March 2023 - eHealth Africa

By Judith Owoicho

Tuberculosis is a big burden in Africa. The region accounts for more than half of the 30 high-burden TB countries worldwide. In 2020, at least half a million lives were sadly lost to this curable and preventable disease in Africa.

Efforts have been made in funding and creating more testing and diagnostic options, however, in many rural villages in Africa, access to modern diagnostics facilities is a significant challenge that results in delayed diagnosis, inadequate treatment, and poor health outcomes for tuberculosis. Lack of the necessary infrastructure and resources, such as electricity, water, and transportation, to set up and operate modern diagnostic facilities continue to impede the elimination of tuberculosis in the region. More effort is required to connect rural populations with central modern diagnostics facilities for TB/HIV diagnostics and care.

Digital technology has shown significant potential in advancing disease surveillance, monitoring, management, and care. It is being applied in innovative ways to help overcome barriers to prevention, detection, treatment, and management of infectious diseases including tuberculosis, to promote treatment adherence, support learning and knowledge dissemination progress in low and middle-income countries. One of such technologies is the Health Telematics Infrastructure (HTI).

Bridging the gap between rural population and urban diagnostic facilities

eHealth Africa worked with the Charité University of Medicine to design HTI, a digital solution to improve, analyze, and evaluate the diagnosis and treatment of TB and HIV. It was implemented in St. Francis Referral Hospital (SFRH), Ifakara Health Institute (IHI) in Ifakara, and Kilombero District, Central Tanzania. The system is a low-cost open-source software solution that captures data, tracks samples, and provides healthcare workers and patients with real-time feedback via SMS. With this digital platform, nurses can access a TB Diagnostics Dashboard on an android phone to view patients’ information and make decisions based on their test results. Patients or disease suspects are registered using an OpenDataKit form template, while sputum/blood samples are labeled with pre-printed QR codes to track shipment status from collection to the central diagnostic facility. Laboratory staff enter the test results into the HTI database, and rural healthcare staff/patients are informed about the availability of test results via SMS messages. So, Instead of patients traveling to facilities, samples and information are transported and managed by the HTI system, which works under low-bandwidth and unstable internet conditions, anywhere with at least 2G coverage.

Overall, the system significantly shortened the previously long turnaround time from first symptom until treatment initiation, it eliminated the paper based workflow and delayed information transmission replacing it with a digital workflow. It shortened the long distance to the molecular test facility by providing mechanisms for village level tests and it eliminated the high financial burden by moving samples and data instead of patients.

Community engagement and involvement

Digital tools such as the HTI offer viable solutions to the challenges faced by rural communities, enabling them to access high-quality healthcare regardless of their location. To ensure the success of digital solutions especially in rural communities, it is important to involve local communities in the planning and implementation process. Community engagement can help to identify the specific needs and challenges faced by rural populations, as well as the most effective ways to address them. In rural Tanzania, there was awareness creation for the communities and in addition, capacity building for community health workers. This ensured that more cases of TB were identified and the rapid spread of the disease curtailed. By involving local communities and organizations in the process, we can ensure the success of these initiatives and work towards a future where all populations have access to modern diagnostics facilities for effective management and control of infectious diseases.

By Judith Owoicho

The theme for international women’s day 2023 has a clear and loud message for all. It says DigitALL: it is a call for inclusion, a call for a world where innovation and technology can be used by more women and for the needs of more women and girls.

Technology has certainly improved the quality of lives and opened doors to opportunities for many around the world. In healthcare, the rapid transformation of healthcare delivery has offered a range of solutions to improve access to healthcare, reduce costs, and improve health outcomes, but not without ushering in a fresh stream of inequality, especially across gender lines.

Despite the potential and adoption of digital health technologies, it is often limited by gender-based disparities in access, use, and benefits. The effects of this inequality are far-reaching, but primarily it has led to a limited understanding of the healthcare needs of women and other marginalized groups. Achieving gender equity in digital health practice has never been this urgent. Here are 4 reasons we must achieve gender equity in digital health.

1. Innovations tailored to the needs of women

It is not uncommon to see digital health tools and innovations developed with no single woman in the room. This can often leave gaps either out of ignorance or just simply failing to see the priority. Research reveals that most digital tools were typically designed for the universal user: a middle-class male. This shows itself in devices that do not fit well on female bodies or that targeted options like menstrual tracking options not initially included in the smartwatch design.

Women have unique health needs and often experience a range of health issues that are specific to their gender, including menstrual health, reproductive health, and menopause. With more women in these rooms, we can ensure that the needs of women are taken into consideration.

2. Economic growth and productivity

Building digital skills in women and girls can create a path to the labor market through internships, apprenticeships, and job placement programs. The eHA academy has added the all-female cohort to their software development and network engineering training academy so that more young women at the early stages of their career can adopt software development/ design skills. The academy sends them off to internships after the training, creating pathways to economic prosperity. Ensuring that women and girls have equal access to and use of digital technologies — mobile phones, computers, and the internet — is central to their economic and social empowerment and inclusive economic recovery.

3. Reduced disparities in access to healthcare for women

Gender bias is a pervasive problem in healthcare, including in the digital health sector. Without addressing this bias, we risk further driving existing disparities in healthcare access and outcomes. Studies have shown that women use more online health and medical information than men. This could suggest If more women have digital skills, it could reduce disparities in access to healthcare for women. Acquiring digital skills will enable them to access information and resources related to healthcare through the internet and they can be better informed and able to take more control of their own health and make informed decisions.

4. Increasing workforce diversity

Achieving gender equity in digital health practice can promote fairness and equal opportunities in the workplace. This will also help increase diversity in the workforce. Promoting the participation of women in digital health will introduce new perspectives and ideas to the field, ultimately leading to better outcomes for patients. By improving health outcomes and increasing workforce diversity, we can create a more productive and inclusive healthcare sector.

We realize that many factors, including social norms, poverty, access to electricity, illiteracy, and even more, are at the intersection of this unevenness in digital skills distribution. But as we move farther into the digital future, we must all collaborate and start from where we are to leave no woman or girl behind.

On this International Women’s Day, we call on collaboration from the government, private sector, and civil society organizations to DigitALL. Let’s move from imagining a gender-equal world free of bias, stereotypes, and discrimination to living in it.

Month: March 2023

How Digital Tools Connect Rural Populations with Modern Diagnostics and Treatment for Tuberculosis (TB)