Electronic health (eHealth) has been recognised as an essential tool to administer healthcare needs. However, the absence of a national eHealth strategy is seen as a challenge towards achieving effective healthcare delivery writes ALEXANDER CHIEJINA.
Recent reports in the media reveal that Nigerians spend up to N78 billion annually on medical tourism overseas. Early indicators from an ongoing survey show that over 50 percent of respondents have either personally experienced or know of a case of negligence in the course of healthcare service provision in a Nigerian hospital.
“Findings so far point to a considerable lack of confidence in the Nigerian health system by a significant percentage of respondents leading to the question: could Telemedicine and eHealth help to restore Nigerians’ trust in the local healthcare system?” asked Benjamin Akinmoyeje, an Information Technology (IT) support advisor at Management Sciences for Health, a non-profit Organisation in the country.
Across the globe, countries are confronted with the challenge of financial burden on government, dearth of health insurance schemes for individuals, ageing global population and increasing population that has placed significant strain on global health.
In a bid to address these challenges, the World Health Organisation (WHO) recognise eHealth as a veritable tool to deliver health information for health professionals and health consumers, through the Internet and telecommunications as well as using IT to improve public health services through education and training of health workers, etc.
As eHealth not only helped health economists focus on a host of inexpensive clinical applications such as tele-neonatology, tele-paediatrics, it has become an essential tool to administer healthcare needs in developed nations with pockets of this developments in developing countries.
With some medical institutions in the country embracing eHealth, the absence of a National eHealth Strategy to facilitate a systematic, coherent and sustainable implementation of telemedicine and eHealth in the country, medical experts believe, has made the development of eHealth and integration into the nation’s healthcare delivery system difficult.
While experts seek that telemedicine and eHealth should be integrated into the curriculum of medical/health training institutions in the country, they believe that the Federal Government should promote advocacy to get the three tiers of government involved in the development of eHealth strategy, with active participation of all major stakeholders — private sector academia/universities, NGOs in health, development partners, professional bodies and associations, etc.
In an interview with BusinessDay during the 17th International Conference on Telemedicine and eHealth (ISfTeH), organised by Society for Telemedicine and eHealth in Nigeria (SfTeHIN), the national representative member of ISfTeH, in Abuja recently, Eyitayo Lambo, former minister of health, said “the implementation of eHealth in the country has been largely piecemeal and uncoordinated as existing pilots were rarely scaled-up.”
While decrying the absence of a comprehensive national eHealth strategy, Lambo enumerated numerous challenges which include lack of policy and an eHealth legislative framework, power problems, lack of political will, absence of a robust ICT infrastructure, poor funding of the health sector, to mention a few.
According to Lambo, “eHealth would provide efficient and cost effective healthcare services for people in remote areas through early diagnostics, logistics and supplies as well as help individuals to make informed decisions about their health. Beneficiaries of eHealth include patients, healthcare professionals and providers, government bodies, policymakers, healthcare educators and students.”
The former minister explained that the National Health Policy and the National Strategic Health Development Plan Framework (2009 – 2015), developed by the Federal Ministry of Health were key documents upon which any work towards developing the eHealth policy should be based upon.
Lambo explained that developing a national eHealth Strategy involves a multi-stakeholder participatory approach and a credible strategy development process, by which the eHealth strategy would be aligned to the strategic priorities of the health sector.
“The Federal Ministry of Health should facilitate a coherent and sustainable implementation of eHealth in Nigeria, get every level of government involved and provide enabling environment for implementation with a national eHealth steering committee should be constituted with SfTeHIN providing professional support. Factors that could facilitate implementation of eHealth include a national ICT policy and a well developed and efficient mobile telecommunications infrastructure,” Lambo advised.
Lending his view, Mohammed Lecky, Senior Strategy Advisor, International Development Research Centre/Nigeria Evidence-Based Health Systems Strengthening Initiative (IDRC-NEHS), said that Federal Government has sought to pay more attention to this important emerging field however, attempt to achieve coherence in the form of an articulated policy framework regarding telemedicine and eHealth which had proved abortive, due to several factors.
BusinessDay investigations show that until 1999, ICT use in Nigeria was next to nothing until development of ICT policies for the telecommunications sector in 2000 and the establishment of the National Information Technology Development Agency (NITDA) to formulate a National Policy for ICT in Nigeria in 2003.
The government established the Nigerian Communications Commission (NCC), launched a government web portal as well data and research satellites in 2003. Government also established the National Space Research Development Agency (NASRDA) to, among other things, formulated roadmaps for implementing eHealth in partnership with the National Planning Commission (NPC).
With the adoption of District Health Information System (DHIS) as a national tool for reporting aggregate data from the lowest to the highest levels, the need for a comprehensive situational analysis as a precondition for the development of a comprehensive national eHealth strategy cannot be overemphasized.
For Olajide Adebola, president, SfTeHIN, “A comprehensive situational analysis of the implementation of telemedicine and eHealth initiatives should be undertaken to identify the strengths, weaknesses, opportunities and threats of the current efforts. The eHealth strategy should address local needs and should involve locally driven solutions.”
While calling for the upgrade of the National Telemedicine Programme at the Federal Ministry of Health to a national eHealth programme with secretariat under the ICT Department in the Federal Ministry of Health, Adebola said that the programme should be strengthened and adequately utilized, and similar desks established at the various State Ministries of Health.
“A National eHealth Committee should be constituted, possibly under the purview of the National Council on Health, with membership drawn from all major stakeholder groups and this body should be charged with the responsibility of providing policy advice to the government on telemedicine and eHealth matters.
“A National eHealth Steering Committee should also be constituted with membership drawn from all major stakeholder groups and the Steering Committee should be charged with the responsibility of guiding/coordinating the development and implementation of the eHealth strategy assisted by National eHealth Working Groups and supported by a National eHealth Secretariat, which is housed in the Federal Ministry of Health,” Adebola added.