Telemedicine and e-health: Antidote towards reaching Nigeria’s MDGs

 There is no gain saying that the nation’s healthcare sector since independence has been plagued with the challenge of achieving the delivery of quality healthcare to the majority of its populace. These are evident in the state of inadequate infrastructure and lack of basic amenities some healthcare institutions in the country are confronted with.

Though several governments in the past and present have carried out one form of refurbishment of facilities at these health institutions, some existing health services are either not affordable or inaccessible to the vulnerable group especially the poor and people living in rural and underdeveloped area.

This can be reflected in the nation’s health induces which shows that Nigeria has one of the worst maternal, newborn and child mortality statistics in the world with an estimated 52,900 Nigerian women and 250,000 newborn dying annually from causes that are largely preventable if appropriate interventions are made available by Skilled Birth Attendants (the midwives) in the rural communities.

In the light of this, medical experts at the recent 4th Nigerian conference on telemedicine and ehealth with the theme “Driving eHealth and Telemedicine in Nigeria” called for the deploying telemedicine and e-health (electronic health) tools which will go a long way in improving the quality and accessible healthcare delivery in the country.

In an interview with BusinessDay, Olajide Adebola, President, Society for Telemedicine and e-Health in Nigeria, (SFTeHIN) said that telemedicine involves the use of medical information transferred from one site to another through electronic communications to improve patient’s health care including diagnosis and treatment.

Adebola hinted that whereas telemedicine may be as simple as two medical professionals discussing a case over the telephone, or as advanced as using video teleconferencing systems, eHealth involves the acquisition and transmission of patient’s medical data such as radiological studies, laboratory results and biomonitoring information to a physician at a convenient time for assessment offline.

According to Adebola “It is time to enact changes in the health care sector in Nigeria through the use of information communications technology (ICT) to improve quality and extension of health care services for the development of the nation. Public health monitoring, disease surveillance, research and quality monitoring require data that depends on the wide spread adoption of eHealth tools & services.

It will be recalled that on the 17th October 2006, there was a meeting of the Society with the then President Olusegun Obasanjo, the minister of health and the ministry key staff with head of other key agencies to discuss on developing eHealth in Nigeria. It was agreed that the committee will be constituted and Nigeria will have a national budget for eHealth in 2007.

The Society was informed about the creation of the national telemedicine programme under the department of Hospital services in the ministry of Health mid 2007 but no policy or guidelines on the programme is available for all stakeholders to know which areas of activities is the focus for deployment of eHealth tools and services till date. We will continue to engage the government on the need to have eHealth governance mechanism in Nigeria because without this, telemedicine/ehealth and Health ICT in general will not thrive.

For his part, Muhammad Ali Pate, Executive Director/CEO, National Primary Health Care Development Agency, (NPHCDA) stated that there is therefore a compelling need for multi-sectoral collaboration among healthcare providers/institutions and the telecommunication industry to ensure the delivery of quality healthcare services to hitherto underserved populations in rural and sub-urban communities of our country given the reality that maternal, newborn and child mortality constitutes a grave challenge to human capital development and the attainment of MDGs 4 and 5 in Nigeria.

In his words “In recognition of the critical role of ICT in strengthening health care development, the NPHCDA conceptualised the Midwives Service Scheme (MSS) with an ICT-based rapid reporting and communication tool which involves data transmission via internet, SMS and voice calls among the various drivers of the scheme. The MADEX (Mobile Application Data Exchange) Application as it is called is Nigeria’s initial footprint on the great sands of mHealth which is driven by the NPHCDA. At the moment, about 1000 mobile phone lines, distributed among 652 health facilities in rural hard-to reach locations linked to 163 referral General Hospitals. These facilities are distributed across all states of the federation and are involved in the collection, transmission and dissemination of health statistics for the purpose of monitoring and evaluation of health service delivery at the primary health care level.”

No doubt, given the increasingly important role of telemedicine and eHealth in contemporary healthcare delivery, there is the need for aggressive advocacy to telecommunications operators to support telemedicine and ehealth initiatives as the government cannot do it alone.

 For participants who spoke to BusinessDay at the conference, there should be
National eHealth Committee comprising all stakeholders such as SFTeHIN, Federal Ministry of Health, Federal Ministry of Communications, and the Nigeria Communications Commission (NCC), National Information Technology Development Agency, National Primary Healthcare Development Agency, National Space Research and development Agency (NASRDA), etc. which should be set up.

Also, the subject should be introduced in the curriculum of health science schools; Centres of Excellence where short-course training in telemedicine and eHealth can be conducted should be identified.

However, the committee to be constituted should as a matter of urgency, work out modalities for the development of a national strategy, policy and draft legislation required to successfully implement and sustain telemedicine and eHealth programmes in Nigeria. Aside this, government should formulate policies that will create the enabling business environment and provide incentives for telecommunications operators, so as to encourage existing telemedicine programmes and development of new ones, particularly in the private sector.