The ongoing brain drain in Africa is becoming more evident and worrisome, especially for countries with a larger population. In countries such as Nigeria that have witnessed an increase in insecurity, worsening economic and social conditions, it is no surprise that professionals and essential workers continue to migrate to more developed countries in search of better opportunities, healthier working environments and improved remuneration.
According to the medical and dental council of Nigeria, there are about 75 000 registered doctors with only about 35 000 currently practising, which brings the doctor to patient ratio in that country to 1:6000 as opposed to 1:600 as recommended by the World Health Organisation (WHO).
The bulk of the limited number of practising doctors are scattered across urban areas with reduced access to rural areas because of poor road networks and insecurity.
These numbers are cause for concern to say the least and which now beg the question, what can be done about it?
Revolutionary qualities of telemedicine
Telemedicine is defined broadly by the WHO as the delivery of healthcare services at a distance using electronic means for “the diagnosis, treatment, and prevention of disease and injuries, research and evaluation, education of health care providers” to improve health.
Telemedicine has the potential to revolutionise healthcare. Around the world, it has assisted in achieving sustainable development goals on global healthcare coverage and has been invaluable to many during the Covid-19 pandemic.
In addition, telemedicine benefits both patients and providers. Patient benefits include increased healthcare delivery to remote communities; better linkages between patients, primary care physicians and specialists; increased access to quality healthcare; and reduced cost. Benefits to healthcare workers range from better coordination between providers at various levels of care (primary to tertiary) to increased access to specialist training.
The demand for healthcare services continues to rise with the increase in the world’s population. Richer nations that can afford to pay for healthcare will sponsor Africa’s brain drain thereby further depleting human resources for health in poor countries.
The somewhat new and exciting fusion of healthcare and technology that is telemedicine is aimed at bridging the gap between healthcare providers and the population. It enables people to seek care from varying medical specialties and professionals around the world without the hassle and cost of travel and logistics.
The implementation of telemedicine and telehealth systems in the developed world has been an ongoing and successful venture, but the developing world is once again late to the trend and trying to play catch up.
The adoption of telehealth and telemedicine services in Europe and the United States is indicative of the joint effort by the various governments and privately owned companies to make healthcare accessible to everyone leveraging on already existing technology and systems such as health insurance, favourable government policies and technological advancement.
A telemedicine awareness study conducted in Ghana in 2019 revealed 71% of respondents were aware of the use of smartphones to access healthcare. Men had higher awareness levels than women, although no clear reason was stated. Although most people had knowledge of telemedicine, only 51% had utilised it at one time or the other.
A telemedicine acceptability and willingness to pay study in South Eastern Nigeria revealed a much lower awareness rate than that of Ghana. More than 65% of the respondents had no knowledge of telemedicine, most of whom were healthcare professionals.
Approaches to expanding telemedicine in Africa
Education: increasing awareness of telemedicine technology and its benefits such as reduction in long waiting times, workplace absenteeism and the overall cost of seeking care is essential to expanding its reach on the continent.
Internet access: most rural communities have very slow and unreliable internet connectivity. To cross this barrier, telemedicine technology in Africa needs to rely heavily on other forms of calls and communication.
Reduce cost: although telemedicine offers health services at lower cost, it is still relatively expensive for the poor and vulnerable. To overcome the cost barriers, services must be priced at an affordable rate for the informal sector.
The potential for growth in telemedicine and telehealth is vast in Africa and can only be evident if the problems facing its adoption can be tackled. Government and private investors have a huge role to play in the integration of this technology into our healthcare services.