• PHC
  • Africa’s eHealth needs more emphasis on developing and integrating PHC

    Effective, accessible primary healthcare’s (PHC) essential to improving population health. The World Bank aims to help by improving and sharing knowledge. Its project Strengthening Primary Health Care for Results supports Maternal, Neonatal and Child Health (MNCH) services, and conforms two of the Bank’s Country Assistance Strategy (CAS) to: 

    Strengthen human capital and safety nets, so access to, and quality of, health servicesPromote accountability.

    It’s also a partner with the Gates Foundation and WHO in the Primary Health Care Performance Initiative (PHCPI), a project recognising PHC as a weak link in most health systems. The objective’s to support countries to strengthen monitoring, tracking and sharing key PHC performance indicators. PHCPI partners highlighted the far-reaching benefits of stronger primary health care .

    The Economist has two examples of these. Brazil and Costa Rica have better healthcare systems than other countries with similar incomes. One reason’s their extensive network of trained PHC workers. Costa Rica PHC doctors and nurses provide 75% of consultation. The country’s third for highest life expectancy in the Americas.

    The two countries GDP per head is between US$ Purchasing Power Parity (PPP)15,000 to 17,000. Six African countries match or exceed the range. It seems more challenging for the other 48. eHealth programmes that help to create, develop support and expand PHC services are priorities for progress.  

    A study in PLOS suggested integrating Informal Healthcare Providers (IHP) may be part of the solution too. What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review used 122 studies, 48% from sub-Saharan Africa to identify large-scale reliance on IHP services.  Globally, they range from 51% to 96% of healthcare providers. Utilisation ranges from 9% to 90%.

    Studies also found poor adherence by IHPs to countries’ clinical guidelines. People rely on them because they’re convenient, affordable and for social and cultural effects. They also offer flexible working hours, sometimes open all hours, more likely to have medicines in stock, closer and provide more rapid services.

    Recommendations from the studies include:

    IHP education, including capacity building and training programmesOversight, including regulation, enforcement and registrationBetter processes, including collaboration and engagementRecognising IHPs’ social and cultural valueReducing the need for IHPs by improving access to formal providers.

    If these are acceptable to Africa’s health systems, integrated eHealth programmes should extend to IHPs. These could include clinical support and eLearning. It also needs wide-ranging stakeholder engagement and to be part of a sophisticated healthcare transformation project, so effective political, clinical and executive leadership.

  • Nigeria’s ATM telehealth device to enhance services in rural communities

    Primary and rural healthcare delivery in Nigeria face a number of longstanding challenges. An estimated 66% of the rural community in the country do not have access to critical medicine, and are in dire need of effective medical infrastructure to support healthcare delivery. While 31% of the population travel more than 20 kilometres seeking standard healthcare in the rural regions.

    In order to address some of these challenges, Springville Management Consulting Limited has partnered with Tele-health Technology Company, to introduce its primary healthcare diagnostic technology solution, 'YOLO Health' says an article in allAfrica.

    The YOLO Health ATM kiosk is an innovative integrated preventive healthcare solution, designed in form of an ATM machine. It offers various health screening capabilities and medical benefits such as online data consulting with doctors, health checkup and health history.

    Managing Director, Chuks Melville Chibundu said "As we continue to seek solutions to challenges in various development sectors, we have recently partnered with one of India's leading healthcare technology solutions providers to proffer easy, quick and affordable diagnostic healthcare services to urban and rural dwellers in Nigeria."

    The YOLO health ATM allows patients to get a quick preventive health checkup or to video consult with reputed healthcare providers. It checks weight, height, BMI, Oxygen saturation and Hemoglobin.

  • Johannesburg starts up eHealth for primary care

    For many Johannesburg residents, seeing a doctor means leaving home as early as 4am to have a place at, or near, the front of the queue at the City’s primary healthcare facilities. Many people can spend the whole day in a clinic queue.

    Reducing waiting times is the eHealth goal of The City of Joburg. A report says Executive Mayor, Clr Parks Tau, launched the Rand electronic patient processing system in the new Jabavu Clinic in Soweto. It’ll reduce long queues and piles of paper at the clinics. It should also reduce the time healthcare professionals spend on paperwork, so increase the time they can spend seeing patients. It’ll also keep records safe, minimise errors and avoid unnecessary mistakes.

    The Mayor said “It’s about delivering services where they are needed the most and dealing with the issues that matter the most. The new system meant Johannesburg residents had leapfrogged into the digital era. We as the City of Johannesburg are using technology to solve the problems that residents face.”

    The system will be rolled out to the rest of public clinics in Johannesburg in due course. eHNA looks forward to hearing about its progress.

  • Tablets support community health workers in South Africa

    South Africa has many healthcare challenges and lots of innovative community health solutions. One of these is Mentor Mothers, and they're now using tablets to become better informed and step up their efforts.

    A study published last October showed that repeated home visits by trained community health workers to neighbourhood mothers led to significant health improvements both for mothers and children, including prevention of mother-to-child HIV transmission. It ws a collaboration between the Philani Maternal, Child Health and Nutrition Trust, USA's University of California and South Africa's Stellenbosch University.

    Mentor mothers caught the attention of professors at USA's Stanford University who agreed to provide the health workers with tablets pre-loaded with educational videos. The videos explain basic health and nutrition facts in a simple and intuitive way, with the aim of helping mentor mothers to improving health in their communities.

    Nomfusi Nquru, one of the twelve mentor mothers testing the project, says her interaction with the videos have been overwhelming positive. Mothers pay careful attention to what is being said in the videos and often ask healthcare questions after watching.

    The tablet project is the brainchild of Dr Maya Adam, a lecturer at Stanford School of Medicine with years of experience in developing digital educational content. According to Adam, who volunteered at Philani during her medical school and undergraduate studies, recruiting successful mothers and training them to become community health workers “is a powerful model for passing on good health practices in a way that is sustainable because women are counseling within their own communities.”

    “Community health workers can help bridge the gap, in the short term, between what we need in access to healthcare providers and what we have,” says Adam. “If we wait for access to education and healthcare in South Africa to catch up with the need for it in these under-resourced communities, we are going to wait for a long time. By using technology like the tablets we can accelerate that process in communities otherwise cut off from main infrastructures.”

    The project will soon be expanding to other regions. The videos are all picture-based, so can easily be translated and used in other countries in Africa. 

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    Image: Mentor Mother Nomfusi Nkubu, from the justcookforkids blog

  • Health app wins Uganda Community Innovation awards

    K-Free, a health solution app aimed at curbing and combating breast cancer, has won the 2014 Uganda Community Innovation awards. It beat 28 finalists. The award is organised by Orange Uganda in conjunction with Huawei Technology.

    The award pooled student developers from leading Ugandan Universities. They were asked to develop mobile apps relevant to community for health, education and agriculture.

    K-Free is an Android mobile app that helps detect breast cancer early by plugging an external pouch-like peripheral to a smartphone. The external device uses low-energy light to take images of breast tissue. After the light is beamed through the breast, computational analyses provides the results, which are immediately available to users.

    K-free was developed by three Makerere University Students, Joshua Sentamu, David Tusubira and Derrick Mutabi. The app is cheaper than a conventional mammogram and doesn’t compromise the quality of the results. As a prize, the K-Free developers won a twelve month internship at Orange Uganda.