African e-health ‘moving in wrong direction’
By Maina Waruru:
Importing or copying the latest 'e-health' technology from developed countries may not be the best way forward for health services in Africa, a conference has heard.A focus on high-tech healthcare solutions could come at the expense of basic prevention such as access to clean water and sanitation, good nutrition and hygiene, and health education, said experts at the AfriHealth conference in Kenya, this week (30 November–1 December).
In a continent where 80 per cent of illnesses stem from preventable infectious diseases, this is a move in the wrong direction, said Yunkap Kwankam, executive director of the International Society for Telemedicine and eHealth.
"While we have a lot to learn in this field from practitioners in the developed world, we must take utmost care not to lose sight of the health needs of our people, as we seem to be doing now," said Kwankam.
"Most African health needs can be solved by the age-old basics of water and sanitation, nutrition and hygiene; if we concentrate on these we will make big strides in the lives of our people."
The conference heard that there was a lack of national e-health and telemedicine strategies (only six African countries have developed a strategy so far) and there is a lack of laws guiding their practice.
Other challenges facing the roll-out of new e-health initiatives are the lack of a legal framework on what qualifies people to work as e-health professionals and the digital divide in skills between the younger and older generations of healthcare professionals.
"E-health in Africa is often practised by non-professionals such as ICT technicians and nurses," said Kwankam. "Countries have not developed criteria on who an e-health professional should be, or what qualifications are needed to be certified as a professional."
Margaret Ogalo, a doctor with Kenya's health ministry said: "The question of how we deal with an older generation of physicians, who are the majority in developing countries and who attended college before the ICT explosion, must be addressed.
"While the younger generation has no problem with new ways of delivering health services, the older generation are resisting and are uncomfortable with situations where we can consult with patients we are not physically seeing," she added.
The majority of older professionals fear the consequences if a diagnosis or consultation conducted remotely via telemedicine goes wrong, according to Shariq Khoja, coordinator of the e-health programme at Aga Khan University, which has health faculties in Kenya and Pakistan.
"It is because of these kinds of concerns that many older professionals seem to have doubts about e-health and telemedicine, and laws need to be put in place to accommodate and mainstream this branch of medicine," said Khoja