Getting SMART About Health Care in Africa

Technology and digitalisation Health

Getting SMART About Health Care in Africa

Posted on: 1st August 2022
By Multiple Authors
Anstes Agnew
Head of Health Delivery
Marème Gaye
Senior eHealth Programme Manager

Nearly 4 billion people around the world do not have access to the essential health-care services they need. Countries face shortages of the required systems, structures and skills.

But health care can be different. It can be revolutionised by technology that bypasses expensive legacy systems and incentives.

One way to do this is by providing individuals with access to their health data on their feature phone, smartphone or a QR code printed on paper, with the ability to share this information with clinicians and caregivers so they can access treatment without having to chase patient history from disparate sources. We saw the success of this approach during Covid-19 and several countries in Africa are taking huge steps forward to make this a standard way of working.

Just last month, the governments of Rwanda and Senegal launched the SMART Health Card, which is central to the “Health My Way” initiative – or in French, “Patient au coeur”. It’s hard to overstate how important this work is to people who have struggled to access even the most basic and important health care in the past. And it is just the latest step in a journey that has seen several successes so far.

For example, when Covid-19 hit Senegal, the country needed a digital immunisation registry, and it needed it quickly, to ensure those most at risk from the virus were prioritised in the vaccine rollout. Together, the president’s team, the Ministry of Health and Oracle, supported by the Tony Blair Institute, deployed the eVaccin project to identify and digitally capture vulnerable groups of people with underlying conditions for the first time. 

Over the course of 2021, teams on the ground used the scaled-up digital vaccine registry to administer Covid-19 vaccines. By early 2022, more than 1.5 million doses had been delivered in the country and are being recorded on the Oracle Health Management System (OHMS). The digital-health infrastructure underpinning Senegal’s international vaccine pass allowed the country to proudly declare itself one of the first in Africa to provide Covid-19 vaccination QR codes to citizens, with more than 25,000 passes issued to travellers in the first month alone.

Establishing this registry did not only result in digitised vaccination data, it has also helped to build a clearer evidence base for public-health decisions. The digital registry meant the government was able to easily ask people as they registered about their co-morbidities. The results gave the first clear sample of underlying conditions in the country’s over-65s population in a fraction of the time it would have taken using the old paper-based system. The digital system made gathering this vital data possible and efficient. 

Since then, Senegal has used eVaccin as the backbone of the country’s SMART Health Card system, which has already issued 60,000 vaccine certificates. There is huge potential to scale this system to enable better monitoring and response to diseases, such as yellow fever, and for driving the development of new vaccines – including those manufactured on the African continent.

Similar success can be seen in Rwanda, where the Ministry of Health and Rwanda Biomedical Centre developed a homegrown Covid-19 app and vaccine pass to facilitate the reopening of the economy and international events, aligned to the SMART Health Card framework.

Innovation cannot flourish without the right policies in place to protect people’s privacy and ensure the safety of their data. As governments like those in Senegal and Rwanda continue to scale the SMART Health Card and other tech-based solutions to respond to the biggest problems their people face, it is vital the right policy foundations for digital-health innovation are in place. The TBI team was well positioned to make this happen, embedded within the Ministries of Health and ICT. These policy foundations include helping to design health-information exchanges, interoperability frameworks, enterprise architecture, data-governance policies, data privacy and cybersecurity regimes.

What makes these initiatives unique is that they deliver a trustworthy credential for cross-border travel, but also allow patients to drive the sharing of their data. This contrasts with the status quo, where health institutions across the public and private sectors can’t or won’t exchange data with different IT systems and standards. Health-care workers must access multiple applications of paper files and where health-management-information systems are in place, they remain disconnected, with limited coverage – thereby hampering policymakers’ complete view of data to make decisions.

Now is the time for both governments and private tech sectors to accelerate adoption, and create a virtuous circle of innovation for their citizens and health-care systems.

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