By SOLA OGUNDIPE
FOR Nigerians who can afford it, seeking medical attention abroad is routine. No thanks to them, health professionals within the medical industry in the United Kingdom, United States of America, Germany, and increasingly, South Africa and India, are smiling to the banks.
For Nigeria to reverse this ugly trend, and position itself to achieve Vision 20:20:20 and the Millennium Development Goals (MDGs), the establishment of good healthcare delivery system is non-negotiable.
No doubt, a number of factors have hampered the rapid growth of the country’s healthcare system, range from inadequate facilities/infrastructure, shortage of personnel, Information system, inadequate training and high illiteracy rate among the people, power (electricity) and bandwidth. However, in some parts of the world, telemedicine has been used to overcome these challenges.
Over the past few years, efforts have been made by the government to address these challenges. In line with the Declaration of the Alma-Ata in 1978 which highlights health as the most important “world-wide social good” and the United Nations 2000 Declaration of the Millennium Development Goals, Nigeria has been striving to harness its resources to achieve efficient and functional healthcare for its people.
Specifically, the National Primary Healthcare Development Agency, an agency under the Health Ministry in Nigeria responsible for development and strengthening of primary healthcare nationwide, was formed to support the promotion and sustenability of high quality primary healthcare system and achieve the Millennium Development Goals relating to the health sector.
Alongside efforts by the World Health Organisation and the various UN agencies that deal with health-related issues to improve the healthcare delivery system, concerted efforts are being made to reduce the differential access to technology of the developed and the developing world.
It is at the convergence of health and technology that eHealth initiatives evolved, creating an unprecedented opportunity to improve access to services and innovations. So what is the way out? Enter the mobile health (mHealth) initiative.
Stakeholders at a recent mobile health (mHealth) workshop put together by MTN Nigeria, voted in favour of adoption of the mobile healthcare system. Already, a United Nations report notes that this system has capacity to help meet four of the eight Millennium Development Goals, MDGs. Basically, mHealth broadly encompasses the use of mobile telecommunications devices and multimedia technologies as they are integrated within increasingly mobile and wireless healthcare delivery system.
In order words, it is the practice of medical and public healthcare supported by a mobile device, including the use of voice, data and SMS. By adopting mHealth in the healthcare delivery system, many more people, will potentially be reached and the health of the people and communities will be greatly enhanced.
This approach is particularly important due to the rapid adoption of mobile phone technology in developing countries. While mHealth has matured in industrialised nations, the field is still evolving in a developing country such as Nigeria. But argument for it is strong. As mobile technology grows, more and more people acquire mobile phones and other mobile devices, making them part of their everyday lives.
It then becomes easier for medical personnel to interact with them and provide health services, obtain health information to aid their researches and make it easy for them to provide the right medical solutions to health challenges in remote locations.
It affords the medical personnel the ease of monitoring their patients regardless of their location. Instances abound. Researchers are routinely exploiting the potentials of common cell phones by adapting them to help health workers diagnose and manage sundry disorders and ailments. With the aid of smartphone-based applications, it is now possible to conduct simple but life-saving diagnostic and treatment manuals, and tools to calculate pulse, respiratory rate, and proper drug dosages.
The adaptation of such inexpensive technology to healthcare needs is a fast growing trend across the world. A good one is the latest Apple iPhone which has an in-built device that can monitor a patient’s heartbeat. The phone now carries the epitaph, the mobile stethoscope. With that kind of information, a patient can monitor his heart rate and send the information to his doctor who makes use of the information to prescribe the right medication, without necessarily seeing the patient, face-to-face.
Clinicians are also finding iPads they are carrying around are the best new tool for helping elderly patients improve mobility, engagement and even reduce the symptoms of Alzhiemers’ or stroke. For hospitals, the value may be more in keeping older patient engaged during inpatient stays, and improving their compliance, mobility and health at home to prevent re-admissions after discharge.
“iPads are also showing up in hospitals, where medical professionals are using them to access patient records, to review medical images, to administer bedside care,” Apple’s new CEO, Tim Cook said at the iPhone 4S launch event. “Over 80 percent of the top hospitals in the US are now testing or piloting iPad. Indeed, healthcare organisations are fast realising that mobile apps provide opportunities to reach new customers, improve the customer experience, and offer competitive differentiators to improve internal workflow.
According to research, because of the rapid evolution of mobile devices, physician demand, and the healthcare enterprise’s need to improve quality and efficiencies, the market for healthcare mobile apps is expected rise to an unprecedented $1.7 billion by 2014.
Even the American Food and Drug Administration, FDA, is loosening up its marketing definitions, and being more specific about mHealth accessories, and is creating a risk profile for mobile software.
A new study by University of Maryland School of Medicine researchers, published in the September issue of the journal Diabetes Care, is one of the first to scientifically examine mobile health technology.
The study indicates that using mobile phones, the Internet and other mobile communications technology to keep patients healthy may have broad applications to help patients and their physicians manage many health conditions.
According to the Principal Investigator, Dr. Charlene C. Quinn, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine, “Mobile health has the potential to help patients better self-manage any chronic disease, not just diabetes.” He describes it as one of the first large, reported, randomized clinical studies examining the mobile health industry, which is rapidly growing.
The main objective of eHealth is to use ICT tools and services such as computers, PDAs, mobile phones, internet access, satellite receivers, etc, to improve healthcare service delivery. In developed countries, most of the eHealth (telemedicine) services are focused on computer based health information system.
However, a shift has occurred in the use of ICT for health which considers the widespread appeal for mobile phones. In a paper written by Patricia Mechael on mHealth in developing countries, as at May 2008, 21.2 percent of the world’s population was using the internet which comprises 5.3 percent in Africa, 14.0 percent in Asia, 23.8 percent in Latin America and 73.4 percent in North America.
More impressively, the number of mobile phone subscribers has grown to 3.4 billion or approximately half of the world’s population with the greatest growth in Asia, Middle East and Africa. Mobile technologies therefore have enabled the mHealth system to decentralize and extend their reach to remote settings, as well as to the people.
Nigeria currently has 80 million active telephone subscribers in just a decade after the launch of GSM and the country is said to have the fasted growing market in the world. Studies of the mHealth system has shown a high success rate in other developing countries like India, Kenya, Tanzania, etc and penetration of mobile network has been a key driver of its high rate of success. The Health Ministry, through its agency, seeks to achieve same for Nigeria, part of which is why it adopted the Public Private Partnership model.
In India for instance, the mHealth model has been successful. The pharmaceutical as well as medical companies are remodeling their business to fit into the system. The first major mHealth intervention was introduced by the popular Apollo Hospital which used telemedicine to provide medical services to people in rural and sub-urban India through an audio-visual delivery system as qualified doctors are scare in those areas.
Also a developing country with a population of 1.21 billion people, India’s mHealth service has successfully provided quality healthcare services to the people and the country has been constantly as a model to be emulated by countries.
Underling the involvement of leading telecommunications provider, MTN Nigeria in the mHealth discourse, a robust CSR policy, said Akinwale Goodluck, Corporate Services Executive, MTN, forms part of the company’s business model. According to Goodluck, MTN’s extensive network coverage, services and solutions will be a vital component in expanding the potential impact of policies and actions geared towards providing healthcare services in Nigeria.
The company is in a position to drive the mHealth service initiative, not just for a commercial opportunity, but also as an opportunity to implement its Corporate Social Investments that will positively and massively impact the people.
MTN has taken this further with its Y’ello Doctor Mobile Medical Intervention Scheme, a project being implemented under the Health Portfolio of its Foundation. This scheme seeks to take doctors to the people especially those in rural areas who cannot afford to transport themselves to bigger towns to access proper medical care. mHealth services will be an upgrade of the Y’ello Mobile Doctor on a bigger scale.
A workshop in Lagos recently featured health experts from the government and private sectors who advanced various options for a successful mHealth service delivery in the health ecosystem of the country.
Stakeholders in the healthcare sector from the National Primary Healthcare Development Agency, Adstrat Global Health Solutions, NEPAD Council, UNICEF, Intel, 3 Way communications, Sickle Cell Foundation of Nigeria, FunMObile, One Number, VAS2NET, and a host of other participants, highlighted case studies and pilots currently running in some of the rural areas and could be scaled up nationally.
For a company with over 40 million subscribers, Fabian Blank, a Principal Partner of McKinsey and Company believes that MTN is well equipped and positioned to manage the mechanism of mHealth service. From transmission, recognition, billing system and connectivity, the telecoms operator will play a vital role in the success of mHealth service.
Mr. Eugen Ivase, Head of PPP in the National Primary Healthcare Development Agency (NPHCDA), commended MTN for providing the platform for stakeholders to deliberate and chart the way forward in the healthcare ecosystem. According to Ivase, the steps being taken by the company is in line with that of the NPHCDA, among other activities geared towards achieving the country’s MDGs and Vision 20:20:20.
Certainly Nigeria stands to benefit from mHealth. Medically, Nigerians will get better and quicker access to qualitative healthcare and economically, it will lay the foundation for stemming the tide of medical tourism and open up new frontiers in the medical and technological sphere in the country.
Dr. Adesina Iluyemi, a medical practitioner and co-founder of ModiSe, mHealth will create a whole new market in Nigeria and further contribute to the growth of the economy of the country. Dr. Iluyemi believes that a functional mHealth system will reduce the emigration of health personnel for greener pastures and create a new revenue stream for the country through those coming into Nigeria to seek solutions to medical challenges.
One unanimous agreement by stakeholders was that technology will be the key driver of establishing a modern healthcare delivery system in Nigeria and telecommunications companies are well positioned to help bring this about. However, the success of the ecosystem will be dependent on the resolution of the critical obstacles in the health system.