Digital Counselling and Telemedicine in East Africa

For those unfamiliar with the term "telemedicine," it simply refers to the practice of treating patients via technology. 


Telemedicine is defined as "the delivery of healthcare and the exchange of healthcare information across distances." Instead of physically visiting a healthcare institution, patients can speak with a healthcare provider via technology through telemedicine. People can now connect with a healthcare provider in real time via video, web portals, and email about symptoms, medical issues and more, using the medium of telemedicine.


Telemedicine has the potential to reduce healthcare costs, increase efficiency and income, improve patient access to care and ultimately result in happier, healthier patients who stay with and trust healthcare providers. In an analysis by Christopher Cheney, he validated this by saying, “Telemedicine visits generate cost savings mainly by diverting patients away from more costly care settings, new research shows.” For example, in the USA, he says, “The bulk of the cost savings from the telemedicine program was generated in diverting patients from emergency departments. Each avoided emergency department visit garnered cost savings ranging from $309 to more than $1,500.”


Self-care treatments are one of the most promising new techniques for enhancing health and well-being, according to the World Health Organization (WHO), both for health systems and for the people who use them. This is because, with or without the help of healthcare professionals, individuals can maintain their health and achieve positive health outcomes through self-care actions. They can do so through telemedicine efforts, which give them digital access to healthcare and counselling.

According to a study by Salient Advisory Inc. in 2022, over the last decade, telemedicine services have grown in popularity and the COVID-19 epidemic has further intensified the expansion of telemedicine services across the world. They discovered that telemedicine has the potential to reduce the load on healthcare practitioners and make healthcare more accessible, especially in Africa, where many countries' health systems are under-resourced.


Their findings show that, particularly in Kenya, Uganda, Rwanda and Tanzania, there is an expanding ecosystem of commercial telemedicine and digital counselling firms.


In these regions, there are about 26 active companies, with 20 of them categorised as telemedicine and six as digital counselling. Kenya has the largest percentage of active telemedicine organisations, followed by Uganda. Almost half of the region's organisations operate in multiple countries, implying that multi-country expansion is possible. Just a few of the global companies are Nivi, ClickMedix, Triggerise, Weltel and Aviro Health. These findings show that, in line with global trends, telemedicine and digital counselling services in East Africa will continue to grow.


They also observed in this study that telemedicine can assist with both the supply and demand sides of the healthcare system's issues. On the supply side, telemedicine and digital counselling services help with scheduling and staffing. As a result, service delivery will be improved. Furthermore, digital patient onboarding, assessment, care and follow-up support can improve the quality of care while reducing in-person strain for healthcare providers. On the demand side, these services can improve healthcare for people who live in rural or under-resourced locations by boosting convenience, reducing patient wait times, and making great healthcare more accessible.


Our contribution at Aviro is through our digital self-care application, Pocket Clinic, which is in line with telemedicine in Africa. We found that when we listened to how users wanted to use technology we got better engagement through our technologies. Our project in Kenya used a Whatsapp Chatbot to digitally guide and assist people through HIV self-testing. When we spoke with partners and clients, we saw that there was a need for linkage to prevention services and the chatbot was expanded to include this. In 2021, Aviro Health CEO, Dr. Musaed Abrahams visited Kenya to meet one of Aviro’s partners, Populations Services Kenya. The two organisations were to discuss how they can work together to get people who want to test for HIV to trust Pocket Clinic. 


In this endeavour, establishing trust with the potential users was crucial and for that to happen, both organisations had to have a good listening ear. PS Kenya is working to increase the number of men who are tested. HIV is stigmatised in general and when Dr. Musaed engaged with our partners and clients, he discovered that many Kenyan males respect their privacy and do not want to be seen testing for HIV. This provided Aviro Health with a fantastic opportunity to emphasise that the Pocket Clinic chatbot provides users with easy access to HIV-related information, testing and referrals to preventative services in privacy. Digital health technologies used in this specific case allowed more people to understand and act on their HIV status.


Pocket Clinic cleverly combines digitally assisted self-care with linkages to actual people and resources. Individual needs are met by our technology, where they are empowered to perform crucial health screenings, such as HIV self-testing and connect individuals to specialists and services that can provide hands-on, supported care as needed.


Our objective is to enable healthcare workers to focus on more difficult cases by delivering technology-based services that streamline workflows, enhance access to high-quality medical information and provide digitally enabled counselling services.

 

Many of the value propositions of digital counselling and telemedicine organisations are based on enhancing care efficiency for patients and providers, albeit this has yet to be rigorously assessed. At Aviro, we designed an admin and reporting tool with live dashboards for Pocket Clinic to help people understand and evaluate the success of digital health interventions.


Many issues about telemedicine's future remain unresolved. More buy-in from governments, customers, and providers is required to accelerate the sector's growth and sustain these services at scale. Overall, this research shows that East Africa's telehealth ecology is changing rapidly. In the future, increased innovation will result in new care models and exciting opportunities for users, providers and governments.


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