Digital health during COVID-19

Today marks the 72nd anniversary of World Health Day and this year’s timely theme is ‘Support Nurses and Midwives’.

This theme is a reminder that healthcare workers are the foundation of all healthcare systems. As we mark the day, we certainly cannot ignore the times: we are in the midst of the biggest health crisis of a generation. COVID-19 has had severe health and economic ramifications and the pandemic has exposed the global fragility of healthcare systems, while revealing the importance of technology and health stakeholder collaborations.

In a recent blog, we expounded on the role of mobile technology as a connectivity tool and a comfort tool, bridging the physical communication gaps between individuals and their families, friends and colleagues in developing countries, in the context of COVID-19.

This blog continues on the same thread and highlights how digital health start-ups are leveraging mobile and frontier technologies to uproot inefficiencies while driving more affordable and quality healthcare in developing countries.

Photo credit GSMA Ecosystem Accelerator portfolio start-up, Jamii.

The state of health systems in developing markets

Health systems in developing countries face numerous structural challenges. Several countries suffer from shortages of qualified healthcare professionals or supplies, resulting in detrimental outcomes for patients. Cost remains an issue and low public funding for healthcare forces people in developing markets to pay high out-of-pocket payments. According to the World Bank, people in developing countries spend half a trillion dollars annually (over $80 per person) on out-of-pocket payments. Consequently, some 400 million people lack access to essential healthcare services, mostly in Africa and South Asia. Six per cent of people in low- and middle-income countries are tipped into, or pushed further into extreme poverty because of health spending. In addition, there is a significant lack of health awareness which drives poor health-seeking behaviours among citizens.

The role of mobile and frontier technologies

Mobile and frontier technologies are not a universal remedy to health system challenges in developing markets. However, they have a vital role to play in addressing some of the major healthcare challenges. Mobile phones are being used to optimise the delivery and receipt of healthcare.

With an additional 9 million nurses and midwives needed globally to reach Sustainable Development Goal 3 on health and wellbeing by 2030, Artificial Intelligence (AI) can support healthcare workers and the broader health systems by empowering nurses, midwives, doctors and other health workers. While deploying AI can be challenging, the technology has the potential to streamline the triage, diagnoses, and post-care follow up process, thereby stretching health workers’ limited time to serve more patients.”  AI can also be used to better understand patterns in the spread of diseases, like the case of COVID-19. Similarly, blockchain technology has huge potential within healthcare from medical records, pharmaceutical supply chains, to smart contracts for payment distribution –  there are plenty of methods to leverage this technology.

Mobile and frontier technologies across developing countries are:

Improving healthcare service delivery and connecting patients to providers

  • oDoc (Sri Lanka & India) runs a mobile-based platform that connects patients with registered doctors and healthcare professionals for video or audio consultation. In light of COVID-19, oDoc has joined hands with the Ministry of Health, Government Medical Officers’ Association (GMOA) and Information and Communication Technology Agency (ICTA) to facilitate free access to healthcare for all across the nation as a response to the pandemic. oDoc received a grant from the GSMA Ecosystem Accelerator Innovation Fund in November 2018 to scale up their service in Sri Lanka to offer low-income earners access to quality and affordable health services.
  • Sehat Kahani (Pakistan) runs a mobile and web-based application that provides affordable healthcare to populations in rural areas and urban slums across Pakistan. The platform connects users to qualified women doctors through virtual and mobile-enabled consultations. Patients can also access the service at community health clinics equipped with tablets and turned into e-health centres. Sehat Kahani has now partnered with Digital Pakistan to combat COVID-19 using their app, which connects patients who need advice, counselling and education on COVID-19 to qualified licensed female doctors. This 24/7 service is free for users for 3 months so that a maximum number of patients can connect to doctors while maintaining social distancing, isolation and quarantine protocols. During the first week they conducted more than 2000 online consultations to help patients dealing with the symptoms of COVID-19. Sehat Kahani received a grant from the GSMA Ecosystem Accelerator Innovation Fund in February 2018 to deploy the health technology in six clinics that support 120 community health workers.
  • 54gene (Nigeria) is an Africa-focused genomics and artificial intelligence start-up that offers genetic testing and molecular diagnostics services. 54gene was founded in 2019 to address the significant gap in the global genomics market: due to the limited availability of properly consented genetic data from Africans, many new drug and diagnostic products are being made without the inclusion of African data. This results in drugs that are less efficient for Africans. Therefore, 54gene aims to facilitate precision medicine across Africa. The start-up recently launched a fund to tackle the current challenges around testing for COVID-19 in Nigeria and raised $500,000 in less than 24 hours of its launch.

Photo credit GSMA Ecosystem Accelerator portfolio start-up, Sehat Kahani.

Optimising the delivery of essential medical products, vaccines and technologies

  • mPharma (Africa) provides mobile and web-based platforms that allow healthcare providers, pharmacies and insurance companies to make medicines accessible and affordable to patients. The e-pharmacy start-up sources, procures, finances and distributes medicine across its partner pharmacies, leaving the pharmacies to focus on the clinical aspects of their work. mPharma also has a consumer-facing mobile app that allows patients to order monthly prescription refills and provides reminders by enrolling in its programme, Mutti. mPharma is currently playing an active role in addressing drug supply shortage and price increases due to ongoing disruptions in the global drug supply chains. The start-up also revealed plans to equip 10 private labs with COVID-19 testing equipment and donate 10,000 testing kits.
  • Iyeza Health (South Africa) offers accessible alternatives to the current status quo in the health products distribution and supply chain. The company uses technology to provide medication delivery services with a focus on medication for maintaining the health of those with lifelong illnesses such as hypertension and diabetes.
  • Zipline (Rwanda & Ghana) uses drones to deliver products ranging from kits for healthcare facilities to patient-specific prescriptions. In response to the coronavirus pandemic, Zipline is already using drones as a tool for social distancing, as deliveries happen without a delivery person. In addition, the start-up’s warehouses in Ghana hold all emergency stocks of masks and gloves so that they can be delivered to regional hospitals in minutes.

Reducing the cost of healthcare for low-income consumers

  • Impact Guru (India) runs an online healthcare financing platform for patients in India. The start-up raises money for medical expenses via full-stack crowdfunding. It recently launched a ‘Fight Covid-19’ fundraiser where donations can be made to a variety of programmes including quarantine support, animal welfare, food distribution, free medical supplies, daily wager support, ventilators/ICU beds, elderly support and doctor’s equipment.
  • Jamii (Tanzania) runs a mobile management platform for health insurance policies that perform the administrative functions of an insurer while providing access to low-cost microhealth insurance policies for MSMEs. The start-up focuses on low-income earners and its policies are ordered and paid for on mobile phones via USSD and mobile money in partnership with Vodacom Tanzania. Jamii received a grant from the GSMA Ecosystem Accelerator Innovation Fund in February 2018 to increase the adoption of microhealth insurance service by MSMEs by facilitating mobile-only onboarding of users.

The building blocks or core components of health care systems such as service delivery, health workforce, health information systems, access to essential medicines, financing and leadership/governance, are often weak or non-existing in developing markets. Mobile and frontier technologies can play a vital role in strengthening these building blocks and addressing some of the major healthcare challenges.

In June 2020, GSMA Mobile for Development will publish a report on Digital Health: Early success models and opportunities in developing countries.The report will expand on healthcare challenges, explore transformative impact of digital health and highlight digital health success models in developing countries.