Right from the onset of the COVID-19 pandemic, health experts have warned of a ticking time bomb in Africa as many feared that the coronavirus would overwhelm the continent’s fragile health care systems, resulting in massive fatalities.
Ten months into the pandemic, the continent of over a billion people appears to be coping better compared to Europe and America where the second wave of infections have already begun.
While researchers are still struggling to understand why the numbers have been low in the continent, health experts in Nigeria are raising concerns over the collateral damage caused by the outbreak – pushing the country further off its existing health targets including on Universal Health Coverage (UHC) 2030, maternal deaths, child deaths under age five, malaria, pneumonia, malnutrition, and HIV infections.
The pandemic has also been blamed for making access to essential health services extremely difficult and escalating existing health challenges especially due to high levels of infodemic – poor perceptions, poor awareness, misconceptions, and misinformation – about COVID-19.
A PREMIUM TIMES report revealed how the pandemic put breastfeeding programmes in the country under severe threat due to misinformation and poor access to hospitals.
But the pandemic also provided enough lessons to help in planning the future of health services in the country, according to the health experts who spoke during the virtual conference organized by the Nigeria Health Watch and their affiliates last week.
Speakers at the event alluded to the disruptions on meeting health targets and the economic disaster occasioned by the outbreak. They however underlined innovative technology as the silver bullet in the pandemic era and for the future.
Digital health: Future of Health Conference
Digitalised health care was the key solution echoed at the 2020 Future of Health Conference themed: ‘Innovation: Improving Health and Scaling Up Healthcare Access’.
According to the organisers, the theme of the conference was chosen in early January without the knowledge that the COVID-19 pandemic will bring the world and health care on its knees.
The plan was to bring innovation in delivering healthcare to underserved communities underlined as crucial in Nigeria’s quest for Universal Health Coverage.
“COVID-19 has highlighted the need for us to now think fast on how to use technologies and innovations to improve healthcare in Nigeria”, said Vivianne Ihekweazu, the anchor of the conference and the Nigerian Health Watch director.
While the short-term implications of the pandemic are evident in the country’s current economic recession and disrupted health systems, the long-term consequences — how it will reshape health and development institutions and occupations — are still difficult to imagine.
The global challenge has however shown how important a tool technological innovations can be. In the heat of the lockdowns and restrictions, many business, companies, government institutions and even families were all able to stay afloat with social tools such as Zoom meetings, social platforms like Facebook, Whatsapp and several other apps and gadgets that enabled communications.
The growth in mobile use around the world is fueling the reach and potential of digital health solutions. According to a recent report from GSMA, a trade body representing the interests of mobile network operators, 67 per cent of the global population is currently subscribed to mobile services, with some 700 million new mobile subscribers predicted to join by 2025.
This year’s Future of Health virtual conference took advantage of technology to amplify innovative approaches to Nigeria’s healthcare.
Nine speakers, representing nine organisations, explained the critical role they played in bridging the gap to healthcare access across the areas of maternal health, epidemics preparedness and primary healthcare.
Innovations in Maternal healthcare
Iyadunni Olubode, country director for MSD for Mothers, moderated the first session on innovations in maternal healthcare. She shared MSD for Mothers’ vision to help create a world where no woman has to die while giving birth anywhere in the world.
The conference followed the release of a recent report, ‘Giving Birth in Nigeria’, a survey conducted in six states across Nigeria within the space of 18 months with funding from MSD for Mothers.
Despite having one of the highest rates of maternal mortality in the world, many cases of women dying during childbirth in Nigeria are still unreported, the report revealed.
Nigeria is still a far cry away from reaching the Sustainable Development Goal (SDG) 3.1 – to reduce maternal mortality rates to not more than 70 per 100,000 live births.
Achieving UHC by 2030 is the central target of SDG 3.8 and 3.1.
The global pandemic only made maternal health indices worse, according to Ms Olubode who noted that to make any difference, Nigeria needs resilient, strong health systems where public sector capacity is complemented by private sector and digital innovations.
Onyedikachi Nwizu, head of operations, Mobicure, a health-tech startup that uses mobile technology to provide both pregnant women and mothers with access to maternal and child health information shared how the digital health company has provided over 50,000 women in Nigeria with lifesaving and life-enhancing maternal-related information via their mobile app, Omomi.
Omomi, which means ‘my child’, takes advantage of Nigeria’s high mobile phone penetration to provide valuable antenatal, postnatal and child health information to parents who need it. It connects mothers to medical personnel in real-time.
Ibironke Dada, programme director for SafeCare at PharmAccess Foundation, described the innovative ways SafeCare through MomCare, a tech programme for improving quality of care and clinical outcomes in pregnant and postpartum women, is giving quality care to both mothers and babies.
Through MomCare, “We believe we can leverage technology to improve maternal and new-born outcomes through different approaches that reduce high out of pocket payment for health and facility dropouts,” she said.
Kendra Njoku, Quality Lead and Health of Programs at mDoc, a digital health social enterprise focused on reducing chronic disease burden in sub-Saharan Africa, spoke about mDoc’s work in optimising self-care during the pandemic to reduce accessible maternal information gaps.
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“To improve health literacy through digital health solutions and innovation, and to improve health outcomes among our women, we had to keep educating them on how to use their digital devices properly,” she noted.
According to the speakers, these innovations in maternal healthcare all helped to bridge the gap in access to healthcare, worsened by the COVID-19 pandemic and should be strengthened in the mapping of future health solutions.
Preparing for future outbreaks
“We need to strengthen the capacity of all countries for early warning, risk reduction, and management of global health risks”, Lawal Bakare, CEO EpidAlert, and moderator for the second session noted.
Some organisations working in various aspects of epidemic preparedness shared insights on how innovations in technology has helped the world manage to stay afloat amid COVID-19 as well as other infectious disease outbreaks.
One such organisation was Pandemic Tech, a global health security incubator which supports health security innovators on the frontline of fighting infections diseases and health security threats.
Andrew Nerlinger, the co-founder, explained that Pandemic Tech brings together the technology and global health security communities in the fight against deadly infectious disease outbreaks.
“Innovation communities like those fostered by Pandemic Tech helped to provide the resources needed to take ideas and turn them into usable, sustainable and successful solutions in the fight for better global health security.”
Lois Olajide, leading the Surveillance Outbreak Response Management and Analysis System (SORMAS), Nigeria’s digital system for surveillance and outbreak data management deployed by the Nigeria Centre for Disease Control (NCDC), explained how the system is being used for rapid collection, reporting & analysis of disease data in real-time for appropriate public health action.
“It has helped to generate data which is key to fighting disease outbreaks not just in Nigeria but across the world,” Ms Olajide said.
“We completely do away with paper-based records, to improve our response to emerging disease outbreaks and maintain an effective response to the current #COVID19 pandemic.”
For example, one important piece of data that would not have been possible without the SORMAS’ analysis system is the fact that only 20 per cent of LGAs in Nigeria were actually responsible for 70 per cent of all COVID-19 cases.
“This kind of data helps prioritise response, understand disease trends, as well as map out risk factors such as high health worker infection rates,” Ms Olajide said.
Moredreck Chibi, Regional Advisor for Health Innovation at the World Health Organisation Regional Office for Africa, noted that empirical evidence has shown that the future of health in African countries will be affected if innovative ways are not deployed to improve our health outcomes.
Reflecting on the role of innovation in Africa’s health security, he said, “The COVID-19 pandemic has galvanised more than 12.8 per cent of the 1000 new or modifications of existing technologies that have been developed worldwide in Africa to improve our healthcare; this would have not been possible otherwise.”
Innovations in Primary Healthcare
“Primary healthcare is the basis by which we hope to achieve universal health coverage”, the Editor-in-Chief at Nigeria Health Watch and moderator of the third session, Adaobi Ezeokoli, said as she set the tone for conversations around innovations in primary healthcare.
She dispelled what may have been a common notion that primary health care is the exclusive need of rural communities, noting that primary health care is capable of meeting more than 70 per cent of people’s health needs.
Shubha Nagesh, Director Research and Follow-up Programmes at Latika Roy Foundation, works with children and adults who have developmental and other disabilities to provide early intervention services, livelihoods development, education, training, and awareness.
She spoke on the long road to accessible healthcare for persons living with disabilities.
This is important to Nagesh because “People with disabilities have been left out of the world’s #COVID19 response. Disability helps to confirm and confront the structures that are not working, and it is the only minority group that one can join at any time and it is in our best interest to pay attention to the outcomes.”
Another organisation with an innovative business model providing inclusive and sustainable products and services across the globe is MobiHealth. Tazeen Rizvi, Mobihealth’s Global Chief Operating Officer shared how with the use of telemedicine, most of the non-communicable diseases in Nigeria such as malaria can be treated even without physically seeing a doctor. She explained that Mobihealth is changing the way PHC services can be accessed across Nigeria.
“How do we integrate healthcare to make sure that people are not totally left out of the safety net? We need to focus on what the community and the individuals need. This requires a lot of collaboration from everybody.”
For Adebowale Odulana, the founder and CEO, Doctoora e-health Limited, which helps to close the gap between the supplier of healthcare and demand for healthcare, primary healthcare is actually a philosophy that goes beyond the facility and encompasses providing basic healthcare needs to the people.
“Technology and innovation work with collaboration between innovating partners,” he said.
All the insights shared by speakers highlighted the importance of innovation in improving healthcare access.
Conversations and communities which foster innovations in healthcare need to continue even as we keep in mind the end goal; innovation must bridge the gap between the healthcare provider and the client, the moderator said.
“These innovations need to be supported by an enabling environment that provides the adequate policy instruments that enable the growth of sustainable and scalable health solutions that ultimately deliver accessible and affordable health for all.”