Title: EHealth Africa: Overcoming the barriers to its implementation' A Case Study of Sub Sahara Africa'
1E-Health Africa Overcoming the barriers to its
implementation. A Case Study of Sub Sahara Africa.
- Presented by
- Akeh Lucas and Morfaw Zigo
- August , 2007
- Karlstad University
2Introduction
- It is of utmost importance to be in good health.
- Good health will make us happy, means we are
active and productive since healthy citizens will
contribute enormously to the growth and
development of the economy. - Hence, health is very important and calls for
concern around the world. - In Sub Sahara Africa, the health situation
demands greater attention. - The region is a DANGER zone.
- Home to thousands of diseases, including
3Introduction Cont
- Malnutrition, malaria, sleeping sickness,
HIV/AIDS etc these diseases claim millions of
souls every year. - Despite efforts carried out so far, the health
situation seems to be deteriorating everyday. - More efforts are needed.
- New solutions must be put in place to remedy the
health situation. - The authors are of the opinion that e-health will
go a long way to remedy the health situation. - However, studies show that a number of barriers
prevent the successful implementation of E-health
in this region
4Introduction Cont
- The authors intend to identify these barriers and
proffer solutions. - Thus, we intend to answer two very important
questions - 1) What are the barriers that prevents the
successful implementation of E-health in SSA? - 2) How can we overcome these barriers?
5Methodology
Primary data source (Email Phone call) Medical
students, Health care workers, Local
Expert. Anecdotal evidence
Politics, Economic and socio-cultural Factors
dominated the answers observed from both data
sources. Technology considered not to be an
immediate priority
Knowledge about E-health in SSA
Secondary data source. Online databases, e.g.
Emerald, PubMed and ProQuest Direct
International Development Data WHO, UNESCO,
USAID, UNECA, AU
Results
Picture Own Source
6- What is E-health?
- e-health is an emerging field in the
intersection of medical informatics, public
health and business referring to health services
and information delivered or enhanced through the
internet and related technologies. In a broader
sense the term characterises not only a technical
development but also a state-of-the mind, a way
of thinking, an attitude and a commitment for a
networked, global thinking, to improve health
care locally, regionally and worldwide by using
information and communication technology. - Eysenbach (2001), e-health guru
7- Our working definition of e-health is
- the use of ICTs for all aspects of healthcare
from clinical diagnosis, home care delivery,
education of health professionals, transparent
management of health resources to general
e-commerce involving both healthcare providers
and consumers - (Own Source)
- Therefore, what are the benefits of E-health?
8Potential benefits of E-health
- Heeks (2004) identified two benefits such
- 1) task level benefit such as the improvement in
the cost or speed of data handling tasks - 2) improvement in the speed and quality of
health management - Thus, ICTs can cut the costs of tasks and
processes and reduce the time to perform these
tasks and processes - Mbarika et al, (2002) e-health would link
hospitals and other medical institutions and
result to an overall improvement of health care
services, efficiency, and proper monitoring of
patients
9Potential benefits of E-health Cont
- Eysenbach (2001), listed 10Es of E-health, some
of the Es include - 1) Efficiency
- 2) Empowering of consumers and customers
- 3) Education of physicians through online
resources - 4) Ethics as a new form of patient-physician
interaction etc. - They argue SSA stands to benefit these and more
if there is a successful implementation of
E-health system in the region. - So, where is Sub Sahara Africa?
10Locating the Region
- Wikipedia defines SSA as a term used to describe
those countries of the African continent that are
not considered part of political North Africa.
The dividing line is the southern edge of the
Sahara Desert, though Chad, Mali, Mauritania, and
Niger belong to both regions. As shown in the map
the North and Sub Sahara regions of Africa have
been separated by the harsh climate of the
sparsely populated Sahara. - Source http//www.idrc.ca/uploads/user-S/111841
66631Map_-_Africa_LRG.jpg
11Health and ICTs in SSA
- The spread of the internet in various parts of
the world have highlighted the fact that SSA,
part of the worlds second largest continent is
the region with the lowest level of economic,
technological and internet development in the
world. There is still very low level of internet
connectivity. - UN Global E-government reports (2003, 2004, 2005,
and 2006) proved that middle Africa has the
lowest rate of e-readiness in the world - Internet World Stat (2006) proved that Africa,
despite the fact that it inhabit 14.10 per cent
of the worlds total population and way ahead of
Europe (12.40 per cent), North America (5.10 per
cent) Middle America (2.9 per cent) etc use only
2.60 of the worlds total internet usage. - However,
12However,
- SSA countries are becoming more aware of the
potentials of ICTs especially in the health care
sector. - In many SSA countries sporadic use of ICTs use in
the health sector have been initiated and carried
out by government and foreign donors e.g. Ghana,
Kenya etc. - But many of these projects fail or do not achieve
the desired results. - So, Why do these projects fail? Why is it
difficult to implement successful e-health
systems in this region? - Barriers???
13Barriers to e-health implementation in Sub Sahara
Africa.
- Based on our research method, we have classified
barriers to e-health in four categories
political, economic, socio-cultural and technical
barriers as shown in the diagram - (Own Source)
14Political barrier has to deal with the following
leadership and vision, political will, self
interest, corruption, low expectancy of
governmental organisationsWHO (2005), few
governments have develop roadmaps for e-health,
but most are still lagging behind due to lack of
vision and insufficient political willOECD
(2005) reports lack of e-health experts or
leaders to champion e-health projectsHaque et
al. (2006) Sub Sahara Africa is governed by
leaders who prefer the status quo or present
state of affairs (leaders are afraid of
change)Ajayi (2006) argues that corruption is
endemic and leaders are pushed by greed to
satisfy their own personal ambitions
15- Transparency International agree that SSA is home
to the worlds most corrupt countries - Amokeode (2004) states that about 100 billion
was stolen from Nigeria alone by its leaders from
1993 to 1998 during the leadership of Late
General Sanni Abacha - These trends have not changed much
- Hence money meant for public expenditures are
directed to private pockets - There are also legal barriers that prevent the
adoption and use of ICTs in the health care
sector - WITSA (2006) most government enact laws that
prevent advances in technology e.g. regulations
may require health care providers to maintain
patients record in a paper-based format such
laws are barriers to the use of ICTs in the
health sector
16- Economic barriers include financial resources at
the disposal of the governments. E-health, like
e-business, e-government and e-education cannot
succeed without a well established communication
networks - WBG (2005) reports, that there are a multitude of
projects apart from e-health in this region,
hence, e-health projects will have to compete
with other projects for the limited resources - UNDP (2004) citizens in this region are very poor
and they cannot afford basic essentials such as
food and clean water and 70 live in rural areas
far away from the urban areas where most ICTs are
found - Also there are frequent power cuts which is a
barrier to e-health. Frequent power cuts leads to
loss of data - UNECA (2005) under developed telecommunication
infrastructure is another potential barrier to
e-health development in SSA
17- UNECA argue that SSA has to invest heavily in
infrastructure in order to benefit from the
opportunities offered by ICTs - Internet World Stats, SSA has less than 2 per
cent of the Worlds telephone lines, less than 1.5
per cent of the total number of PCs, and less
than 1 per cent of the total internet users.
These low figures are all barriers to e-health
adoption
18- SSA has one of the worlds lowest adult literacy
rate, with only 60 per cent of the population of
15 and over able to read and write in 2000.
UNESCO Global Monitoring Report (2006) - Lack of trained professionals and skills in
disseminating ICTs based training in e-health - Issue of digital divide within and without
countries in this region - Shortage of medical personnel, particularly
specialists - Some doctors not willing to accept a change to
new technology (resistance to change) - Local health care workers fear this change may
lead to job loss - Patients also not willing to stay away from their
doctors for fear of their confidentiality of
medical records
19- Overcoming barriers to e-health development in
SSA. - This part has been broken down into two
- 1) what governments, organisations, individuals,
scholars have said and have done and are doing
and, - 2) What the authors believe ought to be done.
20Solutions to political barriers
- Legislation amended to reduce taxes on ICTs
equipments - The need for New Public Management, hence a
general overhaul of the public service - Corruption must be stamped and be punishable by
law - Embezzled funds must be redirected to finance
e-health projects - The need for e-health experts
21- Solutions to Economic barriers
- Infrastructure development
- Poverty alleviation
- Assistance from donor organisations
- Solutions to Socio-Cultural barriers
- Education
- Digital divides
- Use of ICTs in public services
22- What ought to be done
- It is important to identify the barriers first
and potential barriers. - Examine their nature, the causes of the barriers
and which of these barriers are the most
problematic - Can a solution to these problematic barriers
result to the elimination of all other barriers - Proffer solutions to tackle them
23Priority factor
- Governments, the civil society, organisations
should concentrate on educating citizens in Sub
Sahara Africa. - Education has the potential to eliminate most of
the barriers to e-health in the region. It will - Empower citizens of the region
- Create employment
- Provide e-health experts
- Reduce resistance to change
- Bridged the digital divide and produce upright
citizens.
24So what should governments do?
- Education should be provided free in primary
schools - ICTs should be made compulsory in the national
curriculum in primary, secondary and tertiary
institutions. - Governments should offer scholarships for
students to be trained in advanced ICT
institutions.
25- Conclusion
- Research was out to
- Identify barriers to the successful
implementation of E-health in SSA - Discuss solutions to these barriers.
- This has been done. E-health in SSA faces a
number challenges which includes political,
economic, socio-cultural and technological
challenges. - So what is the way forward?
- Reforms are needed, bridging the digital divide
is an urgent issue, education is of primary
importance to bridge this divide - Urgent need for better public management and good
governance. - Assistance is needed from Multi-national
Corporation and foreign donors etc - We would like to say that SSA governments have
to do better than what they have done. It is not
a rich institutional arrangement that matters. It
is not attending conferences and signing papers
that matters. What is needed is action. Words,
policies, strategies, must be matched with
actions. - THANKS FOR LISTENING