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PharmAccess, Sanofi and CarePay partner to digitize diabetes and hypertension care in Kenya

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An innovative pilot that will empower patients to access affordable and quality NCD care with a mobile phone and offers healthcare financing stakeholders a potentially scalable and efficient service model.

PharmAccess, CarePay and Sanofi have announced a new partnership, Ngao Ya Afya (“Shield for Health”). Ngao Ya Afya aims to facilitate access to better diabetes and hypertension care in Kenya through a low cost, mobile technology enabled model. The partnership is committed to advancing patient access to care and testing new solutions to support government and private payers address healthcare affordability and financing challenges.

Non-Communicable Diseases (NCDs) are the leading cause of death globally, killing 41 million people each year, equivalent to 71% of all deaths globally . NCDs account for 27% of the total deaths and over 50% of total hospital admissions in Kenya . The highest risks of dying from NCDs are in low and middle-income countries (LMIC) – especially sub-Saharan Africa – with 85% of these deaths occurring in LMICs. Worldwide these countries are struggling to scale up NCD response due to lack of funding, staff and infrastructure. This program aims to use mobile technology to show how access to diabetes and hypertension care for individuals and their families across some of the most deprived regions can be increased.

(Dr. Loise Nyanjau, Cardiovascular Focal Point, NCD Unit, Ministry of Health Kenya & Dr. Eva Njenga, Chair NCD Alliance Kenya)

At the core of Ngao Ya Afya is M-TIBA, a health finance platform, integrating payments and transforming health schemes to drive healthcare inclusion. Funds on M-TIBA are specifically dedicated for healthcare and can only be used to pay for selected health schemes and services at accredited healthcare facilities. Over one million Kenyans have registered on M-TIBA through a range of healthcare insurance, savings and donor-funded programs. The rapid growth of M-TIBA in under 2 years is unprecedented in the African healthcare landscape.

This program aims to use the platform to scale-up access to NCD care for individuals and their families – particularly among vulnerable families. The partners have designed a comprehensive service and finance package for diabetes and hypertension care that will be tested as a pilot in Kenya. It will roll out in three health facilities that are part of the M-TIBA network – reaching around 500 diabetes and hypertension patients and running until the end of 2019.

M-TIBA will provide security and transparency for transactions conducted under the program. The doctors as well as other partners will have continuous insight into how the funds are being spent and on what kinds of care. These insights will be used to improve access, efficiency and quality in diabetes and hypertension care.

Commenting on the announcement, Isaiah Okoth, PharmAccess Kenya Country Director said, “Mobile solutions are crucial for scale up of NCD care in Kenya and low-middle income countries generally – especially in sub-Saharan Africa. With this project, we hope to develop scalable, low cost quality service that that gives people in need access to care and empowers patients to take charge of their own health.”

Jon Fairest, Head of Sanofi in Africa, said, “Non-communicable diseases are a growing burden in Kenya and in Africa. To be able to address this situation we need to create an ecosystem of partnership and develop innovative and sustainable care model for the sake of patients.

Ngao Ya Afya is a good example of collaboration using mobile phones to provide services for patients. We look forward to engaging with government, private payers and other stakeholders to make Ngao Ya Afya sustainable in Kenya.”

Kees Van Lede, CEO, Carepay says, “You can see the devastating effect of NCDs on many families in Kenya, as care drains scarce resources and impacts on the future prospects of the whole family. M-TIBA enables direct targeting of groups that need support the most. The insights into healthcare usage and the quality of delivery are critical for designing effective and long-lasting solutions.”

In addition, PharmAccess works closely with sister organization the Joep Lange Institute, which is also providing consultative expertise on this project.

 

-PharmAccess Foundation

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Play Zuri Health launches its first mHealth App to help provide affordable and accessible healthcare solutions

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Play Zuri Health Limited Mobile App (Source: Zuri Health)

Play Zuri Health Limited, a branch of the Play Communications Limited announced the launch of their first mobile app, Zuri Health; that can be downloaded from the Google Play Store, Apple Store as well as the Zuri Health website.

Zuri Health’s mission is to provide certified, affordable and accessible healthcare solutions via mobile with dedicated apps, wap and SMS services based on availability, location and specialization of the medical providers.

Users will have access to a myriad of professionals and services from across their home counties. They are able to book appointments instantly with any medical professional or hospital within their geographic regions, book laboratory tests, chat with the practitioners via both message and video as an added feature and request for home visits by the Licensed and Certified Medical Practitioners.

Under Pharmacy, users can get their prescription and over the counter medication online and have it delivered to their doorstep.

The SMS service functionality of Zuri Health has been designed to reach a wide range of individuals or users who may not have access to WAP or internet enabled devices.

The app’s code was written with the daily challenges patients face in the journey of seeking affordable and accessible healthcare solutions. We solve the problem of expensive and inconvenient hospital trips for small or minor diagnosis and prescriptions, long waiting times and queues during doctors’ visits and appointments scheduling and booking which can be tasking.

Through our mobile app, we also help doctors to tap into a wider market of on-demand patients and earn extra money while saving lives.

Play Zuri Health Limited co-Founders, Arthur Ikechukwu Anoke and Daisy Isiaho (Source: Zuri Health)

“Zuri Health App is very personal to me. Millions of people in Africa do not have access to quality medical care. At Zuri Health we have taken time to develop a product that will fill that gap, giving doctors a wider and easier platform to reach patients who need them. With Zuri Health the underserved populace can now access affordable and sustainable healthcare.” Arthur Ikechukwu Anoke- C.E.O and Co- Founder Zuri Health.

Daisy Isiaho Project Manager and Co-founder in an interview said, “In my view, there is an urgent need to drive more meaningful conversations in relation to frameworks around Telemedicine because in Africa very few countries have these yet its fundamental if we should achieve the Sustainable Development Goals.”

Since the beta launch in November 2020 the company’s predicted three year growth plan is to have more than 20,000 registered doctors listed, 250,000 premium users and at least 1,000,000 mobile downloads.

Visit Zuri Health

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Live A Full Life With Sickle Cell Disease

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Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.

The World Sickle Cell Day is a United Nation’s recognized day to raise awareness about sickle cell disease (SCD) at a national and international level. On 22nd December 2008, the UN General Assembly adopted a resolution that recognizes sickle cell disease as a public health issue and “one of the world’s foremost genetic diseases.” The resolution calls for UN member states to raise awareness about sickle cell on June 19th of each year.

In this article, I would be creating awareness on sickle cell disease, the causes, symptoms, treatment and prevention.

What is sickle cell disease (SCD)

Sickle cell anemia (sickle cell disease) is a disorder of the blood caused by inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells). The abnormal hemoglobin causes distorted (sickled) red blood cells.

Occurrence

SCD is more common in certain ethnic groups, including:

  • People of African descent,
  • Including African-Americans (among whom 1 in 12 carries a sickle cell gene)
  • Hispanic-Americans from Central and South America
  • People of Middle Eastern, Asian, Indian, and Mediterranean descent
  • Approximately 2000 infants are born annually with the disease
  • SCD affects approximately 200,000 Americans annually
  • 1 in 365 African Americans
  • 1 in 13 African Americans have the traits (carrying only 1 of the gene, S)

(CDC August 2017, Mayo Clinic)

Economics of SCD

10 years ago; Medical expenditure for children with SCD averaged $12,000 yearly for those with Medicaid and $15,000 yearly for those with commercial insurance.

There were also 113,000 hospitalizations costing over $500,000 paid by Medicare and Medicaid of which 75% of the visits were in adults and each with at least 3 Emergency Room visits per year. Children with SCD miss a minimum of 18 days per school year

Total healthcare costs nowadays for SCD is estimated at $2billion per year.

According to (David A.N et al 2018), ‘In Nigeria, the prevalence of SCD is 20–30/1000 live births. The burden of the disease has reached a level where it contributes 9–16% to under-five mortality in many West African countries. Hemoglobinopathies alone represent a health burden comparable to that of communicable and other major diseases’

Causes of SCD

Healthy red blood cells are round, and they move freely through small blood vessels to carry oxygen to all parts of the body. In SCD, the red blood cells become hard and sticky and look like a C-shaped called a “sickle” and they are not able to carry enough oxygen. When they travel through small blood vessels, they get stuck and clog the blood flow.

The sites most often affected by clogging or stacking of sickle cells are found in the lungs, liver, muscle, bone, spleen, eyes, and kidneys and other parts and tissues of the body: explains why patients complain of a lot of pain in these areas as the symptom of the disease.

Patients also have immunity suppression which leads to infections by bacteria, and viruses.

Symptoms of SCD includes;

  • Excessive fatigue, irritability from anemia
  • Jaundice (yellowing of eyes and skin), may also include retina damage
  • Swelling and pain in hands, and feet, Pain in chest, back arms and legs, also damage of hip
  • Frequent infections,
  • Pain and problems in the spleen, (Nausea, vomiting, diarrhea)
  • Delayed growth
  • Stroke (20–30% of children stroke, 23% in African Americans)
  • Genitalia (priapism, a constant erection, in which severe episodes may lead to impotency)

Treatment of Sickle Cell Anemia

Treatment of SCD pain or crisis is done in the following manner:

Rehydration: with IV fluids, helps Red blood cells return to normal shape

Also Read: The ELMA Group of Foundations Commits ZAR 2 Billion to COVID-19 Response in Africa

Drugs:

  • Antibiotics: used to treat underlying infections. In some cases antibiotic prophylaxis, penicillins are recommended.
  • Pain medications to treat acute pain
  • Hydroxyurea: helps increase production of red blood cells

Immunization: Pneumococcal and Meningococcal vaccines have drastically reduced the rate of infections in SCD

Blood transfusion: improves oxygen and nutrients needed

Supplemental oxygen by mask makes breathing easier and improves oxygen levels in the blood

Bone marrow transplant: for severe complications and matching donors.

Prevention

  • Genetic counselling and testing (better before marriage and at pregnancy) can help prevent the likelihood of passing gene to your child
  • Preventing infections can be achieved by practising simple hand washing techniques at every opportunity. Hand sanitiser gels and wipes are also available and affordable
  • Immunisation is very important and one must assure shots and records are current to cut down on the rate of common infections.
  • Re-hydration with fluids at all times is essential.
  • Avoid staying in places with low concentration of oxygen, e.g. unpressurised air planes, or high altitudes

For more information about SCD, please speak to your Pharmacist or Doctor.

Article by Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.

Ref:

  • https://en.wikipedia.org/wiki/Sickle_cell_disease.
  • Mayo clinic https://www.gstatic.com/healthricherkp/pdf/sickle-cell-anemia.pdf
  • CDC https://www.cdc.gov/ncbddd/sicklecell/data.html
  • Sickle cell Disease: Public health agenda & Social, Economic and Health implications by CDR Althea M Grant, PhD September 2012
  • www.score_international.org/resources/conference_presentations
  • Overview of the management & prognosis of sickle cell disease, Joseph Palermo, D.O.
  • Economic impact of sickle cell Hospitalization. R Singh, Ryan Jordan and Charin Hanlon
  • www.bloodjournal.org/content/124/21/5971
  • Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria

Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria.

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Adaku Efuribe: COVID-19 treatment and the dangers of drug misuse in Nigeria

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Adaku Efuribe (Image credit: Adaku Efuribe)

Drug misuse is defined as the use of a substance for a purpose not consistent with legal or medical guidelines (WHO, 2006). It has a negative impact on health or functioning and may take the form of drug dependence, or be part of a wider spectrum of problematic or harmful behaviour (Department of Health, 2006).

At the moment there seems to be an increased risk of self-medication and drug misuse especially in countries where prescription only medicines could be bought without prescription. For instance, countries like Nigeria where some patent medicines dealers who are meant to sell GSL medicines end up dispensing pharmacy only medicines and prescription only medicines.

As soon as a new drug for managing COVID-19 is announced by mainstream media, people run off to the shops to buy these drugs, even people who have not tested positive for the coronavirus, indulge in self-medication in a bid to prevent contracting the virus.

I am worried about the recent announcement for Dexamethasone as a new drug for treating COVID 19. Information reaching me shows, following hours of announcing this drug by the media, some Nigerian resident has started trooping to their pharmacy, ‘chemist’ and illegal drug dealers to buy dexamethasone tablets.

Dexamethasone is a corticosteroid, it has high glucocorticoid activity, and it should not be used without the guidance of a clinician. According to the Electronic Medicines Compendium (EMC), depending on the dose and duration of therapy, adrenocortical insufficiency caused by glucocorticoid therapy can continue for several months and in individual cases more than a year after cessation of therapy.

Also Read: Lockdown Bozza: Developed to simplify the lockdown regulations in South Africa

Through immunosuppression, treatment with Dexamethasone can lead to an increased risk of bacterial, viral, parasitic, opportunistic and fungal infections. It can mask the symptoms of an existing or developing infection, thereby making a diagnosis more difficult. Latent infections, like tuberculosis or hepatitis B, can be reactivated.

Dexamethasone also has some side effects; the following side effects are common (occurring in greater than 30%) for patients taking dexamethasone:

· Increased appetite.

· Irritability.

· Difficulty sleeping (insomnia)

· Swelling in your ankles and feet (fluid retention)

· Heartburn.

· Muscle weakness.

· Impaired wound healing.

· Increased blood sugar levels

If only the media companies understood the fact that prescription only medicines could be bought without prescription in some countries, they would thread carefully and choose appropriate wording when announcing potential drugs for COVID-19 treatment.

It’s the duty of the Ministry of health and drug regulatory bodies of those countries where prescription medication could be bought in the market like sweets to continue to create awareness, educate the general public on the dangers of self-medication, drug misuse and drug abuse. They must not relent in their efforts of managing drug distribution/regulation.

My advice to people living in countries where you could buy prescription only medicines without prescription is this:

Do not run off to buy the latest drug announced for COVID-19 treatment.

This drug is a corticosteroid and should only be taken if prescribed by a clinician.

Please do not indulge in medication misuse and abuse. It could lead to adverse effects or even death

Author: Adaku Efuribe is a Clinical Pharmacist & Global consultant in Medicines Management

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