A Progressive Healthcare industry
How far has Africa come, the pitfalls and the milestones
Dr Rajeev Rao Eashwari
Director eHealth, Hospital Services
Gauteng Provincial Department of Health
eMail: Rajeev.Eashwari@gauteng.gov.za
gMail: drraajeev@gmail.com
Cell: 083 220 1037

Agenda
•Healthcare in Africa, a trip down memory lane
•The challenges in the industry
•Lack of funds and infrastructure : How technology is
changing this scenario
•What the future of public healthcare looks like with
technology in the midst.

Healthcare in
Africa, a trip down
memory lane
In 1913 Albert Schweitzer founded one of the
first modern hospitals in Africa dedicated to
the health of the local population. The Albert
Schweitzer Hospital is located in Lambaréné, a
small town in Gabon (French Equatorial Africa).
in 1952 He won the Nobel Prize for his work
there. Schweitzer used the prize money to
build a leper colony.
in 1965 He managed the hospital until his
death.
In 2022 The Albert Schweitzer Hospital still
faces huge obstacles: a million-dollar budget
deficit, antiquated facilities, a rising burden of
HIV and tuberculosis.

Largest
Hospital in
Africa and the
8th largest in
the world
Chris Hani Baragwanath Hospital (1942) is a hospital in Soweto,
Johannesburg, South Africa, it is the largest hospital in Africa and
eight largest hospital in the world. It has 6,760 staff members,
3,400 beds and occupies 70 ha (170 acres).

Africa
Population
Whereas the population is expected
to decrease somewhat until 2100 in
Asia, Europe, and South America, it
is predicted to grow significantly in
Africa.
While there were 1.4 billion
inhabitants on the continent at the
beginning of 2022, the number of
inhabitants is expected to reach 3.9
billion by 2100. In total, the global
population is expected to reach
nearly 10.4 billions by 2100.
Source: https://www.statista.com/statistics/272789/world-population-by-continent/
1.4
billion
in
2022
3.9
billion
by
2100
African Continent
17.9% of World Population

Healthcare Burden in Africa
Source: https://www.statista.com/statistics/1029287/top-ten-causes-of-death-in-africa/

Africa
Healthcare
Burden
A Heavy Burden: The Productivity Cost of Illness in
Africa
• The diseases afflicting the African population are
responsible for a substantial loss in health,
estimated at 704 765 879 DALYs in 2015 alone.
• In the WHO African Region, total losses
amounted to 629 603 271 DALYs.
• Out of that total, 416 671 978 DALYs (59.1%)
were from communicable, maternal, perinatal
and nutritional conditions;
• 216 073 399 DALYs (30.7%) were from non-
communicable diseases (NCDs) and
• 71 551 401 DALYs (10.2%) were from injuries.
• Five countries (the Democratic Republic of the
Congo, Ethiopia, Nigeria, South Africa and the
United Republic of Tanzania) accounted for
almost 50% of the total DALYs accrued in the
Region.
Source: https://www.afro.who.int/sites/default/files/2019-03/Productivity%20cost%20of%20illness%202019-03-21.pdf

Africa
COVID-9
Statistics
Source:
https://who.maps.arcgis.com/ap
ps/dashboards/0c9b3a8b68d04
37a8cf28581e9c063a9

A majority of Africans, mostly the poor and those in the
middle-income bracket, rely on under-funded public health
facilities while a small minority has access to well-funded,
quality private health care.
In 2001, African countries agreed to allocate at least 15% of
their budgets to health care.
Several African countries have made significant progress in
healthcare with strategic health planning, public health
reforms, and adopting new technologies.
Healthcare in Africa, A situational analysis

Healthcare in Africa, A situational analysis
Africa has faced some of the worst pandemics in history like Ebola and Zika and is now
fighting Coronavirus. People in Africa are living in fear and uncertainty over the rising
viral infections, coupled with poor health service offerings.
African communities and the African Government are continually striving to stop the
spread of communicable and other infectious diseases. It is the No. 1 priority in public
health is to identify the challenges in the healthcare system and overcome them.
Some of the past studies and surveys have given us valuable inputs in this direction.
Highlights from the African Epidemiological Association report aptly mentions the top
three reasons why African healthcare is going through a massive crisis.
• Worker Shortage
• Inefficient Management
• Counterfeit drugs

Healthcare in African countries has a lot of room for improvement. Governments
and NGOs are actively looking to fix that.
For instance, countries like Zambia, Nigeria, Zimbabwe, Kenya, and South Africa
have made significant strides to improve healthcare for their citizens by introducing
Strategic health planning, public health reforms, and adopting new technology.
Strategic health planning is employed to revamp the health sector of a country
setting goals and creating objectives for areas where a state would like to improve
on and then proceeded to construct a plan to accomplish these objectives.
In the health sector, especially, healthcare planning must take into account potential
government challenges faced by the people, technological advancements, policy
changes, and economic trends that could change the countries’ operations in a
significant way.
Healthcare in Africa, A situational analysis

üDynamic Medical Needs of the Public
üA wide range of diseases is often challenging and require specific tactics to
control. Besides, they are highly in need of medicine and medical support
dynamically.
And some other lesser-known issues.
üInsufficient budget allocation to healthcare
üMedical supplies are unaffordable prices and face disruptions in the
supply
üInefficient coordination between public and private healthcare sectors
üMisunderstanding between policymakers in the changing health industry.
Significant challenge for public health in Africa.
Source: https://zm.tauedu.org/blog/10-ways-to-address-healthcare-challenges-in-africa/#challenges-in-the-african-healthcare-system

How Technology Is Changing Health Care
Challenges to be addressed are:
•Infrastructure issues
•Shortage of health professionals and
•Insufficient digital data

What does infrastructure mean in healthcare?
Hospitals and other healthcare facilities depend critically on
A strong public health infrastructure that includes:
• A capable and qualified workforce,
• An up-to-date data and information systems, and agencies
that can assess and respond to public health needs
• Without power supply:
• All critical equipment needs power.
• Digitization of patient information is hampered

Shortage of health professionals …
Prolonged waiting time because of shortage of human resources
Africa has less than one health worker per 1000 population compared to 10 per 1000 in
Europe
Insufficiency and inadequacy of health workers which is leading to
• physical and mental exhaustion, leading to Burnout and in some cases
• Increased litigation because of avoidable errors
• Africa is experiencing a massive exodus of healthcare professionals to Western Europe
and North America.
The health problems in Africa are worsened by unequal distribution of health
professionals
• Between Countries
• Between the provinces (some are better than the others).
• Between the private and public sectors, (difference in remuneration)
• Between urban and rural

Lack of data in real-time due to
Lack of electronic health records across the continuum of care
Poor paper based record-keeping, causes unnecessary delays for
patients.
Patients’ folders are missing, misfiled or lost,
Duplicate folder are created adding to the confusion
The medical history of the patient is lost, which can create
further complications leading to incorrect diagnosis and in some
extreme cases death of the patient.
Possibility of litigation costs erodes the healthcare budget

On a positive note

How Technology Is impacting Health Care
Source: https://www.cloudera.com/campaign/how-a-data-driven-culture-delivers-business-success.
Artificial Intelligence
Recently AI techniques have sent vast
waves across healthcare, even fuelling
an active discussion of whether AI
doctors will eventually replace human
physicians in the future.
We believe that human physicians will
not be replaced by machines in the
foreseeable future, but AI can
definitely assist physicians to make
better clinical decisions or even
replace human judgement in certain
functional areas of healthcare (eg,
radiology).
AIDING SOFTWARE
The interpretation of Portable chest radiographs can be
asses using a new visualization method – the interpretation
time is reduced by >60% versus the Standard reporting
time.

Artificial Intelligence
AI solutions exist today that help reduce the time
physicians spend taking notes, making patient-doctor
interactions efficient and helping patients recall the
key points of physician-patient interactions. These are
examples of giving day-to-day tools a digital upgrade.
True digital transformation spans
people,
process and
technology.
• The key role data, analytics and innovation leaders
play in empowering organizations for better
business outcomes.
• A data-driven culture should be part of a successful
strategy digital transformation.
How Technology Is impacting Health Care

How Technology Is impacting Health Care
Source: https://www.pelebox.com/

How Technology Is impacting Health Care
Source: https://edition.cnn.com/2018/12/21/health/medical-transport-drones-scli-intl/index.html

How Technology Is impacting Health Care
Source: https://edition.cnn.com/2018/12/21/health/medical-transport-drones-scli-intl/index.html
Remote care- Hello Doctor
While infrastructure can be poor, the number of mobile internet users in sub-Saharan Africa is growing rapidly.
According to GSMA, the mobile industry’s trade body, smartphone connections in the region reached 302 million in
2018. GSMA expects this to rise to nearly 700 million by 2025.
As a result, apps that enable remote access to medical advice and diagnosis are popping up across the continent.
Hello Doctor, a South African app, provides essential healthcare information, access to advice and a call back from a
doctor for 55 rand ($3) a month.
You can dial *120*1019# or Download the Hello Doctor App for access once you have
registered above.

How Technology Is impacting Health Care
Source: https://www.vulamobile.com/
Remote care- Vula App
VulaApp, a South African app,
Get more accurate referrals, and treat the patients who really need your expertise.
Quality referrals We’ve worked with specialists in academic hospitals to make sure the right clinical information for
your speciality is captured in the referral.
Educate and train The chat feedback about specific referrals can help primary health workers to up-skill in your
speciality.
You can dial *120*1019# or Download the Hello Doctor App for access once you have
registered above.

Mobile Applications in Personal Health Service.

üImprove the Doctor-Patient Ratio. ...
üCombat the Brain Drain Phenomenon. ...
üBetter Medical Education. ...
üIncrease the Budgetary Allocation. ...
üBetter Collaboration. ...
üImproved Coordination. ...
üWidespread Public Awareness. ...
üIncorporating Technology into Healthcare.
Healthcare Challenges can be addressed

How In Africa, the public healthcare system is tied with many NGO’s and independent organizations locally and from
other nations who are providing aid to overcome the challenges in this direction.
A public health program is an extensive plan covering various aspects beyond the physical wellbeing of people. It
responds to issues like any injury, violence in the community, various vaccination programs, and infectious diseases.
A graduate of the master’s in public health speaks a ton about your commitment to improving wellbeing. After
completing a master’s in public health, here are some of the ways you can contribute to the public:
• Study the disparities in the access to healthcare and its reach to different parts in the African nation and formulate
a plan of action
• Counsel communities and individuals of the law for better healthcare for everyone
• Carefully study the health issues that are impacting the lives of many in Africa and other countries, and prevent
the spread of such diseases
• Suggest changes and implement new health policies that benefit those who are in a dire need
• Improve and form new community partnerships and associations with foreign NGOs
• Discover technology-based solutions through research and implement them for better medical care for the public
• Administrative and political support Encourage innovation, and support start ups-
Education Can Resolve Healthcare Challenges…

Conclusion
The system needs to improve the doctor-patient ratio, quality of
medical education, budget allocation, adapt to digital platforms and set
up R&D centres, access to information, and reduce brain drain.
There has to be a close collaboration, partnerships, associations and
implement appropriate solutions across all agencies.
• Between African countries with WHO and UN on framing people-friendly
policies
• Collaboration between Governments, Industry, Academics, NGOs, and
Funders
• Coordination of public and private healthcare sector.
All these measures will help meet the challenges in healthcare and
education which play an important role.

Dr Rajeev Rao Eashwari
eMail: Rajeev.Eashwari@gauteng.gov.za
gMail: drraajeev@gmail.com
Cell: 083 220 1037