opendi.At the recent EAC ministerial meeting on health, she said the population of the region had grown tremendously over the years without corresponding investment in healthcare staff training.

    To address the shortage, the EAC announced plans to establish a college of medicine and health professions. The facility will provide and award specialist postgraduate training fellowship qualifications in medicine and other health professionals in East Africa.

    The EAC has also established centres of excellence in the medical and health sciences, which would enable the partner states to address the shortage of medical staff. EAC has designated five centres of excellence in health and allied sectors in the region. These are the Health Institute (Tanzania), Cancer Institute (Uganda) and Nutritional Sciences Institute in Burundi. Others are Biomedical Engineering, eHealth and Health Rehabilitation Sciences in Rwanda and Kidney Institute in Kenya. This’s a model for other African countries to consider.

  • Drones can be faster than conventional emergency responses

    Drones’ potential’s increasingly linked to supply chains, especially those of the big, online retailers. A report in eHNA described Rwanda’s use in delivering medical supplies. A report by Pew Charitable Trusts identified a new role coming up for drones carrying medical supplies to natural disasters and replacing ambulances that are slow to respond to emergencies in remote areas. This fits Africa’s needs.

    Italo Subbarao, Associate Dean of William Carey University College of Osteopathic Medicine, has built three drone prototypes that can support medical care needed for large-scale disasters. A study of the effects of the towering tornado that struck Hattiesburg, Mississippi in 2013 found that emergency medical responders were slowed down by fallen trees, power lines and debris as they tried to reach the injured. 

    Drones carrying medical supplies, cameras, microphones and interactive goggles can find survivors with an emergency doctor on the scene assessing victims, reading vital signs and administering emergency care. The drone concept doesn’t only fit large-scale emergencies. It can support doctors and other healthcare professionals dealing with serious local emergencies that need specific medical supplies.

    The drones’ potential’s confirmed by a Swedish research letter from a team at Karolinska Institutet, published in the Journal of the Journal of the American Medical Association (JAMA).  For 18 drone flights, average time to take off for delivery of a defibrillator was three seconds. They were an average of 17 minutes faster than in reaching the location of Out of Hospital Cardiac Arrests (OHCA). While this service carries a specific, pre-loaded drone, it points to the benefits of drones with bespoke payloads ordered by doctors attending a wider range of medical emergencies. It’s a new opportunity for Africa’s healthcare. 

  • Technology’s key for South Africa’s healthcare future

    South Africans generally evaluate their health positively. This is what the annual Future Health Index found. Released by Royal Philips, most South Africans, 80%, rate their health “good, very good or excellent.” Healthcare professionals on the other hand are less optimistic. Roughly 33% of healthcare professionals agree that the overall health of the population in the country is positive says an article in IT-Online. 

    The discrepancy between the two views is vast. They likely stem from healthcare professionals perceptions of access to healthcare. Results suggest that both groups perceive more access to healthcare than the system provides. It seems to offer a requirement and an opportunity to improve healthcare access.

    “Through the Future Health Index, (FHI) we are examining current realities of how well the healthcare system is set up for the future in order to quantify the readiness of health systems across five continents to meet future healthcare challenges,” says Jasper Westerink, CEO of Philips Africa. “The FHI has uncovered a number of significant areas where our healthcare system must transform if we are going to succeed in delivering long-term value based care.”

    The report says both the general population and healthcare professionals in South Africa acknowledge the importance of connected care technology in preventing medical issues and contributing to the population’s health. Most participants believe that technology and innovations are underutilised, providing opportunities to increase healthcare’s effectiveness. eHealth and mHealth investment’s essential to set up a modern healthcare system for South Africa’s future.

  • Cyber-security training must be effective

    Now Africa has its own cyber-security advice, reported on eHNA, it’s important that health systems have effective training in place. The Internet Infrastructure Security Guidelines for Africa was unveiled by the Internet Society and the African Union Commission (AUC) at the African Internet Summit, in Nairobi. It has awareness as one of four core principles that have to be deployed. 

    A report from Enterprise Management Associates says cyber-security awareness programmes have a lot to learn. Already reported by eHNA, it says training that achieve better cyber-security awareness:

    • Involves interactive elements
    • Is continuous, with regular follow-ups
    • Simulates real-life attacks
    • Monitors users’ effectiveness.

    These are four criteria that Africa’s health system can adopt in applying this part of the AUC’s good practices.

  • Hospitals need better cyber-security from their app developers

    The pace of innovation in healthcare is staggering. mHealth apps are helping to push it along. Innovators are speeding apps through development processes to bring them to market as quickly as possible. It often means cyber-security’s not a priority, leaving healthcare organisations to pick up the consequences.

    “There are a million different apps out there – the problem is the low barrier to entry into the healthcare market,” said Kurt Hagerman, CISO at cyber-security firm Armor Defense, in an article in Healthcare IT News.“When you look at the EHR vendors, they cannot be everything, they have to focus on a core set of services and then allow others to supplement those large, monolithic EHR systems with other apps.”

    With some EHRs having a narrow focus, there’s a rush to capitalise on using mHealth to provide personal health data and advice. These factors combined are a challenge for health systems to use the latest innovations without compromising protected health information and personally-identifiable information. 

    The first step’s educating developers about the healthcare industry and its unique requirements. Health systems working with app developers need to be explicit from the outset about their cyber-security requirements. Hagerman says “To protect confidentiality, integrity and availability, you have to build strong authentication credentials, you have to encrypt.

    Beyond education, it’s up to health systems to be better at enforcing cyber-security, ask app developers the right questions and demand the protections that defend patient health data. “A sense of urgency is building – you cannot just build an app, there are security requirements. The industry is starting to correct this a little bit,” he added.

    Healthcare providers need to construct a stronger message for developers. Better cyber-security’s crucial to protect patients’ personal data. They can’t afford to carry the risks of insecure and vulnerable mHealth.   

  • Six actions can help with the 2030 SDGs

    The World Health Statistics 2017, one of WHO’s annual publications, compiles data from its 194 Member States on 21 health-related Sustainable Development Goals (SDG3) targets. It provides a snapshot of advances and threats to the health of the world’s people.

    The 2030 Agenda for Sustainable Development is the world’s most comprehensive roadmap for sustainable development. Health development can be sustainable when resources are managed by and for all people in ways which support the health and well- being of present and future generations. It also needs sufficient healthcare resources to meet people’s needs.

    To help build better systems for health and to achieve the SDG3s WHO’s promoting six main lines of action:

    • Monitoring the health-related SDG3s
    • Health system strengthening for Universal Health Coverage (UHC)
    • Health equity, so no one’s left behind
    • Sustainable health financing
    • Innovation, research and development
    • Inter-sectoral action for health.  

    Research and innovation are key prerequisites for achieving SDG3s. Innovation’s not only invention and development of new technologies. It’s finding new ways to delivery healthcare and improve health. Continuous investment in research and innovation in new technologies and health service are essential. Without these, many of the ambitious SDG3 targets may not be achieved. Acfee sees eHealth being a major part of these initiatives.

  • New cybersecurity guidelines for Africa

    Cyber-crime’s severity’s increasing worldwide. The devastation was evident in the Wannacry attacks, reported on eHNA. Africa wasn’t immune.

    Many African countries lag behind with their cyber-security. It leaves eHealth vulnerable. To address this, a new set of Internet Infrastructure Security Guidelines for Africa was unveiled by the Internet Society and the African Union Commission (AUC) at the African Internet Summit, in Nairobi.

    The guidelines are new for Africa. They’re a big step forward in creating a more secure Internet infrastructure and changing African countries’ cyber-security priorities. A joint statement, reported in an article in ITWeb Africa, says "They will help AU member states strengthen the security of their local Internet infrastructure through actions at a regional, national, ISP/operator and organisational level."

    Africa's cyber-security environment faces a unique combination of challenges. They include a lack of strategies, plans and standards, lack of awareness of the risks of using technology, underinvestment, talent shortages and data overloads. Dawit Bekele, Director of the Internet Society African Regional Bureau sees potential improvement. "Africa has achieved major strides in developing its Internet Infrastructure in the past decade. However, the Internet won't provide the aspired benefits unless we can trust it. We have seen from recent experiences that Africa is not immune from cyber-attacks and other security threats. These guidelines, developed in collaboration with the African Union Commission, will help African countries put in place the necessary measures to increase the security of their Internet infrastructure."

    The guidance is just the first step. Moctar Yeday, Head, Information Society Division, African Union says "The Commission of the African Union will continue its partnership with the Internet Society on a second set of guidelines addressing personal data protection in Africa." Keeping up cyber-security’s profile is important to progress, so extra guidance is a constructive step.

    As Africa becomes more connected, healthcare, businesses, governments, citizens and key industries rely on the Internet to provide services. These guidelines provide the essential recommendations to protect Internet infrastructure.

  • Africa has five big SDG features

    Countries’ performance against Sustainable Development Goals (SDG) is set out in a report from WHO. World Health Statistics 2017: Monitoring health for the SDGs includes health data for SDG3 for Sub-Saharan Africa (SSA) and North Africa. Three features stand out, with most data for 2015.

    Of the 18 SDG3’s, a comparison of Africa’s performance with the percentage gap from the global average shows eleven are high scores that need improving, seven are low rates that need improving. Three stand out, with two others.

    Number 3 on the graph is life expectancy at birth. Number 6 is the number of people needing interventions for Neglected Tropical Diseases (NTD). Number 5 is the incidence of malaria. Two others are number 1, maternal mortality and 11’s the adolescent birth rate.

    Suicide mortality rate and alcohol consumption are 8 and 9. Africa has a good start on these.

    Taken as a whole, achieving the SDG3 goals is a considerable undertaking for most African countries. An average for North African countries shows they’re starting from a better baseline than SSA countries.

    How can eHealth help? With 18 targets across a range of often related health factors indicate that an effective eHealth approach’s to implement a solution with integrated architecture and Interoperability (IOp) where core data, such as patients’ IDs and health records are accessible by all end users. This will support both healthcare and public health endeavours to achieve SDG3’s goals.

  • Medical devices’ cyber-security testing’s not good enough

    As cyber-attacks expand, and since the alarm bells after WannaCry, reported on eHNA, cyber-security’s priority should’ve increased dramatically. It seems it’s starting from a low baseline for medical devices.

    A survey by Ponemon Institute for Synopsis says device suppliers think the chances of cyber-attacks on their products are 67%. US healthcare organisations as users think the probability’s 56%. These may be a bit low, but despite this, the survey shows only 5% of healthcare providers test their medical devices at least once a year. More alarmingly, 53% don’t test their cyber-security at all.

    A similar deficit prevails with device makers. Only 9% say they test their devices at least once a year. About 43% don’t test their device’s cyber-security. This highlights an important procurement criterion for Africa’s health systems.

    These are vulnerabilities that Africa’s health systems should address too. It’s especially critical when 80% of medical device makers and users say medical devices are very difficult to secure. Another vulnerability’s revealed by only 25% of respondents who say cyber-security protocols or architecture inside devices provide adequate protection for clinicians and patients.

    Medical Device Security: An Industry Under Attack and Unprepared to Defend says patients have already suffered from cyber-attacks and adverse events. About 31% of device makers and 40% of healthcare providers say they are aware of these. Of these, 38% of providers say inappropriate therapy or treatment was provided to patients. About 39% of device makers say cyber-attacks have taken control of their medical devices.             

    Ponemon’s report sets out a string of risks. They’re:

    • Device makers and users low confidence that patients and clinicians are protected
    • Using mobile devices affects healthcare organisations’ cyber-security’s risk postures. Clinicians depend upon their mobile devices to more efficiently serve patients
    • Budget increases to improve medical devices’ cyber-security often happen after a serious breach
    • Medical device security practices aren’t the most effective, relying on cyber-security requirements instead thorough practices such as testing
    • Most organisations don’t encrypt traffic between Internet of Thins (IoT) devices
    • Medical devices contain vulnerable code because of a lack of quality assurance and testing procedures and a rush to release
    • Testing rarely occurs, with only 9% of makers and 5% of users testing at least once a year
    • Accountability medical devices’ cyber-security is lacking
    • Makers and users aren’t aligned on current cyber-security risks, with healthcare providers more likely to be concerned about their devices’ cyber-security and risks, and suppliers’ lack of action to protect patients and users
    • Insufficient compliance with regulatory advice and guidance
    • Most makers and users don’t disclose their medical devices’ privacy and security risks. 

    Ponemon says makers and users say cyber-security’s hard to achieve. It suffers from accidental coding errors, lack of knowledge and training for secure coding practices and pressure on development teams to meet product deadlines. It seems that the clichéd paradigm shift’s needed.

  • Can high-speed broadband improve health?

    Acfee sees a huge role for eHealth as helping to achieve healthier Africans. It seems the American Medical Informatics Association (AMIA) has taken it further. In a long letter to the Federal Communications Commission (FCC), AMIA says high-speed Internet access to low-income populations could enable them to benefit from mHealth interventions. Examples include disadvantaged populations accessing mHealth and participating in research studies without paying data charges. 

    It also proposes that FCC policies should leverage broadband-enabled solutions for specific patient populations, such as substance abusers and patients with chronic diseases. Wider and cheaper Internet access is seen as increasing mHealth use by underserved communities, improving their access to health information and care and improving clinical outcomes.

    The concept builds on the FCC’s assertion that of broadband-enabled services and technologies are improving availability and accessibility and transforming healthcare. AMIA also says broadband access is, or soon will be, a social determinant of health, defined as” structural determinants and conditions in which people are born, grow, live, work and age.” Examples are socio-economic status, education, physical environment, employment, life-style choices, clean water supplies and social support.

    This paradigm shift enhances mHealth’s role in health and healthcare. For Africa’s health systems, it may mean a shift to a wide, integrated and bigger mHealth strategies with more explicit, realisable benefits.

  • Which is best, data repository or data warehouse?

    As Africa’s eHealth moves on, its health systems need to decide how to keep their new data. A choice’s between repositories and warehouses. A post by Tim Campbell in Health Catalyst says the belief in the value of data repositories can be overstated and limiting. Their functionalities are too narrow, being mainly just a place to put data, so they’re just databases. 

    Repositories’ roles in improving healthcare are often limited by their limited analytic functions and opportunities. Consequently, they can’t provide the depth of data needed to inform decisions on healthcare costs, quality and effectiveness, so support better healthcare across its continuum, an essential perspective.

    Healthcare’s wide-ranging complexity can often lead to several repositories, so data silos. Campbell proposes a better solution, a Late-Binding™ Data Warehouse (LDW). It enables data extraction and binding of data available for entire organisations. It’s quicker to pull and bind data. Its flexible architecture enables simple adjustments to meet users’ specific needs. LDW’s claim to reduce errors, so avoid wasted time, leading to increased efficiency and lower costs. These time-savings are put at 80%.

    These choices are essential for Africa’s health systems. A critical consideration’s investing in the analytic skills, so people, to enable the data to be used to good effect, whether it’s in a repository or a warehouse.

  • Patching for cyber-security’s harder that it looks

    While US hospitals weren’t disrupted much by WannaCry, described in eHNA, their cyber-security experts aren’t complacent. An article in Fierce Healthcare says cybersecurity experts weren’t surprised by WannaCry’s ransomware attack because many had predicted something like it in terms of size and scope.

    Microsoft had provided a patch that prevented the attack, but many organisations hadn’t implemented it. A US cyber-security view’s that it’s an overwhelming task for healthcare exacerbated by two issues, a lack of professionals and weak patch management. Improving both seems likely as WannaCry’s provided healthcare’s ICT risk managers the justification to increase cyber-security investment. It applies to Africa’s health systems too.

    This may not be enough. Better public-private coordination’s critical going forward. US eHealth’s seen as lagging behind modern cyber-security practices, so collaboration must move its priority up. The article says more than 85% of small- or medium-sized hospitals don’t have a qualified cyber-security manager.

    These skills are essential for effective patch and ICT inventory management. It’s a more complex task for healthcare organisations with several software iterations limited asset management systems. Co-ordinating updates for many machines across eHealth and into mHealth needs ICT teams to account for software layered on operating systems that could become inoperable afters a security patch. It’s more awkward when there’s no automated way to applying.

    Challenges for Africa’s health systems are greater. Stretched resources and an even greater lack of people with cyber-security skills and qualifications present an obstacle on the scale of Kilimanjaro. Making a start’s the first step.

  • Merck eHealth Meetup’s been in Tunis

    Sharing ideas, trends and initiatives on eHealth’s vital for learning and progress. Merck, a science and technology company, set up its eHealth Meetup in April 2016 as part of its Merck Accelerator Africa programmes. After its successful launch in Johannesburg, Merck North West Africa (NWA) brought it to Tunis.

    The event announced an Incubator headed by Merck NWA to:

    • Train young professionals and students on entrepreneurship and build multi-disciplinary  teams to work with their main, local markets
    • Help successful teams to raise money and build market strategies
    • Build a network of supporting partners.

    Africa.com has described the event as providing a platform for the digital innovation community to discuss current and future trends and to network. eHealth Meetup’s main goal as setting up a forum for business leaders, entrepreneurs, policy-makers, scholars and aspiring entrepreneurs to exchange ideas about entrepreneurship. Content includes coverage of current trends in Africa’s dynamic economies and leveraging experience from across the world to create a thriving African start-up community.

    It’ll be valuable to see how health and healthcare in Tunisia and NWA benefit from eHealth Meetup. Will its eHealth make a big step up, or a slow burn?

  • Africa’s GDP set to take a tumble

    Economic growth provides extra resources for governments. Then they have more to spend on public services, including public health and healthcare. eHealth, towards the end of the chain can expect more money too. It’s not good news that the International Monetary Fund (IMF) has forecast a dip in Africa’s GDP growth.

    Sub-Saharan Africa Regional Economic Outlook: Restarting the Growth Engine says sub-Saharan Africa’s (SSA) economic growth’s fragile. In 2016, it slowed in about two-thirds of the countries, accounting for 83% of GDP. IMF now estimates it to be just 1.5%, the worst performance in over two decades. For 2017, it estimates GDP growth as 2.5%, but not sustainable, driven largely by one-off factors in the three largest countries.

    •  Nigeria: higher public spending ahead of elections
    •  Angola: the fading of effects of drought
    • South Africa: modest improvements in terms of trade.

    While some countries can still expected to their GDP to grow between 5% to 7.5%, the underlying regional momentum’s weak, and down on trends. It’s also just exceeding population growth, a crucial drawback for health and healthcare. 

    Angola, Nigeria, and the Central African Economic and Monetary Community (CEMAC) are adversely affected by low oil prices and the resulting budgetary revenue losses and balance of payments pressures. Other commodity exporters, such as Ghana, Zambia, and Zimbabwe are facing larger fiscal deficits too. 

    Côte d’Ivoire, Kenya, and Senegal, which don’t depend so much on commodities, fiscal deficits have been high for several years as governments aimed to address social and infrastructure deficits.  While their growth remains robust, vulnerabilities are starting to emerge. Public debt’s rising, borrowing costs are up, some arrears are emerging and the banking sector’s non-performing loans are increasing. 

    The IMF says outlook is affected by drought, pests and insecurity. About half of SSA countries report food insecurity.

    Adding North Africa to the SSA forecasts also shows a slight drop in 2017 average GDP growth too, with a pick-up in 2018. It’s not all doom and gloom. An important feature of the IMF data’s that 42% of African countries are still forecast to grow more than the continent’s average. About 52% are forecast to achieve it in 2018. In 2016, GDP was more skewed, with about two thirds of Africa’s countries above average. Will this forecast deterioration translate into Africa’s eHealth having an widenning gap too?

  • The next WHO DG is from Africa - are these the main challenges and opportunities?

    It’s with considerable pride that eHNA can post about WHO’s next Director-General’s from Africa. Tedros Adhanom Ghebreyesus, a former health minister and foreign minister of Ethiopia, will be WHO’s next Director-General (DG). He’s the first African to lead the UN agency.


    The Thomson Reuters Foundation asked global health experts and charity leaders what the new DG’s priorities should be. Their answers are in an article in allAfrica.


    He’ll immediately be confronted by an extensive array of urgent, long-term public health challenges. They include:

    • Outbreaks of highly infectious global epidemics such as Ebola, cholera, yellow fever, Zika and MERS
    • Global rise in Non-communicable Diseases (NCD), such as cancer, diabetes and heart disease
    • Impact of stress and hardship on mental health and wellbeing
    • Continuing fight against HIV, malaria, TB and maternal, adolescent and child health.

    WHO must also help drive Universal Health Coverage (UHC) and bridge the divides between global, national and local communities’ health systems. These can determine the courses of outbreaks or health risks.

    Health challenges start and end in communities, so the new DG must be ready to put people at the centre. One way’s to give local communities a seat at the global public health table to contribute to building a stronger, more resilient and healthier world.

    Building on Africa’s health ministers’ recent eHealth leadership initiative in Geneva, reported on eHNA, is a specific priority for Africa. It includes leading advances in technology and using open access data bases and data warehouses, eHealth innovation and mHealth technologies. There’s an opportunity for WHO to embrace and promote these more effectively. This needs a context of WHO calling on new ideas and innovations if it is to meet the numerous health challenges facing communities.

    Other initiatives include:

    • Expanding strong confidence in WHO’s role in rapidly responding to, managing and containing emerging and re-emerging infectious diseases
    • Ensuring there is international and national leadership regarding the major health threat of antimicrobial resistance and the management of drug resistant infections, including CDC’s outpatients antibiotic stewardship plans, reported on eHNA
    • Emphasising healthcare workers’ protection
    • Addressing inequality in health by promoting quality healthcare to disadvantaged communities, especially women and children
    • Expanding and broadening WHO’s funding base beyond the US and Europe

    The WHO has a tremendous opportunity to accelerate recent advances in global health. Tedros can spearhead a highly effective, efficient, and forward-thinking WHO that embraces innovation, to achieve a world where affordable, quality healthcare’s in reach of those currently denied it. It’ll take time. It’s a never ending journey. eHNA looks forward to the new DG taking Africa further along the road.

  • Which clinical databases do Africa’s health systems need?

    Extending eHealth across clinical services creates opportunities for investment in databases for research into perspectives such as clinical standards, practices, quality, cost-effectiveness and efficiency. Deciding which to pursue within Africa’s very constrained healthcare budgets isn’t easy. The choice’s considerable when it comes to research. 

    The US National Library of Medicine has 69 clinical databases supported by the National Institutes of Health (NIH). They extend over a wide range of topics. Examples from the NIH Data Sharing Repositories list are:

    The repositories, all supported by the NIH, provide data accessible for reuse. Some aggregate information about biomedical data and information sharing systems. The US approach shows that research findings are an important part of health systems’ repository services. Holding data just from eHealth services may not be enough for health systems. Findings from research that use eHealth data can offer benefits to wider health systems and other countries.

    It’s an opportunity for Africa’s health systems to develop and share research data. Maybe high priorities are communicable diseases, Non-communicable diseases (NCD) and antibiotic prescribing practices.

  • Fitness trackers are unfit for counting calorie burning

    For some enthusiasts, fitness without trackers is an unfulfilled goal. Unfortunately, trackers aren’t good at everything they claim. A study by a team at Stanford University School of Medicine, and reported in the Journal of Personalized Medicine, found that fitness trackers can accurately measure heart rate, but not calories burned. It reviewed the accuracy of seven wristband activity monitors with 60 users. Six measured heart rate within 5%. None measured energy expenditure well.

    The not quite magnificent seven were Apple Watch, Basis Peak, Fitbit Surge, Microsoft Band, Mio Alpha 2, PulseOn and Samsung Gear S2. Their performance is determined by their technological prowess. Skin colour and Body Mass Index (BMI) can affect their measurements.

    For calorie burning, the best performer was out by an average of 27%. It was much closer than the least accurate, which was out by 93%. These disparities indicate that they not very dependable for dietary life-style decisions. It seems like suppliers need to go back to the drawing board after a substantial lunch.