How African patients benefit from digital health services

With rising internet connectivity, African governments are turning to digital health services to address a health worker shortage — and to better connect rural communities. However, not everyone is quick to catch on.

ADVERTISEMENT
Harriet Uwanziga is one of several million Rwandans who have used the services of Babyl, a digital health service provider with a global patient network in 15 countries.

Only three years ago, Babyl collaborated with the Rwandan government to create Africa’s first digital universal primary care service, with the goal of increasing access to health care throughout the small East African country.

Babyl is reliant on the rapid expansion of internet and phone services in Rwanda. It provides health consultations, doctor’s appointments, and other services. SMS messages can be used to arrange prescriptions, referrals, and payment.

In Kampala, Uganda, a smartphone user In Kampala, Uganda, a smartphone user
Patients can communicate with their health care providers via SMS and messaging apps.
Photographer: ISAAC KASAMANI/AFP/Getty Images
Uwanziga, on the other hand, is skeptical. “I don’t have faith in this digital system,” she told DW. “There might be a misdiagnosis, a patient may experience certain symptoms identical for different illnesses. It’s best to see a doctor for a thorough examination.”

The concept of Babyl Babyl Rwanda is well aware of the skepticism. However, it has attempted to dispel any doubts with an elaborate philosophy dating back 2,500 years to the ancient city of Babylon.

“Citizens seeking medical advice frequently gathered in the town square to share ideas on treatments for common illnesses,” according to the company’s website. “This is one of the earliest examples of healthcare democratization.”

The concept is straightforward: a registered patient sends an SMS code to schedule an appointment, and a doctor calls the patient’s mobile phone at the agreed-upon time. In accordance with additional SMS codes sent via Babyl, the patient’s local pharmacy or health care facility will dispense the prescribed medicine or conduct laboratory tests.

Close-up of hands at a pharmacy packaging tablets Close-up of hands at a pharmacy packaging tablets
After showing an SMS code, patients can pick up their medication at a local pharmacy.
Photographer: BARBARA DEBOUT/AFP/Getty Images
‘It’s not easy to break into the market.’
Babyl Rwanda’s medical director, Calliope Simba, described the company’s difficult path to success.

“It was difficult to penetrate the market due to low levels of literacy in digital health care services,” Simba explained to DW. “We still need to make sure that everyone in the country understands that doing consultations online is possible.”

Simba hopes that his services will help improve access to medical services and alleviate a number of issues caused by the sector’s numerous deficits in the long run.

“In health, there is a shortage of human resources, and we have a doctor-patient ratio of one to 80,000,” he explained. Furthermore, many doctors and nurses prefer to work in cities, he claims. As a result, digital consultations would make it easier for rural residents to access services.

A text message is displayed on a cell phone.

A text message is displayed on a cell phone.
SMS messages can be used to arrange prescriptions, referrals, and payments.
SolidarMed Digital services aid in the reduction of health-care costs.
Access to health services remains a major challenge for many African countries. According to the World Health Organization, Africa has three doctors for every 10,000 people, compared to 84 doctors for every 10,000 people in Germany.

According to the Global Perspectives Initiative, a German NGO that works to develop new approaches to meeting the UN’s sustainable development goals, health centers in African countries are frequently far away, equipment is insufficient, and services are expensive.

Health insurance is uncommon in Africa, where many people must pay for their own medical care. In this context, digital services help to further reduce costs such as long-distance doctor visits.

In a bedroom, an African family relaxes with a newspaper and a tablet.

In a bedroom, an African family relaxes with a newspaper and a tablet.
Smartphones and mobile devices have long been a part of African daily life.
Blend Images/Hello Lovely/picture collaboration
Africa is setting the standard for digital health strategies.
Hannah Hölscher, global health project manager at the Global Perspectives Initiative, spoke with DW about how digital technology has aided in the development of health services on the continent.

“In Nigeria, LifeBank provides a 24-hour service that delivers blood and oxygen directly to your door,” she explained. “In Kenya, Suri Health operates a virtual hospital with doctor appointments.

“Africa has a young population, and many of these young people are well-educated and familiar with digital technologies,” Hölscher explained.

“41 countries have developed digital health strategies. In European countries, there is no such thing.”

However, financing for such programs remains a challenge, she added, urging more investment in the sector.

ADVERTISEMENT
Infrastructure and education are critical to expanding health-care services.
Michael Hobbins of the Swiss NGO SolidarMed emphasized Africa’s innovative potential as well. In the health sector, however, he observes significant variation across countries and regions.

“There are hospitals without computers or internet access, and documentation is kept in large, handwritten books,” Hobbins told DW.

“Papers containing data are sometimes transported several kilometers for digitization.” Others, primarily private hospitals in major cities, had gone digital-only, he noted.

Hobbins advocated for investments in infrastructure and education, highlighting the dangers of relying on digital services in areas where people are digitally illiterate. Patients would still rely on face-to-face contact in such areas, he said.

Hobbins also mentioned a number of unresolved legal issues, including who has access to patients’ data and how it is protected.

“Digitalization is important in developing health services, but it is not the most important factor,” he said.