E-health: exercise extra care

By Issa Sikiti da Silva, in Dakar, Senegal

By connecting primary health workers to primary healthcare centres and connecting these centres electronically to departments and referral centres in hospitals for the exchange of data, a significant improvement in access and cost-effectiveness may be effected.

This statement by the World Health Organisation (WHO) published in its Strategy 2004-2007 eHealth for Health-care Delivery encompasses more or less the definition of e-health specifically based on primary health care (PHC).


But some experts are divided about the real impact of IT health as mixed results from various studies continue to send mixed signals, and therefore wonder how far it can help cut costs and enhance quality of healthcare.

“In my point of view, e-health is still a work in progress,” a medical expert in Senegal told Biztechafrica in the capital city Dakar.

The expert, who did not want to be named, said: “Is it some sort of cure-all for health system woes? I’m afraid to say I don’t know. Research is still ongoing.” He added that the limitations of some studies made it difficult to fully understand its real impact.

“Therefore, any attempt by African governments to rush into it could be disastrous and therefore counter-productive. They should exercise extra-care and know where they are putting their feet. Different countries and worlds mean different realities and therefore different ways of tackling those realities.

“Thorough feasibility study needs to be undertaken, first, to determine if e-health is suitable to your country’s needs, and can really change the face of your country’s healthcare system.

“Maybe it doesn’t need e-health right away, maybe it needs something else not as complex as e-health, something simpler that you haven’t been able to bring into it all these years.”

The expert said several barriers could be standing in the way of e-health in many African countries given the underdevelopment of their ICTs and the deteriorating state of their healthcare systems. “They shouldn’t in any way rush into e-health if those barriers are not broken. It will be a waste of resources, time and energy. I don’t like the way some African countries are doing it or planning to do it. And believe me, it will not get them anywhere as long as those barriers are not broken.

“Look, you have many healthcare centres in Africa that are understaffed, lack everything from computers to desks, drugs, beds, bedsheet, proper medical equipment, and most of the staff working there are computer illiterate, let alone being paid well and on time.

“And one day you wake up suddenly and say I want this centre to become fully e-health compliant to make prevention, diagnosis and patient management easy? Can you imagine the amount of resources is going to be spent if you were to turn such a poorly-equipped traditional healthcare into an e-healthcare centre?

The World Health Organisation says many countries have embarked on e-health activities with limited success because insufficient attention has been paid to identifying and tackling potential constraints, which it says include:

  • lack of proper needs assessment
  • lack of vision, strategy and national plans
  • lack of information and awareness about eHCD applications

(eHCD = eHealth for health-care delivery)

  • computer illiteracy
  • insufficient resources to meet costs
  • limited expertise in medical informatics
  • weak information and telecommunications infrastructures
  • absence of legislative, ethical and constitutional frameworks
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