Ideas.memo | Bolaji Ogalu
Telemedicine is what happens when information technology meets medicine. It involves the delivery of health care and the sharing of medical knowledge over a distance using telecommunication especially for people who lack the means.
Telemedicine has various applications in different medical situations. For instance, telemonitoring relates to distant control of vital signs, while teleconsultation involves enabling real-time consultation through videoconference or instant messaging, thereby aiding collaboration among health professionals.
The interrogation for the formal adoption of telemedicine is important today in Africa for a number of reasons: the high cost of medical care, the inadequate health workforce, the ailing health facilities, and the challenge of an ever-growing population. The figures on the mortality rate of persons living in Africa are disturbing. The adult mortality rate for Nigeria is 32.45 deaths per 100 population, with an annual average growth of 2.47%, while the maternal mortality rate is pegged at 917 deaths per 100,000 live births (2017 est.) these startling figures are predominantly caused by delays in reaching treatment; delays in identifying the illness or medical condition; and delays in getting necessary medical help. These delays are interrelated and most deaths occur from these multiple forms of delay. Both The World Health Organisation and Nigerian Federal Ministry of Health identifies distance and cost of transportation to health care facilities especially in rural communities as a hurdle to accessing healthcare. This shows health care is inaccessible to a large percentage of the rural populace in Nigeria.
Telemedicine covers all forms of accessibility
For any health care delivery system to be effective, it must be accessible, accessibility involves – economic, physical, and information accessibility. Telemedicine makes healthcare physically accessible, mainly because the internet has made the world and communities borderless, physical barriers are broken through communication tech, from the comfort of one’s home medical services can be administered without the need for physical presence except where absolutely necessary. In Nigeria, it was recorded that majority of patients (78.1%) spend 2 hours or less on the queue before being seen by a doctor, and less than 1 hour to actually see the doctor, this reduces productivity, a study also showed that it costs patients $43 in lost time for each medical visit — more than the average $32 out-of-pocket cost for the care itself. Through telemedicine, patients can avoid long and expensive journeys to seek help by receiving remote consultation, diagnosis, and treatment from specialists in far off hospitals.
No doubt good health is expensive, but in Nigeria, it is a luxury, it is estimated that 82.9 million Nigerians are living in poverty, this represents 40.1% of Nigerians. In more context, 4 out of 10 individuals in Nigeria are poor, this could mean that the average Nigerian is one medical bill away from poverty or extreme poverty and medical insurance is largely missing in action. Apart from the direct medical bills, associated costs also hinder access to healthcare. Telemedicine can make healthcare more economically accessible, with the possibility of quick diagnosis, monitoring. This could prevent ailments from becoming severe medical conditions thereby saving cost for a wider population.
4 out of 10 individuals in Nigeria are poor, this could mean that the average Nigerian is one medical bill away from poverty or extreme poverty and medical insurance is largely missing in action.
From low manpower to remote service delivery
In Africa, it’s reported that there is a shortage of doctors, with Nigeria having a doctor to patient ratio of 1 to 6000 patients. This is attributed to the current brain drain in the Nigeria health service sector, it is estimated that 2,000 medical doctors leave Nigeria yearly. The few that stay back are unevenly distributed with most concentrated in urban areas. Consequently, rural communities, where many Nigerians reside, find it difficult to access quality health care. Besides doctors, the country also faces a dearth of other health workers and medical facilities. Telemedicine has the potential of increasing health-care delivery and making more expert health personnel accessible by patients in unmanned distant areas and to provide advanced emergency care through modern technologies. It can make specialists who are largely based in urban areas and are significantly few when compared to primary health care providers, available to people virtually and even foster collaboration between both types of healthcare providers.
In Nigeria, the availability of affordable smartphones continue to drive an increase in mobile phone usage and internet connectivity, recent data from the Nigerian Communication Commission shows that there are over 123 million active mobile subscribers, accounting to a mobile penetration rate of 87% of the population. Interestingly, there is a consistent annual growth of over 14.32%. If the delivery of health services to remote locations is harnessed through the current growing tech savvy-predominantly-youth-driven population, it has the potential of improving Nigeria’s health services and making healthcare more accessible.
Mobile penetration can also foster information accessibility since – a core functionality of the internet is the free flow of information between people especially through the use of social media and instant messaging applications. The easy flow of information whether from patient to doctor or between doctors makes telemedicine a goldmine that needs to be actively explored, this could also nurture cross-border health collaboration. A legitimate concern may arise with regard to the privacy of the medical information being shared especially the patient’s medical records. The existing statutory framework protects the privacy of medical information. More recently, The Nigerian Patients’ Bill of Rights explicitly protects the confidentiality of medical records.
In conclusion, telemedicine answers some questions
It would be preposterous to assume that telemedicine can be a remedy to cure all Nigeria’s healthcare accessibility ills as there are some medical situations that cannot be attended to remotely, but we must ask ourselves some pertinent questions.
1. Can telemedicine break physical barriers by providing remote service delivery?
2. Can telemedicine help reduce cost with prompt diagnose and monitoring especially in rural communities in Nigeria?
3. Can telemedicine help promptly share information beneficial to patients and healthcare personnel?
The answers to these questions are definitely yes, even if it makes healthcare accessible to only 8% of the population it means 16,077,087.92 could still have access which is significant in complimenting mainstream healthcare delivery. It’s imperative that Governments particularly from developing economies reconnoitre alternative ways of delivering health services to citizens and technology has provided a platform that is more accessible especially to underserved communities, breaks physical barriers, and provides health information speedily.
The opinions expressed are the sole responsibility of the authors and do not necessarily represent the official position of borg.
The ideas expressed qualifies as copyright and is protected under the Berne Convention.
Reproduction and translation for non-commercial purposes are authorised, provided the source is acknowledged and the publisher is notified.
©2020 borg. Legal & Policy Research