The opportunities for satellite based services for improving the health delivery in the sub- Saharan region High level conference ''Space for the African Citizen" Brussels, BELGIUM 16 th September 2010 Presented by: Dr. Peter Ngatia Director for Capacity Building AMREF Nairobi, Kenya

2 Africa

Africa in Perspective The African continent is huge. It is larger than United States, India, Argentina, Western Europe, British Isles and China combined. Source: The Times Atlas 3

Africas Health Challenges Common and most urgent health challenges: – Severe shortage of health care professionals – Insufficient or even absence of health care for rural and remote areas population – Where clinics exist, they are often poorly equipped, understaffed and situated beyond the reach of the existing infrastructure – High maternal and prenatal mortality rate. – High burden of diseases of mostly preventable disease. 4

Opportunities for improving health care Remote consultation, diagnosis and treatment; Training and learning for health workers; Gathering, compilation, dissemination of health information; Effective dissemination and access to research findings; Monitoring, and reporting of public health threats and response; Health education. 5

Why Satellite? Fiber coverage across Africa. Minimal access for land-locked and rural communities. Satellite coverage from just one provider. 6 Africas share of global internet access is 1% of which is in South Africa

Fibre Optic in Africa Does the execution of these fiber optic projects imply that infrastructure obstacles within Africa will be shortly overcome? Unfortunately, no. – Approximately 80% of sub-Saharan African live in the rural areas. – The fibre optic is primarily around the coastal strip and urban centres. – It would require massive resources to lay cables that connect towns with rural villages and facilities. 7

District & primary Health level health facilities Medical schools & middle level colleges MOH & national level hospitals Improving Health Delivery Opportunities for improving health delivery in sub-Saharan Africa using satellite-based services Community 8

District & primary Health level health facilities MOH & national level hospitals Improving Health Delivery Telemedicine (The delivery of health services using ICT e.g. satellite technology, for diagnosis, treatment and preventions of diseases and injuries, and the Continuing Medical Education of health care providers). – Rural health workers liaise with experienced specialists on diagnosis and treatment (tele consultation). – Rural health workers continue practice-based learning and professional development (teleducation and teletraining) – Rural facilities link to national health information systems – Extends the reach and coverage of health care – Faster patient referrals. 9

District & primary Health level health facilities Medical schools & middle level colleges Improving Health Delivery Training, Learning and Research – Availability of free literature data bases (Hinari, African journals online) – Telemedicine system archives cases as case studies that can be used by schools in teaching – Teleducation and teletraining for Continuing Professional Education (CPD) of health workers – Simulations 10

District & primary Health level health facilities Medical schools & middle level colleges Health information data and information Links C-HMIS with MOH D-HMIS with MOH N-HMIS with MOS Results into informed health planning Community Improving Health Delivery 11

Preventing illness in Uganda Veronica is a midwife in Southern Uganda. She uses her PDA for her work and for her community. She travels to the wireless router that stores the surveillance report for the entire district and where she uploads reports from the rural health clinic where she works. She also can down load news and medical information. If there is an outbreak of measles somewhere in the district, she will learn of it before it reaches her community. She can advise people how to prevent catching it. Equally, if her report shows a local rise in cholera, the district will review her data and send medications and specialist assistance to help out. It used to take six months before the district would respond to this type of distress message, if at all. 12

District & primary Health level health facilities Improving Health Delivery Health Promotion and Education – Provision of better health services for rural communities e.g. Health Education messages. – Surveillance of adherence to treatment e.g. DOTs for TB and ART – Disease and Emergency Tracking Community 13

The Panafrica eNetwork This is a US$50 million project which will connect 53 PAN-African countries through satellite, fibre optics and wireless links fro providing telemedicine, tele education, inter alia. The Network will e VSAT based start network with VSAT terminal. The Network will connect 5 universities - 2 from India and 3 from Africa and 3 super specialised hospitals from India and 7 from Africa. These will be connected to 53 remote hospitals. The telemedicine system will support the 10 super speciality hospitals to provide Continuous Medical Education (CME) in 53 remote collections. Medicine 14

Satellite African eHealth vaLidation (SAHEL) Project Objective: To support the extension of health services to facilities and communities in rural Africa using satellite technology in complement to other ICTs 15

Constraints and challenges Government regulatory policies Cost of VSATS and bandwidth Technophobia may slow take up Poor government investment in ICTs in general Cultural inhibitions and barriers that prevent use of ICTs Capacity to service and maintain ICT infrastructure 16

Long live the pioneers of this noble programme! Thanks AMREF, thanks Accenture, thanks NCK, thanks my teachers. I cant believe where I could be if this programme had not began. I could probably be still the naïve ECN waiting for instructions from my bosses without any contribution coming from my side. Surely, technology has revolutionised our lives and change the way we did things previously. I am now a proud KRCHN and waiting for AVNS to commence the degree programme. Nurse Otieno from Kisumu, graduating class of December AVNS students during an eLearning training session at AMREF

Questions ? 18 Thank You! Merci!