Digital Health Apps in AfricaDigital Health Apps are becoming an increasingly popular part of the “mHealth” or “mobile health” industry around the world. The widespread use of digital health apps in Africa is linked to a rapid increase in cell phone access over the past 20 years. For example, only 8% of Ghanaians owned a cell phone in 2002. By 2015, that number grew tenfold to 83%. In 2017, Sub-Saharan Africa had 778 cellular and 300 mobile internet subscriptions per 1000 people.

A Pew Research Center survey of 7,052 people across Ghana, Kenya, Nigeria, Senegal, South Africa, Tanzania and Uganda found that an average of two-thirds of respondents own cell phones. Across Africa, people use smartphones less widely than regular mobile phones. For example, 34% of respondents in South Africa own smartphones. Regardless, rising cell phone access offers the potential to improve access to health care for many across the continent.

Healthcare in Africa

Less than 50% of people across Africa can access modern health facilities, and 80% rely on public health facilities. However, public health facilities often experience chronic drug shortages, causing many patients to die from otherwise curable diseases. In 2015 alone, approximately 1.6 million people in Africa died of tuberculosis, malaria or HIV-related illnesses. Proper medication or vaccines can prevent, treat or even cure these diseases.

Many African countries spend less than 10% of their gross domestic product on healthcare. The lack of funding for health care limits the accessibility to adequate health care. There is also a lack of skilled medical personnel throughout the continent, as many trained doctors are drawn to the European and American job markets.

mHealth Benefits and Innovations

Technology is now transforming healthcare in Africa by helping improve healthcare access and quality in remote areas. These digital platforms also simplify the process for doctors and policymakers to access data. In turn, doctors and policymakers can use that data to make better-informed individual and system-wide healthcare decisions.

According to a report by the World Health Organization, digital health apps also have the ability to decrease the financial and physical burden associated with transportation to healthcare facilities, “overcome communication delays” through reliable and real-time data and “increase health workers’ adherence to clinical guidelines.” The four digital health apps below are among the many innovations helping to make healthcare more attainable throughout Africa.

  1. Hello Doctor: The South African app Hello Doctor enables people to talk to qualified doctors via their mobile phones. Doctors are available 24 hours a day and respond to call requests within one hour. The app aims to serve an easy point of access for patients and provide health education based on doctors’ advice.
  2. FD-Detector: This app detects fake medications by coding and determining their authenticity. Nigeria has long faced drug counterfeit issues. In June 2018, Nigeria’s National Agency for Food and Drug Administration destroyed an estimated $10 million worth of counterfeit drugs. Part of the problem is that less than 2% of medications prescribed in Africa are actually produced in the continent, which both limits access to local drugs and forces patients to pay the increased prices of imported drugs. FD-Detector uses a medication’s bar code to authenticate it and verify its expiration date. The app was created by five teenage girls from Nigeria, whose innovation won the 2018 Tehnovation Challenge—an international competition in which girls from around the world learn how to become technology leaders and entrepreneurs.
  3. mTrac: mTrac is a mobile health app that allows health workers in Uganda to submit weekly health surveillance data via SMS. As data is collected, an “SMS alert is sent to every member of the district health management team for immediate response when any preset threshold is reached”. For example, according to the United Nations Children’s Fund. “20 cases of typhoid or a single case of viral hemorrhagic fever” would trigger an alert to local health officials. By the end of 2020, mTrac hopes to expand its current database of 62,000 registered health workers to 300,000 registered users.
  4. Market Garden: The Institute for Social Transformation, a Ugandan nonprofit, developed this app designed to connect its primarily female vendors with local Ugandan grocers and consumers looking for fresh products. This direct link reduces crowds, allowing vendors to sell produce in adherence to COVID-19 social distancing restrictions. As a result, vendors can continue to safely earn an income during the lockdown. The Market Garden app allows vendors to receive direct mobile payments. This feature reduces the risk of virus transmission through cash exchanges.

Challenges for mHealth

The cost of cell phones and unreliable cell phone service serve as barriers to digital health in Africa. For these reasons, mHealth is biased toward wealthier groups. In Uganda, for instance, 93% of individuals with secondary education or higher own a mobile phone. Compare this number to the 61% of individuals with lower levels of education and the accessibility gap becomes clear. Gender also plays a role: six of the seven countries surveyed by the Pew Research Center, men are more likely to own a mobile phone than women.

For mHealth to continue expanding and thriving throughout the continent, the Brookings Institution states, “Governments will need to play an active role…through regulation, legal frameworks, and technical training in the health sector.” When access to technology becomes widely available, digital health apps in Africa have the power to make healthcare widely accessible.

– Zoe Engels

Photo: Wikimedia

Telemedicine In BangladeshBangladesh, a South Asian country known for its river deltas and coastal regions, has faced rapid urbanization and environmental degradation due to large-scale flooding across the country. Increasing population density and environmental erosion have made many Bangladeshis the subjects of devastating poverty. In 2018, The World Bank reported that, while the situation in Bangladesh has drastically improved since the 1990s, 22 million people still fall below the poverty line. For many, this means their health is in jeopardy, health care education suffers compromise and access to medical services is nearly impossible.

Today, there is still a stigma surrounding the need for health care in certain rural regions of Bangladesh. One common saying is “rog pushai rakha.” In Bengali, the phrase translates to “stockpiling their diseases.” This refers to the lack of importance Bangladeshis have placed on their health care. In some cases, portrayals still show medicine as inaccessible and unnecessary. This mindset can spell trouble for those living in rural Bangladesh where medicine was not always widely available.

However, the emergence of new medical communication technology, known as telemedicine, is changing the outlook for health care in Bangladesh.

What Telemedicine is and How it Works

Telemedicine, sometimes called telehealth, is “a direct line — whether it’s a phone call, video chat or text message — to a physician or care provider via telecommunication.” It is a rapidly growing technology in the health care field around the world as it ensures easier access to those who may not otherwise receive medical care.

While the technology initially focused on elderly patients and those with disabilities, telemedicine is now helping people in countries with critical health care gaps caused by geography, limited numbers of physicians and financial restraints.

Telemedicine in Bangladesh

In Bangladesh, access to health care largely concentrates in urban areas. This means there is a large gap in health care between rural and urban areas. Seventy percent of Bangladeshis live in rural areas, according to the World Health Organization.

Telemedicine in Bangladesh is a recent advancement. In 1999, it first entered rural regions of Bangladesh that did not have easy access to medical care. While the initial care lacked critical technology infrastructure, the recent expansion of bandwidths and networks into rural areas has made telemedicine more accessible for Bangladeshis.

Moreover, the Bangladeshi government has taken steps to facilitate health care needs by establishing new telemedicine programs. In 2001, the government established a cooperative known as the Bangladesh Telemedicine Association to promote telemedicine organizations. In 2003, the Sustainable Development Network Program emerged to promote cooperation between different providers.

A boat delivers laptops, medical tools and prescription printing devices each week to rural areas in Bangladesh. Individuals in need of care can travel to temporary medical centers where they receive access to physician care through the internet. These checkups are similar to checkups that established medical centers offer where patients can describe their condition, ask questions and obtain prescription drugs.

Telemedicine in Bangladesh is beneficial for more than sickness. This new technology also allows individuals to ask questions concerning their personal development, their child’s development and their nutritional needs. For many, this is a life-changing experience that not only helps with illness but also expands the general knowledge and understanding of people who did not previously have access to such education.

Nonprofits Helping the Cause

The introduction of telemedicine in Bangladesh would not be possible without local cooperation. One non-governmental organization (NGO) helping the cause is Friendship Bangladesh. Friendship Bangladesh, an NGO started in 1994, emerged to “help poor people in remote and unaddressed communities in Bangladesh.” Its aid includes a variety of programs, including those focused on education, economic development, disaster management, citizenship and cultural preservation. The organization’s special emphasis on health care has led to the emergence of telehealth solutions.

The development of mHealth, an app that can diagnose up to 32 common illnesses, and SATMED, a satellite service that allows local NGOs to share patient information using the internet, are innovative solutions to the health care problems in Bangladesh. These programs, developed by Friendship Bangladesh, have dramatically increased access and improved the efficiency of health care.

In 2017, Friendship Bangladesh provided a total of 4.2 million people with access to Friendship’s health care, including 48,000 who garnered access to the mHealth app. Friendship also employed three floating hospitals with access to satellite communication and conducted 1,392 nutrition demonstrations to help educate people on nutritional needs.

In 2020, Friendship aims to increase the number of satellite clinic days, strengthen the nutritional demonstration sessions and maintain the current floating hospitals.

The Future of Medicine in Bangladesh

Most recently, in 2018, a new telemedicine technology entered Bangladesh. Teledaktar (TD) is the newest virtual medical service that is helping expand access to medical care, according to  NPR. By creating makeshift medical centers in rural regions with little access to health care, TD is further closing the gap between doctors and patients in the most rural areas of the country.

Despite the challenges in Bangladesh, access to adequate health care is possible. The inclusion of telemedicine into common health care practices is one development in improving health care. An increase in trained physicians, along with an increase in rural health facilities, are among the recent successes to Bangladeshi health care. Moreover, the government initiation of a stakeholder dialogue with the U.N. Human Resource for Health (HRH) has created more effective dialogues that advocate for the expansion of health care across the country. With new programs, new partners and new technologies, the future of medicine in Bangladesh is hopeful.

Aly Hill
Photo: Flickr


Healthcare in AfricaMany think that underdeveloped countries in Africa will forever be stuck with poor healthcare. Yet, few media outlets show the innovative approaches African countries are taking to address this issue. In reality, Uganda, Kenya, Nigeria and other parts of sub-Saharan Africa are turning to the tech world to build better healthcare in Africa.

Mobile Technology Maps Medicinal Needs

The inefficient infrastructure in Africa puts people’s health at risk. Health clinics, which take some people hours to reach, are not always stocked with the medicine being requested by patients. For this reason, Uganda is utilizing mTRAC to construct a proper supply cycle.

On a weekly basis, healthcare workers report diseases, malaria cases and stock quantities of medicine via SMS. Then volunteer health workers in the Villiage Health Teams (VHTs) monitor the weekly count of malaria cases, severe malnutrition, ACT and amoxicillin stock.

The communities themselves provide the most impressive source of data. The people getting these services have the opportunity to provide feedback on healthcare issues such as the absence of health workers and out-of-stock medication. The data is processed onto a dashboard for the District Health Teams. The information is then filtered to the Ministry of Health in Kampala. Reporting their specific district and health facilities helps biostatisticians identify alerts and make informed decisions on drug redistribution and disease response initiatives.

There is a similar mobile pilot known as mHealth in Kenya. Novartis created mHealth to study medicine supplies for a more efficient distribution system. Pharmacists in Nairobi and Mombasa register patients in an SMS survey. The input creates a map of locations where medicine is needed. These digital technologies go a long way in delivering better healthcare in Africa.

A.I. Diagnostics Save Children

Mobile Apps also improve diagnostic procedures. Birth asphyxia is one of the world’s three leading causes of infant mortality. Annually, around 1.2 million infants die or suffer from disabilities such as cerebral palsy, deafness and paralysis due to perinatal asphyxia.

Ubenwa is a Nigerian A.I. that is programmed to detect asphyxia by analyzing the amplitude and frequency of an infant’s cry. The algorithm has been made available to smartphone users for an instant diagnosis. The availability of this app empowers Nigerian communities that do not have access to or cannot afford clinical alternatives.

Ugandan children between infancy and five years of age can receive an early diagnosis of pneumonia with a biomedical smart vest called Mama-Ope. Because of the similar symptoms of diseases like malaria, asthma or tuberculosis, it is not uncommon for pneumonia to be misdiagnosed. Mama-Ope is designed to avoid such inconsistencies in these diagnostics.

Patients with pneumonia die when the severity of the disease is not recognized. It is vital that viral and bacterial pneumonia are differentiated during diagnosis. Otherwise, the result is an improper, life-threatening prescription of drugs. The smart vest measures all vital signs simultaneously, which reduces diagnostic time. Health workers are also able to use the telemedicine device for tracking and monitoring their patients’ records. With the capability of cloud storage, Mama-Ope can change healthcare in Africa.

3-D Printer Transforms E-waste Into Prosthetic Limbs

In the small country of Togo, wedged between Ghana and Benin, lies the tech hub WoeLabs, famous for using toxic e-waste to create the first 3-D printer in Africa. Electronic waste shipped from Western countries has polluted Africa with digital dumps. The material is burned, leaving behind hazardous gases.

Togo’s neighboring country Ghana holds the largest scrapyard to cushion the globe’s annual 42 megatons of e-waste. WoeLabs in Togo’s capital, Lomé, made a 3-D Printer with Ghana’s digital scrap in one year. To date, WoeLabs has produced 20 printers. This work inspired other labs to change healthcare in Africa. Sudan is now using 3-D printing to make prosthetic limbs, and Not Impossible Labs is also helping amputees through this innovative and unconventional use of technology.

Through mobile systems such as mTRAC in Uganda and mHealth in Kenya, healthcare systems are better able to improve drug redistribution in health centers in need of medical supplies. The smart vest Mama-Ope contributes to healthcare reform by not only by diagnosing patients but also by storing records in the virtual cloud. Finally, the 3-D printers built in Togo ultimately exemplify how these communities of underresourced people can transform a hazardous situation into an opportunity to improve healthcare in Africa.

Crystal Tabares
Photo: Flickr