eHealth: a key enabler for strengthening health systems

The use of the internet and information and communication technologies (ICTs) in health has far-reaching implications for public health. eHealth saves lives, saves money, improves the health of individuals and populations and promotes equity and social justice. In the African Region, more and more countries are proving the benefits of eHealth.

Credit: WHO /Evelyn Hockstein.

The World Health Organization (WHO) defines eHealth as “the cost-effective and secure use of ICTs for health and health-related purposes” (Resolution WHA.58.28).

There is a consensus in the growing literature in the emerging field of eHealth about the benefits of its applications – for patients, health care workers, governments and health systems.

These range from improved access to health advice to enhanced quality of care through remote consultation and telemedicine and improved disease surveillance. It also makes it possible for policy and decision-makers to strengthen the intelligence gathering capacity of health systems and their ability to use information for decision making.

Recognizing ICT’s significant developmental role and cross-cutting impact, an ICT-related target was included in Millennium Development Goal n. 8. (see AHO figures 6.8.2.1 and 6.8.2.2).

The Ouagadougou and Algiers declarations also addressed the importance of eHealth in the strengthening of health systems.
 

Regional and national initiatives

ICTs offer the potential to overcome some of the major bottlenecks in the African Region, like health workforce shortages and the reach of remote areas with training, support and online consultation opportunities.

eHealth applications such as National Health Observatories (NHOs) as web-based platforms; Enterprise Resource Planning systems for better management; and telemedicine and mobile health can enhance national health systems improving healthcare delivery. Electronic medical records; electronic referrals and prescriptions; and eLearning are also helpful eHealth resources.

The African Health Observatory (AHO) supports regional and country efforts at strengthening health systems through its online based tools, its operations and the assistance to NHOs implementation. AHO also hosts the global initiative eHealth Technical Advisory Group on Strategy Network.

Other eHealth initiatives include the Telemedicine Network for Francophone African Countries; the ePORTUGUÊSe network; HINARI; and the Pan African eNetwork Project.

A number of initiatives have been launched in countries by the public and private sectors, which include the support of WHO.

eHealth and innovation in women's and children's health: A baseline review, a joint report by WHO and the International Telecommunication Union (ITU), based on a 64-country survey, demonstrates – as never before in such detail – the vital role that eHealth is playing in this area today.

This report presents 2 case studies from the African Region. In Rwanda a text messaging-based alert system helps improve maternal and child health; and in rural Zambia a text messaging programme is accelerating early infant HIV diagnosis.

Challenges

Availability of eHealth solutions is still an issue, although there has been a marked improvement in the last decade. The use of eHealth solutions is hampered by fragile and irregular energy supply in some areas of the Region; inadequate internet connectivity, availability and accessibility; and inadequate availability of computers and other IT devices.

Policy-makers, health authorities and health practitioners are not fully aware of the potential benefits of the use of ICT for health. Most countries in the Region lack an eHealth national strategy or policy framework that could avoid fragmentation of eHealth solutions.

The rapid advances in ICT have put countries under intense market pressure to adopt ICT-associated services. There is a need to ensure that the introduction of ICT in the health sector is driven by country needs and appropriate policies.

The number of health workers capable of leveraging ICT in their work is another challenge. There are insufficient numbers of health workers with the capacity to design, deploy and effectively manage eHealth projects and programmes.

On the other hand, the majority of the eHealth projects implemented so far in the Region have not been adequately monitored or evaluated. The challenge is to ensure the availability of efficient systems for monitoring and evaluation, as well as for sharing of experiences and lessons learnt.

WHO and ITU have been organizing several workshops and meetings aiming to facilitate the development of comprehensive eHealth strategies within the countries in the Region.

Useful resources

National eHealth Strategy Toolkit
OneHealth Tool
Directory of eHealth policies
Compendium of innovative health technologies for low-resource settings 2013
Global Observatory for eHealth
WHO eHealth website

Useful documents

Utilizing eHealth solutions to improve national health systems in the African Region
eHealth solutions in the African Region: Current context and perspectives
Leveraging eHealth to improve national health systems in the African Region, The African Health Monitor, issue 14
Management of patient information: Trends and challenges in Member States – Report
WHO Resolution on eHealth
eHealth standardization and interoperability