In Africa, using apps to expand access to healthcare

Serge Mahougnon’s condition was worsening. What little food he ate, he could not keep downIn February 2020, temperatures in Cotonou, Bénin, reached close to 30° Celsius, but Mahougnon was freezing. The 24-year-old financial trader was suffering from Typhoid fever, a disease that begins with intestinal inflammation, and can be fatal.

I couldn’t just wait in a clinic – it’s not even certain you’ll see a doctor when you go. As you sit there waiting and suffering, there are 30 people ahead of you, and the doctor will see them all before you, because the clinics often take people in the order they arrive, even if you have an appointment.

Mahougnon had been bed-ridden for four days when his cousin told him about a mobile phone application that can locate doctors nearby and find clinics that accept his brand of health insurance.

He downloaded GoMedical, booked an appointment for the next day, and received confirmation by SMS. Greeted at the clinic by a GoMedical agent, Mahougnon waited just five minutes to see the doctor.

Changing the habits of both patients and doctors

Launched in 2017 by the Benin startup Open Si, GoMedical – now its own enterprise – processes between 200 and 250 bookings per day across Benin, with some 450 doctors on its books.

Before, “people weren’t making appointments, and they would just go and wait all day if they had to,” says Doria Rey, GoMedical’s Executive Director. “But we’ve seen that we’re helping change the habits of both patients and doctors: people are starting to book appointments, and doctors are honoring them.

Rey says that by easing access to healthcare, apps like this help prevent the widespread practice of self-medication. GoMedical’s subscribers have shot up to more than 22,000 patients in just a few years. Another reason for its success: a virtual “wallet” allows one to add credit or pay for a family member.

A coming boom in Africa’s e-health industry

The innovation is part of a giant leap in mobile health technology. More than 318,000 health apps are available worldwide, according to a 2017 report by science and health data company, IQVIA.

Apps range from general wellness tips to telemedicine for booking and payments. With health management apps, people monitor their health conditions, keep track of medication, and allow healthcare providers to consult and share health records remotely.

Observers point to the proliferation of health apps and increasing mobile connectivity as signs of a coming boom in the e-health industry in Africa.

According to global mobile industry representative GSMA, Sub-Saharan Africa is home to 456 million unique mobile phone users – a phone penetration rate of just 44% compared to 66% worldwide and 86% in Europe.

With a young population at ease with mobile money accounts and apps for shopping, banking and healthcare, that number is expected to rise.

Digital solutions are the future of equitable, quality health care and resilient health systems,” said WHO Regional Director for Africa, Dr Matshidiso Moeti in 2018. “And great strides have been made in boosting telemedicine, eLearning and mobile health in the African region”.

Preparing for possible outbreaks

Innovative e-health initiatives have swept the continent. South African app Hello Doctor enables people to talk to doctors via their mobile phones.

With M-Tiba in Kenya, users can pay for healthcare treatment at a distance and transmit data anonymously, so health authorities can spot trends and prepare for possible outbreaks.

To combat the surge of counterfeit medicines in Nigeria, a group of teens invented the FD-Detector, which analyzes a drug’s barcode to verify its authenticity and expiration date.

Experts urge governments to make the most of this innovation bonanza, by scaling up initiatives and coordinating apps with national health strategies.

Health workers in Uganda for example, use mTrac to submit weekly health surveillance data by SMS to the country’s health management information system. Tracking everything from medicine stocks to disease symptoms and maternal or neonatal deaths, the system then submits data automatically for analysis. Whenever disease symptoms or health problems reach a certain number or level of severity, an SMS alert is sent out.

E-health depends on more than mere technology

recent article in the Lancet argued that with “the world’s largest burden of disease and the most severe shortage of health-care workers,” African countries could benefit most from the proliferation of digital health solutions.

GoMedical plans to add a feature that determines the number of unoccupied beds in nearby hospitals, and another that locates the clinics best equipped to treat certain illnesses.

Among Africa’s obstacles to better care is the vast rural-urban digital divide, with low connectivity in rural areas and low levels of digital literacy.

Of course, e-health depends on more than mere technology. Progress is being held back by the continent’s shortage of well-trained healthcare workers and good quality medicines.

For those now connected like Serge Mahougnon, however, apps and the behavioral shifts they generate can improve care – and save lives.

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This article was originally published in iD4D – Ideas for Development.

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