There have been dramatic changes in the African health system over recent decades. Massive reductions in maternal mortality have been achieved and greatly escalated malaria control activities have been implemented since the turn of the century. However, the average life expectancy of just fifty-one years in men and fifty-four years in women highlights the desperate need for a better, sustainable healthcare solution. There are many challenges that need to be addressed to achieve this, and here we will explore these issues and see how mHealth, or medical distance education, can play a revolutionising role in the transition.
Shortage of health professionals
Sub-Sahara Africa is home to eleven per cent of the world’s population and bears a quarter of global disease, yet it is home to only three per cent of the world’s trained medical professionals. Health professionals such as doctors, nurses, midwifes and pharmacists are in severe shortage. In some regions, just two physicians serve a community of ten thousand people.
Prevalence of disease
Many of the continent’s population suffer from diseases like malaria that are both preventable and treatable. While parasitic and infectious illnesses are the primary causes of mortality, incidences of non-communicable diseases such as cancer and diabetes are increasing.
Difficult to distribute medicines
Much of the population of Sub-Sahara Africa resides in rural areas that extend over a huge geographical region. These areas often have poor road infrastructure and limited medical storage facilities. This means that it is difficult to transport medicines and vaccinations to these regions and once they are there, there is nowhere to store surplus stock for future use. In addition to the logistical problems, cost is also an issue as over half of the African population survives on under one US dollar per day.
A large proportion of the population in sub-Sahara Africa is affected by poverty. In less severe situations of poverty there can be limited access to basic healthcare, while in cases of extreme poverty there is a lack of basic living requirements that subsequently impacts on health. Basic living requirements include sanitation, satisfactory housing and sufficient nutrition. Without these fundamental elements, those living in both relative poverty and extreme poverty are much more likely to face health complications and decreased life expectancy.
Snowballing older population
An aging population is another issue that will need to be urgently addressed in the coming decade. With the median age of many countries being below twenty years, the proportion of older people is set to rise dramatically. In sub-Sahara Africa there were thirty-four million people aged sixty and above in 2005, but projections indicate this will rise to over sixty-seven million people by 2030, even taking into account excessive mortality rates. This burgeoning older population will have a huge impact on the health system.
Key challenges affecting the current healthcare system
It is clear that the health system in sub-Sahara Africa is affected by a wide variety of issues relating to existing disease and demographic trends. In summary, the main challenges include:
- A severe shortage of medically trained professionals
- Limited ability to prevent and treat parasitic and infectious diseases
- Limited ability to diagnose and treat communicable diseases
- Difficulties in the distribution of affordable medicines and vaccinations
- Large proportions of the population affected by poverty
- A burgeoning older population
A need for a creative approach
The transition to a better, sustainable health system is possible through collaboration with governments, charities and local communities, and by learning from the successes of other parts of the world that have faced similar problems. Creative thinking must underpin the transition so that improvements are tailored to the unique challenges and aptitudes of sub-Sahara Africa.
Harnessing mobile prevalence
While challenges need to be addressed to better the system, the healthcare model needs to embrace Africa’s strengths to achieve sustainability. The continent has made huge strides in the communications sector, with Sub-Sahara Africa being the world’s fastest-growing mobile market between 2010 and 2015. Currently, one in three people now own a mobile phone. With a shortage of medically trained professionals being one of the key issues affecting the health system, this prevalence of mobile phones should be harnessed. Mobile phone ownership can easily be combined with technology to enable distance education, making it easier to provide medical training to a wider demographic, including those living in remote areas.
Using mobile for medical education
Mobile technology has already been used in Africa to make improvements in healthcare. A system called mTRAC has been implemented in Uganda which holds data on medical stocks throughout the country. Other digital initiatives revolving around the medicinal supply chain have been piloted. By utilising mobile technology, it is also possible to create easier access to medical education – a vital element of an improved health system.
The use of e-learning, or online courses, is an innovative way of promoting distance learning in many fields. In healthcare it is commonly referred to as mHealth. Online courses support regular medical studies and are particularly helpful in increasing level of skill and for exam preparation. For those about to embark on medical studies or for students already attending medical school, mHealth can greatly enhance the learning process with its ability to provide a wide range of resources to a broad audience.
Revolutionising the healthcare system
E-learning (notebook) or m-learning (mobile phone) have the potential to revolutionise the healthcare system by enabling easy access to educational materials, wherever the student may be. This ease of access and addition of learning resources results in higher grades and reduced failure rates. This in turn produces better qualified medical professionals from both urban and rural areas. While there are of course many challenges to address to improve healthcare in Africa, by using mHealth to tackle the severe shortage of medical professionals, it will already be on the path to a better and sustainable system.
Jens Ischebeck, African edtech specialist: Website publisher www.apps-for-learning.com.
The website presents and compares e-learning and mobile learning providers with a special focus on the African market. Tags are e-learning, m-learning, online courses (MOOC), medical exam preparations (MCAT & USMLE).
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