Okey Okuzu is the founder and chief executive officer (CEO) of InStrat Global Health Solutions, a United Kingdom Space Agency International Partnership Programme seeking to raise the standard of Nigerian healthcare outcomes in areas with poor communication through the application of satellite connectivity. He tells ANTHONIA OBOKOH in this interview what Nigeria can do to deepen penetration of e-health services.
Can you give an insight into the current state of healthcare in Nigeria?
Nigeria, like many other countries, is working towards improving basic healthcare facilities in rural areas. As Africa’s largest economy and most populous nation, improvements in Nigeria’s health system are required to address the widening geographic and socio-economic disparities in health care access across the country.
However, chronic infrastructure deficits and other health system challenges have led to difficulty in attracting and retaining frontline health workers to work in remote parts of the country, inadequate and irregular training programmes, and weak data management systems. This has impaired the ability of Nigeria’s health care system to deliver quality health care to rural and hard-to-reach populations, placing them at greater risk of economic and social isolation.
Who is InStrat and what services do you offer?
InStrat Global Health Solutions (InStrat) company is funded to address up information on health delivering in Nigeria through the help of mobile app information with funding support from the UK Space Agency, the International Partnership Programme (IPP).
InStrat is focused on global health innovation by deploying turnkey mobile health solutions using 3G wireless and satellite internet connectivity to reach populations in underserved regions. However, the Nigeria e-health innovation project was commissioned in March 2017 as a concerted and strategic response to the telecommunication infrastructure deficits and health system challenges impairing the delivery of quality health services to rural and hard-to-reach populations across the country.
InStrat Global Health Solutions was formed in 2010 to leverage appropriate health technologies to foster improved healthcare in developing countries. They have successfully introduced and scaled multiple mobile health solutions in partnership with international and Government partners. They are able to reach any health worker in any health facility, in any location, with mobile health solutions.
Using InStrat satellite technology, the project extended the reach of quality essential health services to remote, off-grid communities by overcoming the ‘last mile’ – the final portion of the communication network that physically reaches the service user.
A consortium of partners including Inmarsat, InStrat Global Health Solutions (InStrat), Nuffield Centre for International Health and Development of the University of Leeds, research teams from University of Abuja, Bayero University Kano, and University of Lagos collaborated with the Federal and State Ministries of Health in Ondo, Kano, Lagos as well as the Federal Capital Territory.
What was the concept behind the establishment of the IPP programme in Nigeria?
Nigeria was invited to be part of this programme to provide health services to help facilities in areas that are not covered by 3G with the use of satellite technology. The International Partnership Programme (IPP) is essentially looking to promote the social impact using the space of technology in addressing key health systems challenges using satellite communication technology to improve health information management and governance, provide video-based health worker training, and strengthen disease surveillance capabilities for mitigating public health risks.
IPP Nigeria has leveraged and demonstrated the unique value proposition of satellite communications to catalyse the emergence of a platform that enables innovative health solutions to reach the last mile and achieve scale in Nigeria, creating the foundation for long-term sustainability.
How does the IPP get funding?
The IPP, by the UK Space Agency is funded through the UK Government and provides local funding through a grant the Overseas Development Agency programme. So they have been funding this for the past two years but the grant has just expired.
So we are working for a renewal of the grant. The investment of IPP is robust enough funding to bring back a hundred and twenty – five primary health facilities in three states of which seventy five are off the grid. This covers the cost of deployment, the hardware, software, connectivity as well as the monetary evaluations, so it enough investment to achieve the objective of the investment.
How will the program work – kindly explain how you intend to use technology to drive the initiative in rural areas?
We first have to recognise that the health needs are most dire in rural areas, that is where we have the poor Nigerians and they have the least access to healthcare solutions and interventions. So it is incumbent on us to try to find ways to get to them.
In rural communities, technology-enabled healthcare applications, coupled with satellite connectivity can help counter the lack of healthcare infrastructure, support an under-skilled workforce, control the spread of communicable diseases and record the increase of manageable conditions such as diabetes.
E-Health solutions can also enable a more equitable treatment for girls and women, by empowering them through access to health information to improve their lives, especially during pre- and post-natal care. Provision of high-speed satellite technology is a key solution for eliminating the geographic barrier and offering better health services to rural areas.
The biggest barrier in reaching them is internet connectivity because there is no 3G or terrestrial network coverage. So with the use of satellite, internet connection can be delivered to any location anywhere on earth wirelessly. We are able to now both deliver InStrat programmes to the primary healthcare facilities in the rural areas and allowing the satellite internet to provide the communication backbone of the services.
There is a lack of medical data in Nigeria, how do you breach that gap to implement such a technologically driven project?
Medical data has been an issue in Nigeria, but there are innovative solutions to help the country develop medical data record for the healthcare system.
Our system captures data’s or we provide tools for health workers to capture data at the primary care level in primary healthcare facilities. So each patients has the unique individual patient record created that is a case file, instead of having a paper case file but rather have a digital case file.
What we do is we have files across thousands of thousands of patients, so we aggregate all the data’s and that data is now what we make available to the healthcare system. So that is where we bridge that data gap, we provide it to the doctor, ministries of Health and also to the National Health Management information system.
How does IPP assist the Nigeria Health ICT Vision of enabling and delivering universal health coverage by 2020?
The achievement of Nigeria’s Health ICT Vision of enabling and delivering universal health coverage by 2020 remains a distinct possibility if the government of Nigeria embraces these insights, sustains the gains recorded so far, and leverages emerging opportunities for its rapid scale-up across the country by ensuring adequate funding, technical and operational arrangements for satellite communications that address geographic disparities in access to health care.
The Government of Nigeria has outlined a bold aspiration to achieve universal health coverage by 2020 and it is explicitly that it cannot be achieved UHC without technology. Nevertheless the second part of it is that primary healthcare systems are integral to every part of our health system. Therefore, UHC is almost dependent in the effectiveness within the primary healthcare system. So taking the two and evaluating it we are deploying technology into the primary healthcare system so we are going to make significant efforts towards the government realisation of the UHC.
Nigeria is really improving in technology; but we need to attend to the policies that address financing of healthcare because if healthcare is well financed it throws more money to address all other component of the sector, so the role of Government is continue providing the political will to ensure continuity and sustainability to better the sector more.
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