Introduction
Sub-Saharan Africa has experienced significant digital transformation over the past two decades, driven primarily by mobile technology penetration and innovation. The region has seen a remarkable increase in mobile phone subscriptions, with over 80% of the population having access to mobile phones. This rapid adoption has enabled sub-Saharan Africa to ‘leapfrog’ traditional landline phone development and transition directly into the digital age.
Digital Technologies in Healthcare
The healthcare sector in sub-Saharan Africa faces numerous challenges, including poor access to care, inadequate human resources, limited healthcare financing, and weak health information management systems. However, health technology is emerging as one of the top five digital business sectors in the region. The use of digital mobile and internet technologies has led to significant developments across various sectors, including healthcare.
Telehealth Systems
Telehealth and telemedicine have gained prominence, especially during the COVID-19 pandemic. Countries like Kenya and Rwanda have launched dedicated telemedicine centers to manage cases. Examples of successful telehealth services include ‘Babyl’ in Rwanda, ‘Hello Doctor’ in South Africa, and ‘one2one’ and ‘Tremendoc’ in Nigeria. Telemedicine has been used successfully for remote interpretation of electrocardiograms (ECGs) and Echocardiograms in Cameroon and Uganda.
Mobile Health (mHealth)
mHealth is one of the most popular forms of digital health technology (DHT) in sub-Saharan Africa. Studies have shown its utility in increasing awareness of hypertension, promoting healthy behaviors, and providing clinical care. For instance, an mHealth application in Nigeria improved blood pressure control by allowing cardiologists to review patient data and communicate with pharmacists.
Social Media
Social media platforms are being used to disseminate health information, share preventive measures, and engage with the public on health-related issues. However, there are concerns about the misuse of these platforms for spreading false information.
Diagnostic Information Systems
Remote monitoring solutions are being developed to address the shortage of cardiologists in sub-Saharan Africa. For example, the Cardio Pad, a portable ECG device, has been used in Cameroon to transmit ECGs to cardiologists in urban centers for interpretation.
Biometric Monitoring Technologies
Wearable and non-wearable biometric monitoring technologies are gaining popularity for managing chronic diseases and promoting healthy lifestyles. Studies in Ghana and Nigeria have shown success in improving blood pressure control using these technologies.
Decision Support Systems
The integration of artificial intelligence (AI) and machine learning (ML) in healthcare is revolutionizing patient care. AI-guided echocardiographic image acquisition has been shown to be effective in identifying rheumatic mitral valve disease in Uganda. AI-enabled ECG devices have also been used for peripartum cardiomyopathy screening in Nigeria.
Successful Initiatives Across Sub-Saharan Africa
Several countries have implemented innovative digital health solutions:
- Angola: ‘Kassai’ provides e-learning for healthcare workers.
- Ghana: ‘mPedigree’ verifies pharmaceutical products, and ‘Bisa’ offers telehealth services.
- Kenya: ‘M-TIBA’ is a mobile health wallet, and ‘Afya Rekod’ provides a digital platform for personal health records.
- Nigeria: ‘Cutica healthcare’ provides health education, and ‘MyItura’ offers a health information system.
- Rwanda: ‘Babyl Rwanda’ provided telehealth services until its closure in 2023.
- South Africa: ‘Hello Doctor’ offers telemedicine services, and ‘MomConnect’ improves perinatal care.
Challenges and Barriers
Despite the progress, several challenges hinder the implementation of DHTs, including unreliable power supply, limited connectivity, financial constraints, low digital literacy, and governance issues. The lack of large digital datasets and data security concerns also pose significant challenges.
Potential Solutions
To address these challenges, the article proposes several solutions:
- Investing in renewable energy to address power supply issues.
- Strengthening healthcare financing through public-private partnerships.
- Improving digital literacy through education and training.
- Creating a regulatory landscape for responsible AI and digital health.
Conclusion
Digital technologies and AI have the potential to transform cardiovascular care in sub-Saharan Africa by improving healthcare efficiency, facilitating health promotion, and enabling personalized medicine. However, realizing these benefits will require investments from both public and private stakeholders, as well as prospective validation and implementation studies evaluating DHTs and healthcare AI tools in the region.
