Disrupting Healthcare Systems in Africa: Challenges and Opportunities

Africa has the most discouraging health statistics in the world. Trailing behind the world on all health indicators, Africa bears 25% of the global disease burden (as a result of its location in the tropics, where germs and parasites are rife). Also, Africa is home to only 2% of the world’s doctors and consumes less than 1% of global health expenditure.

According to the African Health Observatory of the World Health Organization, in about half of African countries, 40% or more of total health expenditure is made up of out-of-pocket payments (OOPs). This is the most regressive way of funding healthcare. The reliance on OOPs creates financial barriers to access to health services and puts people at the risk of impoverishment. Furthermore, the current financial flows within the health systems are creating and worsen inefficiencies and inequities, for example through skewed allocation of funds to urban areas and specialized care. These weaknesses in the health financing systems have been identified as the main underlying reasons for the limited progress towards achieving the health Millennium Development Goals (MDGs) in Africa.

It is easy to bring the myriad of problems plaguing the healthcare system of the continent to the fore, but creating lasting and sustainable solutions to these problems is imperative, if the continent must care for its inhabitants and earn revenue from medical tourism, as Africa has the human resource and traditional medicine plants (raw materials) for medicine production -a venture yet to be fully exploited.

Challenges or Opportunities?

Africa has all (or almost all) it needs. The beauty of all these challenges is the opportunity to create lasting solutions through innovation. This is where African entrepreneurs have to step in and cause a change that spills into other sectors of the African economy. Yet, this is not forgetting there are some entrepreneurs who have taken over the reins from African government, to solve these challenges. Such entrepreneurs are doing an exceptional job at salvaging the deteriorating state of healthcare on the continent. The following are instances.

Zimbabwe: Dr. Cadx

Outrepreneurs had a long chat with Gift Gana, Zimbabwean entrepreneur and innovator in the healthcare system. He co-founded Dr. CADx, a computer-aided diagnostic system helping doctors diagnose medical images more accurately and at a low cost. Dr. Cadx is designed to help reduce the human errors that have dire consequences for patients and drive up medical costs. The device does this by deploying an artificial intelligence system available at any given time of the day (even in remote areas) and which will greatly improve the quality of patient management and save lives. Dr. CADx is set to revolutionize the healthcare system, benefiting patients, doctors and hospitals alike.

L-R: Founders of Dr. Cadx, Tatenda Madzorera and Gift Gana

Since the launch of Dr. Cadx in August 2016, Gana has received nominations and recognitions for the innovation and was one of ten nominees for the 2017 Innovation Prize Africa.

He has this to say: “The awards ceremony in Accra was a great time meeting, connecting and sharing ideas with other Africa innovators. Of course it was a disappointment not to win, but I congratulate the winners who do have disruptive innovations that will have a big impact in Africa and the world. Indeed IPA was an exciting time as we celebrated the innovation that is happening in Africa.”

His innovation was borne out of the dearth of radiologists in his home country, Zimbabwe. Scarcity of health professionals is commonplace in Africa.

“The main problem that we are tackling is that there is a serious scarcity of radiologists especially, in Africa. Radiologists specialize in the interpretation of medical images. For instance, here in Zimbabwe there are only 17 radiologists to cater for a population of 16 million people; giving a ratio of about 1 radiologist for 940,000 people as compared to a ratio of 1:9000 in the US. This is the same scenario in many African countries where also none of these few radiologists work in public hospitals that serve the majority of the population. Medical images are thus interpreted by general doctors or other medical workers, who because of lack of expertise, make misdiagnoses in more than 30% of the cases they review. As a result, millions of patients fail to get the right treatment or the treatment is delayed, leading to more complications like increased complexity and cost of treatment, spread of communicable disease likes TB, reduced quality of life and even death.”

Gana and his team, which he regards as his greatest asset in his entrepreneurial journey, have developed a prototype which rapidly diagnoses TB in chest X-rays, with a high accuracy of 92% in less than 15 seconds and is being expanded to other diseases and imaging techniques. When it is applied to distinguishing chest X-rays with TB or lung cancer from normal ones, it currently achieves an accuracy of 82%. The team is currently working to include other common chest diseases like pneumonia.

The team has achieved high accuracy in pilot tests on retrospective cases for tuberculosis and believes it is almost ready for use in TB screening. To validate this, they are now preparing to advance to the next phase of conducting a clinical trial of solution. This will pave way for obtaining regulatory clearance for Dr. CADx.

Dr. CADx is still at the pre-revenue stage, but the differentiation for the app (in comparison to the big players present in Zimbabwe and other African countries) is that the system achieves way higher accuracy and does not sacrifice specificity for sensitivity.

There is great need for the Dr. Cadx solution and the team is planning to start with tuberculosis screening in countries with a high tuberculosis burden like Zimbabwe, South Africa, Nigeria, Kenya and Ethiopia.

Funding is a major challenge for most African inventors. Gana and his team are still looking for investment, especially to fund clinical trials. However, as a nominee for Innovation Prize for Africa, it received a $5000 voucher and has also received $70,000 worth of services from Seedstars, including credits on Amazon Web Services, which the team presently usesto access computing resources to train their system.

Other innovators and teams are treading the path of Gana and Dr. CADx in disrupting the healthcare system in Africa.

Cameroun: Cardio Pad

In Cameroun, there are fewer than 50 heart specialists, most of who are based in the cities of Douala and Yaoundé, leaving rural areas with virtually no cardiac care. Patients living in rural areas must make long journeys to reach experts, resulting in greater risk, time and money. However, one e-Health startup is changing the narrative, by making Africa’s first handheld medical computer tablet available. The device will allow healthcare workers in rural areas to send results of cardiac tests to specialists, via mobile phones.

A screenshot of the Cardio Pad page on Himore Medical’s website

Led by Marc Arthur Zang Adzaba, Himore Medical, a company that designs and manufactures medical embedded systems (autonomous electronic and computer systems) has patented a medical touchscreen device known as the Cardio Pad.

The Cardio Pad is part of a complete diagnostic kit and goes for about US$2,000, less than half the price of other less portable systems. A healthcare worke takes some reading from the pad and then transmits this information to a national data centre. Once the ECG (or electrocardiogram, a test that checks for problems with the electrical activity of your heart) is received, a cardiologist makes a diagnosis and sends it back to the centre to be relayed to the healthcare worker treating the patient, along with prescription instructions.

Tanzania: Jamii

In Tanzania, West Africa, the health insurance options available are often not within the reach of low-income earners and the informal sector which make up a significant number of Africa’s population. Lillian Makoi’s Jamii Africa, a Tanzanian startup, is building a mobile health insurance platform which allows users to access cheap insurance via USSD (starting at $1 per month). Jamii plans to launch in five other African countries this year and part of their plans will be to leverage their strategic partnerships with Jubilee Insurance and Vodacom Tanzania to enable mobile premium collection and a cashless facility from over 400 hospitals.

Screenshot from Jamii Africa’s website

These are just a few of the pathfinders and disruptors changing the narrative of Africa’s healthcare systems. Challenges such as funding, inauspicious government policies, raw materials and skilled manpower still plague the healthcare startup ecosystem in the continent and they have to be tackled, for the groundswell of innovations taking place to make substantial impact against the dipping indices prevalent in Africa’s health statistics.

There are lots of other startups doing great work in Africa’s health sector and the story does not stop here. Which startup or entrepreneur is challenging the status quo in other parts of Africa? Leave your comments.

Featured Image: kpmgafrica

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Chiamaka Akuba37 Posts

Chiamaka Akuba is a graduate of Mass Communication of the University of Lagos, Nigeria. She is passionate about emerging markets and entrepreneurship and is actively working with the industry. She loves her conversations challenging and can’t help laughing when you call her ‘Honourable Writer of the Federal Republic'. Chiamaka is a Staff Writer at Outrepreneurs.

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