Time for public health to seriously invest in portable diagnostics technologies

By Lahja Nashuuta

ALMOST in every country in the world the large portion of its population lives in rural areas. In Namibia, about 53,34 percent of the citizenry resides in rural areas. However, health care in these continues to lags behind in terms of both quantity and quality.

People in rural areas face different health challenges than those living in towns and cities. Comparing to rural areas, people living in urban areas have access to public transportation, proper medical care, and modern prevention programmes.

But getting health care can be problematic when you are living in remote areas. You might not be able to get to hospital quickly in an emergency. You also might not want to travel long distances to get routine check-ups and screenings.

Rural settlements often have no doctors, apart from nurses that are manning sparse clinics. Specialised medical care is tens and hundreds of kilometres away in cities and towns.

Because it can be hard to get proper care, health problems among rural people may be more serious by the time they get a proper disgnosis, hence they are said to have higher rates of chronic diseases than people in urban areas, according to the World Health Organisation (WHO).

For instance in Namibia, seeking medical help in rural areas will require walking several kilometres to the nearest clinic, which is worsened by lack of transport.

And in many cases, patients are forced to track back home without treatment due to lack of manpower at most public health centres. People at centres like Oshakati Intermediate Hospital, which serves almost all the four northern regions, spend hours in long queues which are taxing.

And most clinics in villages that offer basic services for minor ailments are being run by a single nurse, with no doctor or an ambulance in case of emergency.

Most of patients with serious medical conditions are referred to state hospitals to either consult the doctor, or to go for check-up.

For instance in Namibia, which is the same across Africa, there is only one state hospital per region with limited health personnel. For instance – Oshakati state hospitals in Oshana region serve as a referral health centre for patients coming from other regions such as Ohangwena, Omusati, and Oshikoto and from as far as Kunene.

Most regional hospitals lack proper diagnostic equipment, which forces patients to be placed on the waiting list that in some cases spread out for several months for instance to get sona or x-ray scan. And many people, mostly those in rural areas, die in the process, as they cannot afford the alternative – which is private treatment.

There have been huge improvements in the Namibian public health sector since independence in terms of equity in access to health services and allocation of resources as well as the decentralisation health care management.

Unlike during the colonial era, when health systems were selectively distributed, with most health services and infrastructure concentrated in the urban areas, today there are 265 clinics, 44 health centres, 30 district hospitals, three intermediate hospitals, including a national referral hospital, as well as some social welfare service points that serve 85 percent of the Namibian population, while private health care serves 15 percent of the population.

But still, much needs to be done in order to improve rural healthcare delivery, and achieve the global target set on the Sustainable Development Goals that seek to ensure health and well-being for all by 2030.

The WHO noted that ICTs have great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services.

The health sector can make use of ICT tools to overcome geographical barriers, and increase access to health care services particularly in remote areas.

For instance, introducing portable medical technologies that a nurse could technically even go to villagers’ homes with her device to test them for the diseases such HIV, TB, diabetes, malaria just to mention a few in order to avoid the waiting lists and long queues at hospitals.

For instance rural clinics should be equipped with i-STAT portable clinical analyser – a handheld device that provide health workers with prompt lab results, instead of sending blood samples to government laboratories in faraway towns and cities, which would often take weeks for the results to arrive back at the clinic. Sometimes they would get lost in the system and not return at all.

Apart from that our health sectors need mobile apps such as South Africa’s momConnect, a mobile app that sends weekly SMS messages to pregnant women on how to manage their pregnancy at different stages.  The app also allows women to log complaints about bad service, and doesn’t require the user to have cellphone data or a smartphone.

May 2017
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