Telehealth: An opportunity to increase quality health access in Africa
Increasingly, the link between the use of information and communications technology (ICT) and the future of health and healthcare is acknowledged, if not broadly accepted or integrated.
ICTs have great potential to address some challenges faced by both developed and developing countries in providing accessible, cost effective, and high-quality healthcare services.
Telehealth (or telemedicine) uses ICTs to overcome geographical barriers and increase access to healthcare services. This is particularly beneficial for rural and underserved communities in developing countries, like those in Africa, where over 400 million people living on the continent have little or no access to healthcare.
The importance of telehealth was highlighted by the COVID-19 pandemic. This heightened the need for innovation, forcing several countries to adopt telehealth and other digital technologies to increase medical health access for their people, leading to the growth of the telehealth market in Africa, which is expected to hit US$5 billion in 2025.
Another major challenge is the high poverty level among the population. For example, it is estimated that, in Nigeria, the cost of virtual consultation ranges between $6 and $26 per session
Telehealth benefits for healthcare in Africa
Telehealth has broad applications in healthcare, and can be used as an alternative or complementary approach for almost any health issue. It covers preventative, promotive, and curative aspects of health, including remote patient monitoring (RPM); store and forward transmission of medical information; and mobile health communication (mHealth).
Telehealth services can be delivered through video consultations, telephone calls, text messages, and chats. This variety of options allows service providers to cater for the healthcare needs of diverse clients, provided the patients have access to a tablet, computer or even a basic smartphone.
Integrating telehealth into healthcare systems in Africa holds tremendous benefits for the continent. Telehealth can play a critical role in filling in the void created by the dearth of medical personnel in many parts of Africa.
The World Health Organisation estimates that there are only four doctors per 10,000 patients in Nigeria, Africa’s most populous country, and only one-quarter of doctors in Africa are deployed to rural areas.
However, telehealth can assist healthcare systems in expanding access to and improving the quality of rural healthcare, minimising the challenges and burdens patients encounter, such as transportation issues related to traveling for specialty care. Telehealth can also improve monitoring, timeliness, and communications within the healthcare system.
Challenges impeding the growth of telehealth in Africa
Telehealth is still yet to be integrated into existing healthcare systems in Africa. Its widespread use is hampered by a number of factors, including poor availability of basic infrastructure such as reliable electrical power, cellular network coverage, and broadband internet service.
Another major challenge is the high poverty level among the population. For example, it is estimated that, in Nigeria, the cost of virtual consultation ranges between $6 and $26 per session. Although this may not be costly in the developed world, but in a country where 40% of the populations live below the poverty line, it makes telehealth services inaccessible to the lower class.
Poor regulatory and political support also limit the growth of telehealth in Africa. In most of Africa, there is no governance and policy mechanism in place at the national, regional, and local levels to ensure implementation, support, and monitoring of telehealth.
The role of government or market actors in the development of telehealth is not explicitly defined by policies or legal frameworks.
Strategies to strengthen telehealth in Africa
The human, infrastructural, policy, and delivery challenges confronting telehealth in Africa must be addressed to optimise its growth and expansion. To achieve this, Bloom Public Health proposes the following strategies:
• Development of policies and legal frameworks to support telehealth: African governments must develop policies to guide the implementation of telehealth across Africa within the ethical confines of medical practice. Regulations and guidelines on the scope of care, minimum criteria for practitioners and facilities, and assessment of quality of care are essential. Pragmatic review of existing insurance laws is also critical to address matters related to telehealth and health insurance.
In South Africa, the Health Professions Council of South Africa (HPCSA) recently amended guidelines for telemedicine; a commendable step towards strengthening telehealth policy and governance.
• Exploring Public-Private Partnerships (PPPs) to increase investment in telehealth: Governments need to boost financial support for telehealth and should explore PPPs to optimise the use of limited financial resources and develop measures to reduce the per-unit cost of care. PPPs can also help to integrate technical, clinical and communication processes to improve the service design and maintain optimal data security protocols, maximising the potential of telehealth.
Bloom Public Health is currently partnering with a State Government in Nigeria to deploy a pilot Telehealth infrastructure. This will be scaled up if successful.
• Increasing public awareness of telehealth: Patient barriers to accessing and using telehealth services, created by the negative perspective of orthodox medicine in rural communities, must be addressed using a continuous learning approach. Public health campaigns to raise awareness of the benefits of telehealth are necessary, and major stakeholders such as community and religious leaders must be engaged.
Globally, telehealth is the future of medicine, and Africa is no exception. Given the tremendous benefits it provides for strengthening healthcare systems and achieving better health coverage, Africa must leverage telehealth to cater for the growing healthcare needs of its population.
Anyakora is the CEO of Bloom Public Health and a public health expert and Odibeli is a pharmacist and the regional communications manager at Bloom Public Health