eTransform Africa: Health Sector
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eTransform Africa: Health Sector Presentation Transcript

  • 1. Vital Wave Consulting Field Teams eTransform Africa:Latin America Argentina Brazil Health Sector Chile Costa Rica Dominican Republic Mexico Peru The World Bank | African Development Bank | African UnionAsia India China Cambodia Uzbekistan PEER REVIEW WORKSHOPEastern Europe Estonia Johannesburg, South Africa UkraineAfrica Egypt January 28, 2011 South Africa Nigeria Kenya Brooke Partridge CEOMiddle East United Arab Emirates Brendan Smith Director of Consulting ServicesUnited States Nam Mokwunye California (Headquarters) Senior Consultant, Tech Transfer
  • 2. Agenda 1 Project Goals & Outcomes 2 Chapter 1 Summary 3 Chapter 2 Summary 4 Chapter 3 Summary © 2010 Vital Wave ConsultingTM 1 Proprietary and Confidential: Do not copy or distribute.
  • 3. Project Goals and Outcomes Overarching Project Goal Raise awareness and stimulate action, among African governments and development practitioners, of how ICTs can contribute to the improvement and transformation of traditional and new economic and social activities in the Health sector. Intended Outcomes The study provide an overview and analysis of current ICT for Health across SSA and beyond. It will also recommend ways in which to scale up the successful application of ICTs to further operationalize their use within the Health sector, while paying appropriate attention to associated risks. © 2010 Vital Wave ConsultingTM 2 Proprietary and Confidential: Do not copy or distribute.
  • 4. Chapter 1: Role of ICT in Health SectorSummary (1)• Defines ICT  ICT in the health sector, also called eHealth, is the use of information and communication technology (ICT)—such as computers, mobile phones, satellites, applications, information systems and digital platforms —to enable, support and deliver health services to patients and populations.• Discusses state of health care in African countries in reference to MDGs 4, 5 and 6• Establishes a framework for looking at health sector development and determines that most African countries are transitioning from phase 1 to 2 with some transitioning from phase 2 to 3• Establishes that progress has been made in MDGs 4,5, and 6 but still much left to do  …under-five child mortality is 20 times (1 in 8) as severe in sub-Saharan Africa it is in OECD regions (1 in 167) and 1.75 times as in Southern Asia (1 in 14), Nigeria (10%) and India (21%) account for nearly one-third and Southern Asia and Sub-Saharan Africa (42%) accounts for 92% of the global under-five mortality cases. Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 3 Proprietary and Confidential: Do not copy or distribute.
  • 5. Chapter 1: Role of ICT in Health SectorSummary (2)• Establishes that some African countries are doing better while other are not  Some African countries, such as Eritrea, Liberia, Ethiopia and Madagascar (4 of the world’s top-10 performers) either reduced under-five deaths by 100 per 1,000 lives, at least 50% or at a reduction rate of at least 5%., The Millennium Development Goals Report 2010• Establishes why ICT could be a game changer for MDGs 4,5 and 6  Enables curbing of wasteful spending  Provides tools to help address 5 obstacles to affordable health discussed further in chap. 3  Funding shortage  Equipment and supplies shortages  Insufficient quantity of skilled health care workers  Population uneducated about prevention and treatment of preventable diseases  Lack of health system infrastructure and communication between rural and urban centers Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 4 Proprietary and Confidential: Do not copy or distribute.
  • 6. Chapter 2: Landscape Analysis of eHealthSummary• Provides landscape analysis of ICT in health sector, first worldwide, then within Africa• Identifies early evidence of eHealth activity in African countries with a focus on  Botswana (eLearning and Health Chat by SMS)  South Africa/Tanzania/Botswana (BEANISH/HIS)  Gabon (Gamelto e-health record cards)  Ghana (MoTech mid-wife survey and advisory)  Rwanda (TracNet, national eHealth system)  Tunisia (Visionet, video network for physicians)• Concludes that health indicators improve with GDP per capita and ICT prevelance• Provides graphed data sets comparing African countries to themselves  Also to Thailand, which has a well-regarded health system, and highlights Tunisia which is possibly transitioning from phase 3 to 4, unlike other African countries• Provides substantial resources: interventions, blogs and publications Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 5 Proprietary and Confidential: Do not copy or distribute.
  • 7. Chapter 2: Landscape AnalysisOnline Comments and Recommendations• “Interesting perspective on the ICT landscape across selected countries in Africa and Thailand. The examples provided were interesting showing the wide use of ICT programs with external financing in selected countries.” -Egbe Osifo-Dawodu• Mention role of physicians and local developers (software)• More private sector examples• Role of telecom sector in making e/mHealth possible• More government uses examples  mobile phone based Internet in south African clinics  mobile-phone armed midwives in Nigeria• Group by services• Group by country size Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 6 Proprietary and Confidential: Do not copy or distribute.
  • 8. Chapter 3: Challenges and OpportunitiesSummary (1)• Expounds on chapter 2’s discussion of obstacles to affordable health care and identifies them as micro-challenges  Funding shortage  Equipment and supplies shortages  Insufficient quantity of skilled health care workers  Population uneducated about prevention and treatment of preventable diseases  Lack of health system infrastructure and communication between rural and urban centers• Identifies opportunities to use ICT to overcome micro-challenges  SMS (educational/instructional)  IVR (voice menus)  Video (tele-medicine)  Radio Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 7 Proprietary and Confidential: Do not copy or distribute.
  • 9. Chapter 3: Challenges and OpportunitiesSummary (2)• Posits that systemic (macro-) challenges make it difficult for African nations to overcome sector-specific micro-challenges—as is being experienced by the health sector  Capital constraints (financial, human—urbanization, intellectual—brain drain)  Capacity building  Organizational issues  Process considerations  Infrastructure  Social cultural pressures  Inadequate safety net• Offers that eHealth intervention opportunities are equally dependent on macro- challenges being addressed Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 8 Proprietary and Confidential: Do not copy or distribute.
  • 10. Chapter 3: Challenges and OpportunitiesSummary (3)• Provides tools for analyzing the relationship between macro, micro and ICT challenges in the health sector• Graphs data sets that compare micro, macro and ICT challenges between African countries with highlights of Thailand Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 9 Proprietary and Confidential: Do not copy or distribute.
  • 11. Chapter 3: Challenges and OpportunitiesMatrix (1.1): Micro, Macro and ICT Health Sector (Micro-level) System-wide (Macro-Level) Impact on Citizens ICT Opportunity ICT Challenge Path to Health Challenge Influencer 1 Funding Shortage  Relatively high cost to  Reduced confidence in  Reduce costs  Insufficient infrastructure  0.5-1YR: low-cost, provide civil services leaders’ ability to deliver (mHealth/tele- (telecom/power) preventive interventions;  Limited revenue sources public services medicine)/increase  Existing intellectual assets reprioritize health  Health deprioritized  Residual impact on cross-sector revenues (spectrum) not maximized funding in policies and quality of life with ICT platform  No cross-sectoral budget  High mortality (telco/mMoney) collaboration  1-5YRS: resolve ICT  Loss of economic  Fund health with ICT-  Commitment of leadership challenges; high-cost productivity assisted interventions savings/revenues 2 Equipment and Supplies  Funding shortage  Service gaps  Deploy real-time ICT to  Low rural connectivity  0.5-1YR: target rural Shortage  Limited access between  More deaths related to enable 1) urban-rural  Device interoperability providers for low- urban and rural areas “multiple delays” communication (tele-  Inefficient supply chain capacity (mobile) supply  Inefficient manual supply  Reduced trust levels medicine) 2) mobile- process (done by hand) chain interventions chain mgmt. (SCM)  Higher preventable assisted supply chain  Commitment of leadership  1-5YRS: increase rural processes mortality management (MASCM) connectivity, roads transportation; higher- capacity database systems 3 Insufficient Quantity of  Underfunded skilled  Increase in “third  Reduce training cost  Low rural connectivity  0.5-1YR: video Skilled Healthcare Workers education system delay”-related mortality and increase penetration  Device and service usability broadband group  High unemployment  Spread of communicable with ICT (broadband, for healthcare workers training at urban and  “Brain drain” diseases video/IVR/SMS)  No proven scalable and rural health centers;  Loss of economic  Increase rural access to stainable business model low-cost mobile productivity due to third specialized care training  Commitment of leadership continuing education delay with ICT (tele-  1-5YRS: increase rural medicine) connectivity; improve education system  Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 10 Proprietary and Confidential: Do not copy or distribute.
  • 12. Chapter 3: Challenges and OpportunitiesMatrix (1.2): Micro, Macro and ICT Health Sector (Micro-level) System-wide (Macro-Level) Impact on Citizens ICT Opportunity ICT Challenge Path to Health Challenge Influencer 4 Population Uneducated  Underfunded primary and  Avoidable high rates of  Radio, TV, and mobile  Literacy of rural populace  0.5-1YR: maximize About Prevention and secondary education system transmission and education campaigns  Mobile phone ownership telecom networks for Treatment of Preventable  Sociocultural norms that mortality due to promoting disease  Cultural norms SMS/voice/video Diseases encourage misunderstanding preventable diseases prevention healthy training  Commitment of leadership of communicable diseases  Spread of epidemics living  1-5YR: improve mobile and unhealthy behaviors  Patient reminders and broadband improve timing and connectivity; increase quality of treatment investment in education 5 Lack of Health System  Lack of financial capital to  Limited access to proper  Use ICT to maximize  Low rural connectivity  0.5-1YR: establish Infrastructure to Enable develop and maintain health medical care community-based  Commitment to inefficient broadband VPNs Communication Between care system  Low levels of trust in health/reduce need for data collection process between centers; arm Rural and Urban Centers  Inadequate rural connectivity healthcare system HSI.  Commitment of leadership healthcare workers with due to licensing regimes,  Bad health translates to  Complete patients’ useful technology; rapid payback models and low economic medical record database digitize records system reduced ROI for operators productivity  Implement VPNs and  1-5YRS: Improve inter-connect rural and broadband connectivity; urban health centers maximize tele-medicine  Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 11 Proprietary and Confidential: Do not copy or distribute.
  • 13. Chapter 3: Challenges and OpportunitiesMatrix (3): ICT and Macro ICT INTERVENTIONS SYSTEMIC (macro-level) CHALLENGES METHOD Capital Constraints Capacity Building Infrastructure Socio-Cultural Norms Social Safety Net Financial Human Intellectual Organiz- Process Regulat Telecom Power Devices Diet & Gender Language Leader- Insu- Social Ational ory Medi- issues ship rance security cation Digital Health 1 X X X X X X Ecosystem (DHE) 2 SMS X X X X X X X 3 IVR X X X X X X Video (tele- 4 X X X X X X X medicine) 5 Radio X X X X X X 6 TV X X X X X X X 7 HMIS X X X X X X X  Financial Forerunners Ripe & Ready Next Generation Markets Unbanked & Unconnected Last Frontier Unexamined © 2010 Vital Wave ConsultingTM 12 Proprietary and Confidential: Do not copy or distribute.
  • 14. Thank you