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  • Articles (2,328)
  • An analytical view of Blockchain aids understanding

    Paradigm shifts are regularly sought after by information and ICT initiatives. As a set of ideas, assumptions, and values that can help to live and see the world, a paradigm doesn’t seem easy to shift. In The Business Blockchain, published by Wiley, William Mougayar describes how Blockchain’s a paradigm shift. 

    It’s part of a sequence of paradigm shifts of the Internet, the World Wide Web, and now Blockchain. He’s firm that Blockchain’s different to all that’s originated before. It’s also tricky to understand, with a clear grasp of its philosophy essential to comprehend its technical components.

    Blockchain has six enablers, programmable: 

    AssetsTrustOwnershipMoneyIdentityContracts.

    Creating ATOMIC, Mougayar delves well into each of these. This delving and diving’s a characteristic of the book. It’s the knowledge and insights that these provide ensure it’s not a superficial overview or description. Examples are the explanation of the set of basic principles and the emphasis on Blockchain’s decentralisation features.

    Wynton Marsalis, the jazz trumpeter said to understand art, you must come to art. Art will not come to you. This resonates with Blockchain. Mougayar’s book’s essential to begin the journey. Africa’s health systems need to follow the tricky route to ensure strategic opportunities are not lost. 

  • Need a Big Data and AI overview; this’s it

    It seems that Big Data isn’t big after all. David Stephenson, in his book Big Data Demystified, published by Pearson, says “Big” significantly understates the volume and differences to conventional data. Understanding it needs to be in its context of AI and Machine Learning (ML). 

    He ranges over Big Data’s:

    UsefulnessEcosystemStrategyImplementationTechnology selectionTeam buildingGovernance and legal compliance.

    Case studies bring each of these into practical environments. While Stephenson’s keen on Big Data, his book’s not an exhortation to rush into initiatives. Instead, his “Keep in mind” boxes are valuable switches from his commentary that provide realistic insights for policy makers, strategists, executives, managers, practitioners, health workers and students.

    It’s clearly written and offers new, late and in between comers to Big Data many very valuable insights and case studies. Examples are his analyses of Big Data’ infrastructure requirements and its 3Vs, Volume, Velocity and Variety. His concept of a “data lake” draws a vivid perspective of Big Data’s difference to databases 

    He includes a salutary lesson. Many Big Data projects “Die on the launch pad because of inadequate preparation, internal resistance or poor programme management.” His case study was a $62m crash.

    As Africa’s health systems move towards more Big Data opportunities, Big Data Demystified will help to set scenarios that lie ahead. Investment in new skills is part of it.

  • Cyber-security projects reveal priorities

    As cyber-security activities step up, Barkly shows how their priorities can indicate strategies that organisations can adopt. 

    Its report identifies twelve cyber-security investment in relative priority order. They’re: 

    Endpoint security using advanced malware protection and prevention, the top priorityAccess and authorisationEndpoint protection using response and threat huntingCyber-security intelligenceData protection using encryptionApplication securityNetwork traffic visibilityWireless securityIncident response toolsBring Your Own Devices(BYOD) securityEmbedded security in IoTDistributed Denial of Service (DDOS) protection, the lowest priority. 

    Alongside these initiatives, cyber-security teams are researching and evaluation cyber-security tools. It’s an activity that needs considerable cyber-security skills and resources. For Africa’s eHealth, it means two initiatives are needed, one to recruit, train and retain experts, and provide additional resources needed by them to fulfil their role. 

  • Cape Town’s eHealth accelerator programme offers opportunities for graduates

    Many of us have good ideas. Turning them into action is often harder.  Cape Town's Accelerator Programmes aims to help. It offers opportunities for graduates to access finance and work experience to turn their ideas into a viable business.

    There are two pilot programmes. Accelerator two opens for applications on the 15th March 2018. Accelerator one has announced its eight finalists. They participate in a ten week online programme and have face to face interactions with their mentors. 

    Business coaches in eHealth started on the 23rd January 2018. The course extends over 10 weeks. There is one topic each week taking about ten hours. Finalists take part in discussions about health problems and solutions. Strategic planning, alignment to health-care environments, defining and marketing proposals are the main themes.  Discussions on topics relevant to running a profitable and beneficial eHealth business are included too.

    Finalists are :

    Petrus Van Niekerk :  Udok allows doctors to interact with patients who are far away as well as administer treatment and monitor patient careDr William Mapham : Vula Mobile is a system which allows doctors to refer patients to specialists in tertiary hospitals Dr Anuschka Coovadia : HealthAtHome is a company that will provide patients with the best care from the comfortability of their homes at an affordable price. Brighton Khumalo : ConnecTB is an online tool which allows health care providers to register and monitor TB patientsNicole Van Der Merwe : GeneCare Molecular Genetics will provide patients with access to customised diet plans as well as exercise programmes which will be accompanied by educational video coachingDr Musaed Abrahams : Aviro Health has developed an app that will mentor nurses in primary health care to efficiently treat patients with HIVSuretha Erasmus : GC Network  has developed a pregnancy screening app that educates pregnant mother of their individual risk for a chromosome abnormality as well as provides detailed information regarding available prenatal testing which will help the mothers make informed decisionsVere Shaba : RAR Group VRHEALTH is a company that created a virtual yet realistic world for substance abuse patients who have been placed in a rehabilitation to develop new behavioral patterns through the virtual world Is the programme a model for Africa’s other health systems? It offers a smart way to encourage and develop Africa’s budding eHealth entrepreneurs. 

  • Acfee welcomes two new interns

    Acfee’s intern programme plays an important role in helping to achieve our goals in the rapidly expanding and competitive African eHealth landscape. In February we welcomed two talented and driven young professionals:

    Ms Kamogelo Motlhomi, a clinical associate graduate from Wits University Ms Nontobeko Shabangu, a public health graduate from Monash University.

    Acfee interns acquire relevant, practical exposure to numerous aspects of the eHealth industry. In return they contribute fresh perspectives on eHealth’s challenges and opportunities, adding new insights and ideas to Acfee’s vibrant talent pool. 

    We look forward to a year of knowledge sharing, value creation and successful outcomes. Welcome to the Acfee team!

  • mHealth’s proven impact still seems elusive

    Africa has an expanding, diverse mHealth core to its eHealth initiatives. The Journal of Medical Internet Research (JMIR) found limited evidence of mHealth’s impact, and hinted that in low-income countries, mHealth’s still at an early development stage.

    JMIR’s systematic review covered 10,689 mHealth articles, including 23 systematic reviews of 371 studies with over 79,609 patients. Seventeen reviews included studies of low- and middle-income countries’ initiatives. 

    SMS for a wide range of purposes seems to be the most common type of mHealth. It includes reminders, alerts, educations, motivation and illness prevention. Ten reviews gave them an Assessment of Multiple Systematic Reviews (AMSTAR) score of 0 to 4, low quality. Seven were rated as moderate quality, an AMSTAR score of 5 to 8. Six were rated as high quality, an AMSTAR score of 9 to 11. 

    mHealth for  chronic disease management scored well for impacts of:

    Improved symptoms and peak flow variability in asthma patients and fewer hospital admissions and improving forced expiratory volume in one secondImproving Chronic Obstructive Pulmonary Diseases (COPD) symptomsImproving heart failure symptoms and fewer deaths and hospital admissionsImproving glycaemic control in diabetes patientsImproving blood pressure in hypertensive patientsReducing weight in overweight and obese patientsBetter attendance ratesBetter adherence to tuberculosis and human immunodeficiency virus therapy in some scenarios, with evidence of decreased viral loads.

    While these are positive results, the benefits may still be moderate.  JMIR concluded that “Evidence for efficacy is still limited. In general, the methodological quality of the studies included in the systematic reviews is low. For some fields, its impact is not evident, the results are mixed, or no long-term studies exist.”

    The lack of reliable evidence doesn’t mean that Africa should slow down its mHealth investment. Instead, it means it should set up a reliable methodology to reveal the range of good and bad impacts. Lessons from these will be invaluable.

  • Telehealth providers have five trends

    As Africa’s mHealth initiatives move on, opportunities to include telehealth are expanding. Options for health systems can follow five provider trends. MDLIVE has described these in Wellness Gone Wireless:Top 5 Trends Driving Telehealth in 2018, available from Fierce Markets. 

    The trends are: 

    Expansion of cloud-based smartphone technology and health and wellness wearables, creating more engaged consumersAI innovation enabling more refined data analytics and personalised patients’ experiencesReduced reliance on reimbursement models, expanding providers and patients populationsConsumer satisfaction driving more demand and lower costsDisciplined focus on data security, driving increased consumer confidence and suppliers’ oversight. 

    Removing barriers to access telemedicine’s part of these trends. It can improve healthcare quality and removes geographic limitations on access. It’s becoming easier to match providers to community needs.

    These are encouraging signs for Africa’s telehealth priorities.

  • eHealth for mental health needs more intelligence

    Cinderella never thought that her success would attach her name to parts of healthcare. Countries’ mental health service is one of them, and its eHealth investment is being held back too. A study in the Journal of Medical Internet Research (JMIR) sets out to explain why. It investigated individual characteristics that influence both preferences and intentions to use eHealth for mental health in Australia. It identifies factors that might inhibit or enable eHealth.

    It found low reported preferences for eHealth for mental health services. Despite this, intentions to access these services are higher. This raises the challenge of how to translate these intentions into activities that use eHealth services. It found that strategies designed to enhance confidence and familiarity and ease people into new Internet-based mental health service programs may be important for increasing the chances of sustainable use. But, will users return to eHealth later? 

    It’s a worthy goal, but the study found that most respondents, almost 86%, prefer face-to-face services. The scope to engage eHealth users was found to be up to 40%. It’s a significant user base that needs supporting.

    Acfee identifies several factors that needed in eHealth to secure benefits. They include:

    Stakeholder engagementMeeting users’ information requirementsEasy to useHigh level of utilisation. 

    Putting these in place for the 40% will increase the chances of sustainable use and benefits realisation. For Africa, with its limited healthcare resource base, supporting up 40% mental health patients with eHealth access offers a valuable way to expand mental health services at minimal cost. It’s an opportunity. It’s not easy to achieve.

  • A smart watch can detect epilepsy

    Epilepsy is a leading serious neurological condition worldwide.  It has particularly significant physical, economic and social consequences.  Recognising the need for an intervention, Empatica Inc. has developed a smart watch to detect seizures in epileptic patients.  They’re calling it Embrace.

    Embrace uses machine learning algorithms to monitor and detect different seizure types, including grand mal or generalised tonic-clonic seizures. Electrodermal Activity (EDA)* sensors in the watch are used to measure multiple indicators of a seizure. 

    It’s also accompanied by an app that will send an alert, via text message, to a healthcare provider or caregiver once a seizure is detected.  Additionally, the app serves as an electronic seizure diary and health record for the user.

    During a clinical study involving 135 epileptic patients, Embrace’s algorithm was shown to detect 100% of the seizures, including the 40% of silent seizures that were unreported in patient clinical diaries.  Following this, the smart watch has received FDA approval as well as approval in Europe as a medical device for epileptic monitoring.

    Embrace’s high sensitivity is revolutionising seizure reporting.  It serves as a much awaited alternative to wearing an EEG, that is automated, and isn’t bulky or cumbersome to wear.

    *signals used to quantify physiological changes in the sympathetic nervous system 

  • Three mHealth apps help with treatment adherence

    Adherence to medication is an increasing problem in primary health care in Africa. It is important for many things, from birth control to antibiotics to ARTs. When medications are forgotten or skipped, most treatments are no longer as effective.  This becomes both costly for the healthcare system and detrimental to a patient’s health.

    Factors impacting adherence are multifaceted and include social, economic and psychological motives.  A sub-Saharan study in 2017 reported the most common barriers to adherence were;

    ForgettingLack of access to adequate foodStigma and discriminationSide-effects of the medicationTraveling

    With the uptake of smartphones in Africa, mHealth apps targeting treatment adherence could be a simple solution.  Here are the top 3 downloaded treatment adherence apps on Google Play Store. 

    PatientPartner

    This app turns patient education into an adventure game and shows patients the importance of sticking to a treatment schedule.

    Medisafe

    In addition to medication reminders, this app will notify friends and family if the user defaults. Medisafe also launched a low-tech version that sends reminders through automated phone calls and text messages. 

    MyTherapy

    After logging their medications on the MyTherapy app, users will receive reminders and alerts to take their medications.  Other features on the app include symptom tracking, healthy lifestyle tips and friends and family support groups.

    Improved adherence means a healthier society and ultimately, a reduced burden on healthcare systems.  Moreover, access to adherence data from these apps could help doctors and policy makers make better informed decisions about how to improve the healthcare system.

  • Voice recognition reduces Tanzania's patient waiting times

    Patients at the Muhimbili National Hospital in Dar es Salaam no longer have to endure long waiting times for their radiology results.  This is thanks to a new technology installation in the department.  Voice recognition or speech recognition technology is now being used to encode doctors notes on patients so that they can easily be transferred to the radiology department. 

    With this new technology, Tanzanian medical professionals are able to dictate into their computers, in the normal course of speaking and have the speech engine recognise what the clinician wants, and then apply the commands or structured words, respectively, to obtain a radiology report for a patient.  There has been some concern around the effect of speech accents on the technology, but this has posed no problems since implementing it at the hospital.  

    The speech engine is also capable of showing the cardiology report template populated with the name of the patient and other demographic data. By dictating the cardiology report narrative, the computer recognises the narrative context and intent and condenses a complete, correct, and structured document.

    This translates to shorter waiting times for patients, greater operational efficiency within the hospital and reduced workload on medical staff who are required to take notes of patient examinations and consultations.  The technology, which uses natural language processing, is constantly learning speech behaviour through repetitive exposure to terms and complex algorithms that organise speech patterns into recognisable behaviour. 

    This bold technology implementation in Tanzania could be a useful pilot for overburdened health care systems in Africa hoping to achieve the same benefits.

  • Can Africa adopt a modern master patient index?

    Paper patient administration and medical records can be unreliable in sustaining patient identification. Overcoming their limitations needs a sound Master Patient Index (MPI) and effective patient identification as a foundation for dependable eHealth. A white paper from Verato, an MPI vendor, describes a way to do it.

    A thesis in The Future of Healthcare Depends on a New Architecture for Patient Identity Interoperability has five components:

    Healthcare will involve extensive co-ordination across the full care continuumThe ability to access patient information is the cornerstone of co-ordinationResolving patient identities across disparate systems and enterprises is critical to accessing informationCurrent MPI technologies can’t resolve patient identities consistently enough or well enough to support emerging information needsMPIs patient identity resolution technology must support the new needs as part of a highly accurate, national patient identity resolution service.

    Africa’s health systems can apply these criteria to their strategic and procurement choices. They apply to all types of eHealth, not just EHRs. It’s a core requirement for improving healthcare efficiency. It supports a shift from point-in-time service towards effective healthcare co-ordination too.

    Three themes are needed for effective access to patient information: 

     Agreed rules and policies for sharing patient dataStandardised access protocols and content in EMRs and EHRsPatient identity matching.

    A unique national patient ID number is seen as supporting these. But Verato sees this as logistically

    Impossible, politically untenable because of privacy implications and would not help link people to pre-existing medical records. Relying on basic demographic identifiers such as name, address, birthdate, gender, phone, email, and social security numbers aren’t a solution because they’re prone to error when patients register at receptions and can change over time. About 8 to 12% of people may have more than one identity in any given hospital system, with actual medical histories spread randomly across them.

    MPI matching techniques was invented in 1969, and obsolete. Verato sees the solution as a pre-built, cloud-based, nationwide MPI that healthcare organisations  can plug into. It can avoid the need for extensive algorithm tuning, data standardisation, data governance, data cleansing, or data stewardship. It can help to achieve better compliance with data standards. 

    As Africa’s eHealth moves on, the concept can be assessed as an investment option. If it’s not, then an option to deal with the limitations of conventional MPIs may be needed.

  • Ghana prioritises telemedicine for universal health coverage

    The Novartis Foundation and the Ghana Health Service have announced the successful integration and scale-up of a pilot telemedicine programme started in the Ashanti Region in 2011.  Full national coverage of telemedicine services is expected to be possible by 2019. 

    The telemedicine programme strengthens healthcare capacity by empowering community health workers, while also improving the quality of their care.  Additionally, this avoids unnecessary referrals, thereby reducing transport costs for patients. 

    Community health workers make use of mobile technology to connect to health professionals and specialists via a tele-consultation centre.  Doctors, nurses and midwives in the tele-consultation centres instruct community health workers and advise on the treatment of their patients, particularly in emergency care. 

    The success of the telemedicine model has prompted Ghana Health Service to implement the programme across the nation as part of its national e-health strategy to improve healthcare delivery.  With sustained government leadership, this initiative could transform healthcare for years to come.

  • Kenya introduces an ePharmacy app

    MyDawa is an eHealth platform that allows consumers to purchase medications and other health and wellness products via a mobile application.  The platform was launched to the Kenyan market in March 2017 and has already attracted more than 30 000 registered users. 

    After downloading the app from the Play Store or App Store, registered users can simply search medications they require, upload a medial prescription if necessary, add to their cart and proceed to payment.  Once the order is completed, medications and products purchased will be delivered to the consumer at their convenience. Purchases that require a prescription are verified by a pharmacist before dispensing to the consumer’s mobile cart. 

    The MyDawa solution allows customers to gain the advantage of having increased transparency, convenience and affordability.  Products sold on the MyDawa app are 40% below the market price, and even 3rd party products are sold 20% cheaper than usual.  The app’s popularity in Kenya is driven by rising healthcare costs and value conscious consumers.  Payment on the app is made simple and allows consumers to pay via M-Pesa.

    This a great example in Africa that emphasizes the need for healthcare vendors to continue to embrace disruption in the industry, to become more efficient, to lower costs, increase accessibility to healthcare and provide patient-centric care.

  • Limited IOp’s a drag on benefits

    For several years, health informaticians and other eHealth’s ICT experts have recognised the link for effective Interoperability (IOp) and eHealth benefits. Now, US finance executives have added to the case for more IOp.

    A US Healthcare Financial Management Association (HFMA) survey of 117 financial executives identified their views. It found an increasing need for an increased IOp priority, slightly up to from 68% in 2015 to over 70%. Almost a quarter, 24%, said their organisations can’t share data effectively with other providers and payers.

    Their views extended to external and internal IOp. Both are seen as a combined, upcoming primary focus of healthcare providers. Three drivers are:

    Current shortcomingsAnticipated future needIncreasing demand for access to numerous data sources.

    While the survey may not have revealed much that’s new about IOp, it’s a valuable reminder that progress is slow. For Africa’s health systems, it confirms the long timescales needed to reach high IOp levels. If it’s taking the rich US health systems so long, Africa’s can’t expect rapid results. Slow, steady and sustained seem to be their IOp plan.

  • Healthcare enters the blockchain ecosystem

    Over the last few years, healthcare has seen a record number of security breaches involving healthcare data.  This has prompted several start-ups to realise the work that needs to be done on the cyber-security front to make healthcare data secure.  Blockchain offers one potential solution to this challenge. Other solutions offered by blockchain include interoperability and the ability to connect data silos for more seamless systems and improved patient safety.

    SimplyVital Health is one of those start-ups experimenting with blockchain technology to give the healthcare industry a facelift. The company has developed a decentralised open-source protocol that will enable frictional-less sharing of healthcare data.  Their Health Nexus is a public-permissioned blockchain. It provides a platform to build advanced healthcare applications while maintaining the privacy and security required in the healthcare industry. 

    The developer tools on the Health Nexus are open source and available for free.  Members are able to build and deploy distributed apps utilising the blockchain protocol for transactions, identity and smart contracts, and a distributed hash table (DHT) for data storage, managed by a governance system. This will allow developers to create valuable solutions for pharmacies, healthcare providers, insurers, clinical researchers or patients.  

    Blockchain is certainly paving opportunities for new business models in healthcare.  The trajectory it will follow in the coming years, however, is an unmapped terrain waiting to be explored.  The road ahead for blockchain and healthcare will also require substantial intra-industry cooperation as well as dialogues between the public and private sectors regarding standards and regulatory frameworks.

     

  • EMGuidance web-platform to simplify medication look-up in South Africa

    Since the launch of their clinical support platform in 2016, EMGuidance has become one of the most popular medical apps in South Africa, even extending to other parts of the globe.  Its popularity is largely due to the comprehensive, up-to-date and locally relevant clinical guides and protocols made easily available to health professionals.

    In fact, the response from health professionals has been so great that EMGuidance is now available as a web-based platform.  The web-based platform essentially functions as a Google search engine with a twist.  This niche search engine only returns locally relevant information – fulfilling a great gap in clinical support tools in South Africa.  Health professionals will now be able to search for relevant South African therapies by trade name, active ingredient or registered indication. 

    Realising the potential for other African countries, EMGuidance has launched a slim-line version of their tool in Sierra Leone.  The positive response from the local community has spurred plans to expand to Kenya, Tanzania and other African countries.  It’s activities and initiatives like EMGuidance that will springboard eHealth in Africa to first-world healthcare delivery.

  • Top ten algorithms that can help healthcare

    As algorithms become more prevalent in eHealth, it’s important to have a clear development path for their use. Two core principles are:

    No single algorithm works best for every problemA learning a target function (f) maps input variables (X) to an output variable (Y), so: Y = f(X), used for predictive modelling.

    An article by James Lee in Towards Data Science sets out ten top algorithms. They’re: 

    Linear regression, a long-standing techniques from some 200 years ago, but a good starting pointLogistic regression, suitable for binary classification problems and their two class valuesLinear discriminant analysis, where prediction rely on calculating a discriminate value for each class and making a prediction for the class with the largest valueClassification and regression trees represented by a binary treeNaive Bayes, a simple, powerful algorithm for predictive modelling using two types of probabilities, one of each class, the other the conditional probability for each class given each x valueK-Nearest Neighbours (KNN), a simple and effective algorithm, where predictions are derived from  new data points by searching  entire data sets for the K most similar instances, the neighbours, and summarizing output variables for those K instancesLearning Vector Quantisation (LVQ), a KNN relative, and an artificial neural network algorithm enabling choices of the number of instances to hang onto, learning precisely what the instances should look likeSupport Vector Machines (SPV) are possibly one of the most popular, using a hyperplane to separate points in input variables spaces by their class, either class 0 or class 1Bagging and Random Forest (BBR), another popular algorithm, called Bootstrap Aggregation or bagging, and can estimate quantities from data samplesBoosting and AdaBoost, an ensemble technique aiming to create strong classifiers from several weak classifiers by building a model from training data then creating a second model that attempts to correct the errors from the first model.

    Selecting algorithms in eHealth uses, four questions need answering, what’s:

    The size, quality, and nature of the dataThe available computational timeThe urgency of the taskThe data to be used for.

    The answers aren’t easy to find. Lee points out that experienced data scientist can’t tell which algorithm’s best before trying different ones. It seems that Africa’s eHealth needs time to ponder these before settling on a preferred short list.

  • Ghana will have a national telemedicine service next year

    Pilotitis become a phenomenon a few years ago as scaling-up eHealth pilots became too challenging. Good scale-up news is the recent  telemedicine initiative by Ghana Health Service and The Novartis Foundation, They’ve announced the successful integration and scale-up of a telemedicine service. National coverage’s planned for 2019. 

    The 24-hour telemedicine service uses mHealth for community health workers to consult specialist health professionals at teleconsultation centres on a range of health topics, including emergencies. It builds from the telemedicine pilot started in 2011 in the Ashanti Region’s Amansie West District.

    An important lesson for other African countries’s the timescale. Seven years may seem like a long time, but eHealth does take time to come to fruition. Over the period, telemedicine has encountered some specific changes. mHealth opportunities have replaced conventional conferencing technology, now obsolete and looking a bit clumsy and chunky.

    Ghana may have set a standard for other African countries to follow. It represents a considerable technological achievement in modernising and transforming healthcare. 

  • mHealth to drive Cote d’Ivoire's immunisation project

    Like falling snow, announcements at the World Economic Forum come thick and fast. Taking place in Davos Switzerland, Thursday 25th, 2018, one of the world’s leading telecommunications operators, Orange SA and the Vaccine Alliance Gavi announced a partnership with Côte d’Ivoire’s Ministry of Health to boost immunisation rates in the countries’ regions and districts with the lowest vaccine coverage.

    A report in Ventures Africa says it’s a joint US$ 5.47m five-year project. Half the money’s from the Gavi Matching Fund, a mechanism financed by the Bill & Melinda Gates Foundation to motivate and provide incentives for private sector investment in immunisation. It builds from Gavi’s longstanding role in the country starting form 2001, Gavi supported Côte d’ Ivoire in introducing eleven vaccines.

    It all fits with the M-Vaccin Côte d’ Ivoire initiative. It uses Orange mobile technology to inform parents about the importance of vaccination. Sending text and voice messages in local languages and targeting messages about keeping immunisation sessions are standard themes. Reminders of their children’s schedules and dates are the main goals.

    The initiative should be transferrable to all African countries. It’ll be good to see vaccination rates above 95% soon.