Leveraging on digital solutions to preserve health systems

WHEN the Covid-19 pandemic swept through the world three years ago, it disturbed life as we knew it. Not only did it interfere with the interaction of people, it altered the quality of life and changed the development trajectory for all countries. And health systems were the most affected. In Africa, the pandemic certainly widened the gaps that already existed within countries’ health care systems.

Hospitals and clinics struggled to cope as all attention was directed towards trying to deal with this new disease that threatened to wipe everyone out.

But in the process, attention moved from other diseases and threatened to reverse gains that had been achieved in the fight against diseases such as HIV, Malaria, TB and non-communicable diseases.

While the Zimbabwean Government did try to ensure availability of services, the restrictions imposed to curb Covid definitely had a negative impact on the ordinary Zimbabwean’s access to healthcare.

Last week, the World Health Organisation announced that Covid-19 was no longer a global health emergency.

Although the pandemic remains a global health threat, the decline in the number of cases, hospital admissions and deaths, coupled with the improved immunity of populations has made it less of a threat than before.

What this means is that it is time for countries to transition from emergency mode to managing Covid-19 alongside other infectious diseases.

Declaring the end to the state of global health emergency, WHO director general Dr Tedros Adhanom Ghebreyesus acknowledged that health systems had been severely disrupted, with millions of people missing out on essential health services, including life-saving vaccinations for children.

“But Covid-19 has been so much more than a health crisis. It has caused severe economic upheaval, erasing trillions from GDP, disrupting travel and trade, shuttering businesses, and plunging millions into poverty. It has caused severe social upheaval, with borders closed, movement restricted, schools shut and millions of people experiencing loneliness, isolation, anxiety and depression,” he said.

The good thing is that this pushed governments to look into ways of trying to mitigate this, to ensure any other pandemic in the future will not have as bad an impact on the healthcare system. In the case of Zimbabwe, several interventions were made, some of which were leveraging on the use of technology to reach out to remote communities.

Ministry of Health and Child Care launched the Impilo electronic health records system, which is meant to improve the efficiency of healthcare delivery and reduce errors, particularly in areas where paper records are still in use.

This system allows for the collection, analysis and dissemination of health data and can help to identify health trends, track diseases outbreaks and inform health care policy.

Next month, the Government will roll out a pilot of the national telemedicine project.

The project will be implemented by the Ministry of Health and Child Care together with the Ministry of Information, Communication Technology, with funding from Potraz and will be launched in Midlands, Manicaland, Mashonaland East, Matabeleland South and Matabeleland North provinces targeting 173 health institutions.

This is part of digital solutions that could help to address challenges being faced in the provision of quality health care for all by improving access to services and increasing efficiency in healthcare delivery.

Telemedicine has become increasingly popular in Africa and, as has been the case for Rwanda and Ghana, among other countries, has contributed to improved access to healthcare services, particularly in remote areas.

In telemedicine, patients can consult with healthcare providers via video conferencing, and healthcare workers can provide remote diagnosis and treatment.

This can also be done through the use of mobile devices such as smartphone and tablets.

Namibia-based medical practitioner Dr Garikai Mushininga says digital health solutions have the potential to significantly improve outcomes for patients with chronic disease by providing better access to care, facilitating selfmanagement, improving adherence to treatment plans, and enhancing communication between patients and healthcare providers.

“Digital healthcare solutions have the potential to transform chronic disease management by improving patient outcomes, reducing healthcare costs, and enhancing the overall quality of care,” he said.

While Zimbabwe is still in the stage of ensuring connectivity for all the communities, these interventions will definitely make a positive impact on the lives of the people and will guarantee the achievement of universal health coverage.

Public health experts believe that not only will these solutions be instrumental in attaining UHC, they will reduce the high maternal and infant mortality among others.

Community working group on health (CWGH) executive director Mr Itai Rusike said during pandemics, shifting services that could be provided remotely without compromising safety and quality to telehealth services can help reduce the burden on facilities and community-health based providers and minimise exposure for patients.

“The adoption of telehealth during pandemics like Covid-19 will allow primary care providers to continue providing medical care to their patients. But the successful implementation of telehealth requires adequate data infrastructures, welltrained staff, and clear management and communication protocols in dealing with patients,” he said. He said Zimbabwe was a lower-middle income country with high health status driven by accessible quality primary health care services from the public sector.

For digital health interventions to work, he said, they needed to be supported by strong policies, investments and regulatory structures.

That way, they could offer an effective means for Zimbabwe to ensure that primary health care remains the first point of contact with the health system and that care is continuous over time and place.

“Although start-up costs for implementing telehealth can be high, there is potential for efficiency gains later on. Remote care and diagnosis via telehealth benefits both patients and the health care system in the long-term by reducing wait times and indirect costs associated with seeking and providing care, including travel and missed work. Additionally, connecting multiple remote sites via telehealth can be cost- effective way of delivering care and managing resources,” noted Mr Rusike. “To be effective and accessible, telehealth service delivery must be designed with the end-user in mind. This includes understanding the information and communication technologies available to the local population, as well as anticipating their needs and concerns with a pivot to telehealth and proactively designing services to mitigate these concerns.”

The Covid-19 pandemic serves as a learning curve of what would or would not work in future and that preparation for the next pandemic starts now. Pandemics will not give countries time to prepare, so having these systems in place now will definitely go a long way in ensuring that access to healthcare is not interrupted should another one strike.

This will ensure the country’s targets under the National Development Strategy can be achieved without any disturbances.

After all, ensuring that Zimbabweans are healthy will translate to better economic outcomes and the attainment of an upper middle-income economy.

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