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Challenges of Telemedicine in Africa

Technology has had a significant impact on the field of healthcare, be it in the form of Telemedicine and Teleradiology; Laparoscopic surgeries, Bionic limbs, Robotic surgeries; 3D imaging and Real time diagnostics, and the list goes on.

Telemedicine: A boon to healthcare sector

With the introduction of Telemedicine, gone are the days when the physical presence of a doctor was required for treating patients. Video-based telemedicine has helped doctors, diagnose, monitor and treat patients who are remotely located using equipment that can extend from basic video conferencing to a full fledged suite of telemedicine scopes and devices.

The service scope of Telemedicine deals with Radiology, Cardiology, Dermatology, Neurology, Psychiatry, Oncology, Pathology, and Ophthalmology etc. Telemedicine is of particular value in the area of second opinion services and post surgical follow up for patients.

 

Telemedicine in Africa

Regardless of its contributions in the form of various procedures and discovery of drugs, Africa still faces major healthcare challenges. Unfortunately owing to reasons such as shortages of physicians, specialists, medicines, equipment, and lack of proper awareness was not implemented enough to a level where it can serve its own people.

Telemedicine in Africa, like every other branch of medicine, owes its existence to this imbalance of demand and supply.

Telemedicine challenges in Africa

Although telemedicine holds significant promise in transforming the accessibility of health care, there are still major barriers to its ability to reach the people of this vast and geographically varied continent.

Challenges that influence the sustainability of a telemedicine endeavor include:

Infrastructural Barrier

Lack of broadband infrastructure continues to be a challenge for the sustained implementation of telemedicine in Africa. Telemedicine services comprise synchronous video and asynchronous store-and-forward services, both of which require robust and therefore expensive broadband telecommunication networks. Due to a lack of proper broadband services in rural and remote areas telemedicine remains out of reach in many areas. With weak internet connections, video streams for telemedicine are suboptimal hence the implementation of technology that relies on an infrastructure that optimizes the utilization of bandwidth is the need of the hour.

High Maintenance and Support Costs

An end to end program ensuring that the telemedicine equipment is up and running is a must. Maintenance problems such as parts replacement, software upgrades, and equipment failures need to be addressed immediately by a trained and certified technician. Though a few issues can be resolved by remote troubleshooting procedures, a scenario such as equipment failure will require on-site visits. A lack of availability of locally trained and certified technician makes this task difficult and expensive. The ability to have remote monitoring tools and technologies that permit off-site support can significantly reduce costs and eliminate downtimes.

Staffing and Training

Telemedicine is not just limited to having technology in place; an identifiable, approachable and well qualified human interface to interact with is required for a seamless implementation and sustainability of the process. Hence, there is a need to hire the right kind of paramedical staff and train them properly so that they are well equipped to carry out the task of providing healthcare in remote areas. Competency, Capability, and Capacity play an important role in the success of any Telemedicine initiative.

Human and cultural factors

Human and cultural factors include; user acceptance of new technology by patients and physicians, motivation, training, and support of staff.

A study conducted by Lewin Group in 2000 showed that “User acceptance by the healthcare workers” was the second biggest challenge after the availability of appropriate technology to the successful implementation of Telemedicine.

Apart from the absence of physical examination, patients and physicians resist adopting telemedicine services due to lack of faith in diagnosis. Despite the growing acceptance of telemedicine, there are sections of patients who prefer seeing their doctors in person. It becomes very important to focus and select the right services which can deliver value.

Recent Scenario of Telemedicine in Africa and contributions from India

Even though much progress is needed for larger implementation of Telemedicine in Africa, there’s still a lot of activity that has happened over last few years.

Pan-Africa e-network project, proposed by our former President of India, Late Dr. A P J Abdul Kalam in 2004, at the Pan African Parliament in Johannesburg seeks to connect 53 member states of the Union through a satellite and fiber optic network to enable access expertise between India and African states, in the areas of tele-education, telemedicine, Voice over IP, infotainment, resource mapping, meteorological services, e-governance and e-commerce services.

This project was described as Africa’s biggest ever procurement in the sector of Information and communication technology (ICT) and as expected it extended ICT infrastructure to rural and previously underserved areas.

Phase I of this project was launched on 26 February 2009 which included 11 Countries and Phase II was launched in 2010 which covered 12 countries.

Pan-Africa e-network project and its contribution towards Telemedicine

  • Under the project, telemedicine patient-end locations have been set up in 11 Indian super specialty hospitals. These have been connected to 33 patient-end hospitals in Africa.Regular telemedicine consultations have already started in some of the countries. Burundi, Ivory Coast, Djibouti, Eritrea, Libya, Malawi, Mozambique, Somalia, and Uganda were among other countries that formally joined the network.Facilities and expertise of some of the best universities and super-specialty hospitals in India were made available for people of Africa.
  • Over 1700 students from several African countries had registered with the Indian universities for the various courses being offered under the tele-education component of the Project.
  • Nearly 700 CME (Continuing Medical Education) lectures were conducted through regular telemedical consultations between the African doctors and the Indian specialists.
  • Training at the regional level conducting workshops in the telemedicine and tele-education modules to facilitate better utilization of different aspects of this Project.
  • Various services, such as primary care and specialist referral service, patients monitoring, medical education, and healthcare information were made available via Telemedicine services
  • In recent years, Teleradiology services have been provided to several countries in Africa, which are experiencing major radiologist shortages, from centers in Bangalore etc.

Telemedicine though still in its developing phase in Africa is potentially very useful as a conduit to quality health care. Even if pervasive barriers prevent its wide scale use and application, the benefits of telemedicine are real and significant. After all, every human being on this earth should have access to quality health care which is an equal right for all.

 

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