Connecting people to health in 2018

Gloria Agyeman Oduro is a nurse with the Ghana Health Service. She serves remote communities in the country’s Western Region, where there are roughly 728 potential patients for every nurse. Accessibility is a major challenge to her work.

The average Ghanaian sees a medical professional for their health outside of a hospital just once a year. But what if patients need extra care outside of an annual check-up? How is a nurse like Oduro to keep track of their health with 700 other patients to see?

“We have this WhatsApp group.”Gloria Agyeman Oduro

Oduro uses the popular messaging platform to text her patients and their caretakers (usually relatives) with useful information to help them manage their health, from facts about nutrition to exercise routines.

“We give them messages and they ask questions in the group,” she said.

It doubles as a support system for patients and caretakers. Patients who would otherwise be tempted to abandon their treatment regimen feel accountable to this community and keep going, making for more successful outcomes.

This is a simple version of telemedicine, or the innovative use of ICT for public health.

Ghana’s government has partnered with the One Million Community Health Workers Campaign to train, you guessed it, 1 million health workers over several years so that every community in Ghana has access to health care. Dr. Sonia Ehrlich Sachs, the campaign’s director, wants each of those workers to have a smartphone.

“A smartphone provides the ability to have real-time data, not the usual one or two years later when someone happens to come by and do a survey,” Sachs said. “The way we use it, real-time data coming in from the smartphone allows for real-time management adjustment, which improves community health care.”

Mobile technology’s spread across Ghana in the past five years has been so rapid, it makes Sach’s ambition seem feasible:

  • Sixty-seven percent of the population, or 19 million people, are mobile phone users.
  • Forty-five percent of Ghanaians regularly access the internet on feature phones.
  • A quarter of the population uses smartphones, up from 17 percent in 2013.

Similar numbers are found across Africa. When you compare the rapid expansion of this technology to the rate at which more traditional infrastructure is established, telemedicine becomes an increasingly viable delivery mechanism for public health services.

The Ghana Health System partnered with Columbia University and the Grameen Foundation to implement the Mobile Technology for Community Health, or MoTech, project. This was a test case for whether basic mobile devices could improve infant and maternal outcomes in rural Ghana. Starting in 2010, MoTech distributed prenatal information to expecting mothers via SMS and received health updates from the women’s health workers via SMS. Now there are dozens of mobile-based programs for child and maternal health across the continent.

Nearby in Nigeria, where smartphones are getting picked up quicker than anywhere else in Africa, Mandela Washington Fellow Arikawe Adeolu Oluseyi is also using telemedicine to improve maternal health in underserved communities.

Oluseyi came to telemedicine after realizing that the communities with the highest maternal mortality figures were also the most remote communities. In Nigeria — which has the third highest rate of maternal mortality in the world — mobile phones let him overcome the barrier of distance. Oluseyi encourages other health care workers to consider ICT as a potential solution.

“We have to always look for how technology can help us do our dream better,” he said.

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