Rwanda’s bid to enhance universal health access through tech blazes yet another trail

Delivery of healthcare in Rwanda has just made another major step to enhance universal access in the remote areas with the recent signing of the agreement between the government and the e-health solution provider Babyl. Adding on the current 750,000 subscribers already under the British technology company’s mobile phone platform, majority of them in the rural areas, the agreement will now extend the text message oriented service to public servants under the RAMA health insurance beginning next month. However, following a pilot study, also set to begin next month in Rwamagana District, the major achievement will be the inclusion of subscribers of the community-based Mutuelle de Santé insurance scheme currently standing at 81 per cent subscription of the population nationally. When the inclusion comes to pass, it will significantly have bridged any gap of distance or infrastructure accessing healthcare to the entire population when needed, and where needed. The government projects a seven-year rollout period of the m-health initiative to reach every cell in the country. e-Health is not only cost–effective, but affords secure use of information and communication technologies. e-Health solutions include mobile health (m-health) such as now being provided by Babyl, as well as training and resource planning for better management, and telemedicine. All these are already operational to varying degrees in the country. They range, on the one hand, maternal healthcare to implement a research-based health information exchange, and the other to train health workers and enhancing their support systems. These include telemedicine where medical experts teach as well as liaise with doctors in district hospitals to address complex medical cases from a hub at the Rwanda Military Hospital in Kanombe, Kigali City. Continent-wide, a similar range of technologies is enabling services including mobile telephony, text messaging, teleconferencing, electronic mail and video-conferencing. Many initiatives in other countries have also been launched by both public and private sectors, though still on a minimal scale. What sets Rwanda apart is the near universal health insurance scheme that is now well on its way to being technologically bolstered, offering a glimpse of the possible. Note that very few African countries have implemented the 2001 Abuja Declaration that called for allocation of at least 15 per cent of GDP to the health sector.Further, the continent bears one-quarter of the global disease burden, yet has only 2 per cent of the world’s doctors. The situation is exacerbated by limited access to primary care due to inadequate infrastructure and long distances, in addition to operational weaknesses that prevent the existing health system from functioning as it should. Millions of Africans, therefore, still suffer from diseases that are relatively simple to prevent or treat. But, in one fell swoop, leveraging digital technologies with the ubiquity of the mobile phone in Africa has proved particularly beneficial in trying to overcome these challenges. Only that, exploiting the feature mobile phone that now reaches deep into the countryside, needs to be scaled up to fully reap from the existing technological gains. This has already been anticipated under the Africa Health Strategy (AHS) 2016–2030 policy framework. The Strategy is premised on the various continental and global health policy commitments and instruments, and draws from previous assessments of the African Union’s health policy instruments. The strategy seeks to integrate research and innovation for health and provide strategic direction to AU Member States in creating better performing health sectors. The Strategy calls for better leveraging of community strengths, public, private and other partnerships as locally being exemplified with Babyl, whose first entry on the continent is Rwanda. It is also about data. The World Health Organisation laments how institutional frameworks for health information in much of Africa have often been found to be fragmented, with responsibility and ways for collecting health data divided across different ministries and disease-specific programmes, creating multiple parallel systems of data collection. Large volume of data as technology is able to mine is crucial in understanding local challenges and providing tailored solutions. Thus, as we are reminded, a functioning health information system requires an integrated effort to collect, process, report, and use health information and knowledge to influence policy-making, programme action, and research.

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Rwanda’s bid to enhance universal health access through tech blazes yet another trail