The CCIH 2021 conference was held May 11 through 27 and brought together people from across the globe for fellowship, learning, and to share their successes and challenges in their work. Each day focused on a different theme in global health. Here are reflections from the fifth day, May 25, where we focused on technology to enhance health care and health systems.
Healthcare is a Basic Human Right
Access to affordable, high-quality healthcare is a basic human right that simply does not exist in many countries, including low- and middle-income countries (LMICs) and some higher income countries.
The recent COVID-19 pandemic has placed unprecedented strain on all healthcare systems, fueling the need for innovative strategies to provide accessible, affordable, high-quality healthcare in a timely manner. Technology provides a tool box that can be used innovatively to create more efficient and accessible healthcare systems that provide equitable services.
Mobile-Based Self-Renewal Systems
As Dr. Lydia Dsane-Selby, Chief Executive Officer, Ghana’s National Health Insurance put it, “Pooling together resources prior to the actual need of them, is the only way to ensure equal access to healthcare.” National health insurance is one of many strategies that can be utilized to ensure this, although there are a number of challenges in implementation.
The Ghana National Health Insurance Scheme (NHIS) provides one of the best examples of how technology can be used to ensure healthcare services are accessible for everyone. The dilemma they faced was that many Ghanians were registered for NHIS, but few could stay active due to the inefficiency of the renewal process.
This meant that many were unable to use health services because they could not afford the fees. So the Ghanian Federal Government decided to launch a self-renewal system that could be done via mobile phone. To solve the issue of no longer having physical insurance cards, they created platforms that could be used by the different healthcare facilities.
Just six months after implementing the system, they noted that 75 percent of all members had renewed their insurance card via mobile app. And the best part of all of this, is that the creation and implementation of the system was quite inexpensive, meaning that many other LMICs would likely be able to easily adopt and implement such a system within their own countries. Watch the interview
The Ideal Digital Solution
Many mainstream tools can be utilized for telehealth, including mobile phones and computer apps, browser platforms, as well as various social media platforms. These are great, especially for use in countries with a high literacy rate and access to strong internet. But what if we could design and create something novel, specifically for the healthcare systems and with lower and middle income countries in mind? What would an ideal digital solution that provides healthcare for the marginalized look like?
As Dr. Sunil Anand, Asia Regional Director, American Leprosy Missions (ALM) put it, “ideally it would provide integrated services, on a smartphone-based platform, with a user-friendly interface that is accessible to the illiterate, while still providing practical data to healthcare workers, most likely icon-based to remove any language barriers.” Sounds like a dream tool doesn’t it?
In India, ALM has designed such a platform called DHARA WL2 (Digital @ Home-Based Artificial Intelligence Enabled Real-Time Appropriate Interventions for WASH, Leprosy and Lymphatic Filariasis). It is a platform capable of screening, grading, managing and delivering high-quality services for Water, Sanitation and Hygiene (WASH) and Neglected Tropical Diseases (NTDs). It has an icon-based module, a photo-based computer vision module and a GIS (Geographic Information System) module. These modules allow for the prevention and treatment of diseases, education and therapy for disabilities, provision of WASH, and nutrition, as well as the mapping of socio-economic demographics.
DHARA WL2 is a single platform that screens for factors like disease, disability, nutrition, WASH, and socio-economic demographic. It provides data and information on risk profile, social benefits, health promotion, first-line treatment, telemedicine, facility referral and livelihood guidance.
This type of platform is revolutionary and empowers people through the use of a precise, individualized service at home. It provides decision makers and healthcare workers with automated analytics in real time so they can make accurate and timely decisions. Due to the fact that it does not rely on literacy or language, it can be applied and adopted into healthcare systems globally. Watch Dr. Anand’s Presentation
Speaking of languages, during the COVID-19 pandemic, this was one of the unspoken barriers that had an impact on communities and the dispersion of information. Many people who spoke minor languages had no accessible resources. So SIL Lead, “a faith-based non-profit that helps local community-based organizations use their own languages to improve their quality of life,” decided to spark a small, yet impactful initiative. SIL LEAD translated the simple phrase “Wash your Hands” in over 650 languages, providing printable handouts on their platform. SIL Lead also took a small comic book developed by Weiman Kow on COVID-19 and made it accessible on their Bloom software, so that others could translate it and use it as a simple and practical resource. Watch Dr. Frank’s Presentation
Taking WhatsApp to the Next Level
WhatsApp is a technology that has gained a lot of traction recently for its user-friendly features and reach. It is a free Wi-Fi/Data-based messaging and calling platform that also allows for the transmission of a variety of media. Andrea Kaufmann, Director for Faith and External Engagement, World Vision International shared how World Vision utilized their preexisting WhatsApp networks to connect with faith leaders during the pandemic. They designed a WhatsApp survey to determine what faith leaders knew about COVID-19, and what they were doing to support, educate, and assist people within their communities.
From these surveys, they discovered that about 80 percent of faith leaders were sharing, teaching or preaching accurate information about COVID (sourced from the World Health Organization and local Ministries of Health). Not only were faith leaders sharing information, but they were actively correcting misinformation. Once conversations of the vaccine came about, they began requesting resources and tools. So World Vision International went a step further, and set up virtual training workshops for pastors and other faith leaders, all via WhatsApp.
This innovative use of WhatsApp revealed the potential use for low-bandwidth virtual platforms to ensure the accurate spread of healthcare information. Additionally, these platforms can be used to combat misinformation and ultimately learn of vulnerabilities and potential opportunities to equip communities with what they really need. Learn more about how you can maximize your WhatsApp account. CCIH members can access a how-to video on using and optimizing social media to lift up their cause, especially for nonprofits. If you are a CCIH member, log in to the member portal and visit Member Only Resources. Watch Andrea Kaufmann’s Presentation
Due to the burden COVID-19 put on healthcare systems, many people went undiagnosed or lacked treatment for other diseases. This was due to either a fear of contracting COVID-19 from hospitals or the lack of space or workforce to care for patients.
How could technology solve such a complex issue? While technology may not solve all problems, tools like telehealth can ease some of the burden that hospitals and clinics face in triaging and diagnosing patients.
Telehealth is a broad term that encompasses the use of all communication technologies, like computers and mobile devices, in order to make healthcare accessible remotely. It has suddenly taken the world by storm in almost every region of the world that has access to fairly stable internet. More and more practitioners turned to it in the height of the pandemic, and many are continuing its use. This technology has allowed hospitals, clinics and other practices to have a much wider reach.
At CURE Kenya, the implementation of telehealth has provided so much freedom and flexibility for families and practitioners. It has allowed for enhanced remote patient care, improved healthcare education, collaboration between practitioners, enhanced outreach and care to patients that may otherwise be unable to come to a hospital. Just imagine how difficult it is for a family with a severely disabled child and limited access to a motorized vehicle to bring their child in weekly for checkups or physical therapy. With telehealth, practitioners can be kept up-to-date about their patients’ well-being and keep track of their progress, all from that family’s home. This takes a burden off of both families and hospitals, and the children still receive care they need. The hospital sees less patients in person, providing more space and time to treat even more patients.
But with every great solution, there are usually a handful of problems. In this case many of the challenges lie within social and cultural norms. According to Nelson Muoki, MBA, Development and Programs Manager, CURE Kenya, “the biggest challenge with telehealth in Kenya is getting patients and practitioners alike to put aside their biases, social and cultural norms in order to fully embrace this technology”. Many have a distrust for non-face to face channels of communication. Additionally, newer apps and programs are incompatible with older technology systems, creating a bit of a divide in terms of access. Finally, as with most technology-based systems today, there is always the concern for data security and privacy. Telehealth is such a novel development that there is still a lack of policies and regulatory frameworks for it in many countries. Watch Nelson Muoki’s Presentation
Technology is a very powerful toolbox that provides an array of innovative solutions for the healthcare sector. While technology can be used in a negative way, we can demonstrate how it can be used for good and for the glory of God. Humans have been gifted with creativity, which, when paired with the faith of believers, creates a force and dynamic that can provide innovative solutions to seemingly unsolvable problems.
About the Author: Rebecca Strachan has recently completed her Masters in Nutrition and Biomedicine at the Technical University of Munich. She is an aspiring young researcher, who hopes to utilize her knowledge of nutrition to make an impact in the biomedical field.