The statistics remain grim; nearly half of the world’s population still lacks access to essential health services, and each year at least 100 million people are pushed into poverty in the attempt to pay for access to these services.
Those figures should be an anomaly, but are the stark reality – and the fact remains that many of the people who fail to get much-needed access to care live in Africa. Emerging economies typically bear the brunt of a lack of access because of gaps in the availability of services and citizens battling to afford even the most basic healthcare.
The challenge of having such a high number of the continent’s people unable to access even basic healthcare, which is a fundamental human right is increasingly being offset by the introduction of solutions borne from rapid technological advancement – innovations that are removing traditional barriers to access.
One such innovation is telehealth – or telemedicine – which is the remote diagnosis and treatment of patients through the use of telecommunications and digital technology such as mobile devices and computers.
Telehealth as a viable solution in the quest for access to care
Telehealth has quickly gained itself a reputation as an effective solution to help achieve the goal of universal health coverage. The industry has grown exponentially and it is predicted that it will be worth approximately $89 million globally by 2023.
This growth can largely be attributed to telehealth’s benefits, which have been widely felt wherever it has been adopted. By enabling healthcare professionals to diagnose and treat patients without needing to see them face-to-face, telehealth effectively helps lower the costs of delivering healthcare services.
Telehealth also has the potential to overcome shortages of healthcare professionals by increasing access to specialists in bigger and more well-equipped medical centres, hospitals and academic institutions. This has far-reaching consequences in places such as Africa, where patients often have to walk long distances or catch multiple forms of transport before they even get the chance to join a long queue to see a medical professional – a reality I have often witnessed myself. I believe telehealth is a big step in the right direction of overcoming this challenge and I am heartened by the encouraging signs of its uptake in Africa.
All telehealth requires is access to a mobile device and internet connection, which has proved to be a massive area of growth in Africa.
Mobile has helped Africa leapfrog many of the challenges the continent faces – ranging from accessing financial services to education – so it comes as little surprise that subscriber penetration reached 444 million in 2017 and is expected to hit 634 million by 2025.
More than just being mobile, though, African citizens are making the move to smartphones and mobile broadband: from 250 million people with smartphones and 38 percent of all connections being mobile broadband at the end of 2017, this will accelerate to 690 million smartphones and mobile broadband connections sitting at 87 percent by 2025.
These millions with smartphones and mobile broadband connections are able to access life-changing – and life-saving – services, such as telehealth solutions.
Creating opportunities for access to healthcare is at the forefront of my vision and innovations like telehealth excite me. This shift has led to a proliferation of platforms and apps that open up access to care.
There are multiple kinds of apps that allow people to talk to or text doctors, get daily health tips and find out what their symptoms can mean, or which help people living with specific illnesses – such as diabetes – manage their disease. And these apps have widely proven to not only improve access to care, but also to ultimately improve the patient experience.
In fact, our latest Future Health Index (FHI) research has shown that a third of South African healthcare professionals say that their patients’ experience has been positively impacted by telehealth in the past five years. It has also indicated that 38% of South Africans are open to remote consultations for non-urgent care – showing the potential of telehealth as a tool to provide care.
Targeting poor and underserved communities
There are additional examples of telehealth solutions that have been implemented specifically to improve access and provide healthcare services to the poor and those living in remote, rural areas.
In Kenya, for instance, 450 healthcare providers have partnered with M-TIBA, a mobile service that allows people to send, spend and save money specifically for healthcare, to provide mobile ultrasounds for over 100 000 patients.
Kenya also launched its national telemedicine initiative for the poor and marginalised in rural areas in 2015. The initiative helps patients and healthcare providers in rural areas to use video conferencing to interact with experts at the country’s biggest referral hospital, Kenyatta National Hospital. This not only helps with diagnosis and treatment, but also with training and research.
In South Africa, the Impilo Initiative also helps give access to care in rural areas, but focuses specifically on women and girls and providing pre- and post-natal care. Established in 2018, it equips community health workers with smartphones and tablets to facilitate virtual doctor’s appointments.
Although there are no formal statistics on hand to reflect exactly how many patients these two initiatives have positively impacted, I have seen enough telehealth solutions in action to know that they make a tangible difference in the lives of the people that need it most.
Philips too, for example, has numerous telehealth solutions that we have piloted in Kenya that we can see are making a real difference in underserved communities. The Philips Foundation, for instance, is supporting a number of projects that explore the use of mobile ultrasound technology at primary care level to enhance availability of affordable services in the underserved communities and remote areas of Kenya.
One such project is called “Mimba Yangu”, in collaboration with the Centre of Excellence in Women and Child Health of the Aga Khan University, which is currently looking into the feasibility, impact and costs of quality antenatal care and examining if ultrasounds before 24 weeks of pregnancy, as recommended by the World Health Organisation (WHO), will result in better health outcomes for mothers and babies.
Together with Amref International University, the Philips Foundation is also testing the viability of ultrasound in the business models of midwives. These projects look, in particular, at our Lumify and Philips Mobile Obstetrics Monitoring (MOM) solutions.
The Lumify uses a smartphone-based mobile app and portable ultrasound to help both healthcare professionals and mothers. Medical professionals are able to deliver care wherever it is needed even in the most remote locations, while mothers are able to see clear and high-quality images of their unborn babies. This means that patients can be treated at the point-of-care with a greater chance of success because of faster and more accurate diagnosis and treatment. We pride ourselves on this innovation as we work towards reducing mother and child mortality rates on the continent.
The Philips Mobile Obstetrics Monitoring (MOM) solution, meanwhile, is a scalable telehealth platform that allows midwives to remotely monitor patients from hospitals or home through data collected from physical examinations and then shared to the centralised MOM server. This data can then be used to determine if a pregnancy is high-risk so that immediate care can be provided.
MOM has been used successfully in Indonesia – which, like most African countries, is an emerging market. I personally witnessed its efficacy as the pilot was run during my time as the Head of the Philips consumer business in Indonesia. In this pilot study, detection of very high-risk pregnancies increased threefold and zero maternal deaths were recorded. There was also a 99 percent reduction in anaemia from the first to the third trimester through enhanced patient management. These results are testament to the impactful difference our innovations are making.
It’s clear then that telehealth presents a clear opportunity for Africa, where nearly 700 women die of pregnancy-related causes every day. Research by the WHOhas shown that at least two thirds of mothers and children can be saved with cost-effective interventions and solutions like the Lumify and MOM – making it critical to introduce them to these countries to avoid preventable deaths.
These examples clearly show the immense potential of telehealth to drive widespread access to essential healthcare services – making it critical for healthcare providers to continue to implement these solutions at scale to give citizens across the African continent the healthcare they deserve.
Article by Jasper Westerink, CEO Philips Africa
Kasha Global Inc. secures $1 Million DFC equity investment to grow and scale across East Africa
Kasha Global Inc. beneficiaries (Source: DFC)
U.S. International Development Finance Corporation (DFC) today announced the disbursement of a $1 million equity investment in Kasha Global Inc., an e-commerce company that provides women’s health and personal care products to customers in Rwanda and Kenya, alongside investments from Finnfund and Swedfund. This investment was made through DFC’s Portfolio for Impact and Innovation (PI2) initiative, which aims to finance early-stage, high-impact solutions to challenges facing developing countries.
“High quality and equitable health services and products are fundamental to the wellbeing, and ultimately the economic potential, of women and girls in the developing world,” said Vice President for DFC’s Office of External Affairs Algene Sajery. “DFC is proud to support Kasha’s innovative business model, which is helping transform the personal care and health system supply chain in East Africa, and provide financing that strengthens economic growth in the region.”
“Kasha is excited to bring DFC on as an investor and as a long term partner,” said Kasha Global Founder & CEO Joanna Bichsel. “With the U.S. Government’s significant ongoing investments in the areas of Global Health and with DFC’s focus on supporting businesses proven to drive both commercial returns as well as social impact, we see strong win-win opportunities as Kasha continues to grow and scale across East Africa and beyond. We have been impressed with the level of support DFC is extending into emerging market businesses and into women-led and women-focused businesses.”
Many women in emerging markets lack access to safe, high-quality, and affordable health and personal care products as well as information surrounding these products. As products are often out of stock or counterfeit, the purchasing experience can be frustrating and disempowering for many women. Further, the stigma surrounding women’s health and personal care products in some cultures can have serious consequences. A UNESCO report estimates that one out of 10 girls in sub-Saharan Africa misses school during her menstrual period, amounting to as much as 20 percent of the school year.
Since 2016, Kasha has helped address women’s lack of access to health and personal care products by delivering a unique, discreet and user-friendly purchasing experience to the customers it serves. Through its e-commerce platform, Kasha has reconfigured the supply chain, delivery channel, and customer experience in order to meet demand. Kasha’s business-to-customer line of business directly sells products to customers in rural and urban locations across East Africa, especially low income communities. Kasha empowers over 400 local women to enter hard to reach communities to provide information and assist customers in purchasing products. The company’s business model is optimized to reach low income communities. Kasha has delivered over 1 million product units to over 130,000 unique customers, of which 63% are low income customers in Rwanda and Kenya.
Despite Kasha’s rapid growth and loyal customer base, fundraising is extremely challenging for start-ups in emerging markets, particularly during the COVID-19 pandemic. By investing $1 million in equity through the PI2 program, DFC aims to help Kasha fill the financing gap, providing the e-commerce company with the capital required to scale its business.
DFC’s investment advances its 2X Women’s Initiative, which has committed more than $4 billion of investment in projects that empower women in developing countries. The Kasha investment also qualifies for the 2X Challenge, an initiative of the G7 countries to support women’s economic empowerment. Kasha was co-founded by two women, 50 percent of Kasha’s senior leadership team are women, 75 percent of board members are women, 64 percent of Kasha’s employees are women, and the company’s products center around care for women and girls. Based on Kasha’s commitment to the 2X Challenge criteria, Kasha, DFC, Finnfund and Swedfund have signed a side letter which highlights Kasha’s 2X accomplishments and sets an example for other companies that seek to improve their businesses using the 2X Challenge criteria.
By focusing on innovative care delivery models and supply chain innovations, DFC’s financing also advances the agency’s Health and Prosperity Initiative, helping respond to COVID-19 and other health-related issues in Rwanda and Kenya.
Swedfund is Sweden’s development finance institution. Finnfund is the Finnish development finance institution.
Play Zuri Health launches its first mHealth App to help provide affordable and accessible healthcare solutions
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.
“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.
Live A Full Life With Sickle Cell Disease
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.
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
- 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.
- 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.
- 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
- 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
- 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.