hen we discuss health matters about Africa, the fabled ‘narratives’ hold true: weak healthcare systems, limited infrastructure, understaffed health facilities, and scarcely digitized methods of collection and storage of health data. A majority of the health data recording in public hospitals is still done on paper and stored in file cabinets for manual analysis, leaving the system open to the danger of important health findings going largely unnoticed and unconsidered; a deeply unsettling possibility for a growing region of 1.2 billion people with a huge health service demand. This loss of healthcare insights is especially tragic in light of the fact that the primary cause of deaths in Africa remains communicable diseases which are preventable. According to UNICEF, there are 5,500 child deaths in the under-five age group every day in Southern and Eastern Africa due to conditions that could be prevented or treated with access to simple, affordable interventions.
Grace is a 28-year old woman in Kenya who has had an intensely personal brush with the statistics. After a dear cousin succumbed to it, she is terrified that her two beautiful daughters could be the next victims of the spike in infectious bacterial pneumonia in her village. Like her neighbors, she too goes to bed with this dread in her heart every night. Is anyone doing anything about it? Yes. Is it helping? Not much. Governments and private stakeholders in the region have provided billions-worth of at-cost treatment in attempts to improve health outcomes, with seemingly little beneficial results for the general population. There seems to be a discord between the current systemized interventions for general health and the demands of the population. The voice of the people remains largely unheard and it is high time the key stakeholders in healthcare take a moment to scrutinize the data for clues.
In the past few years, Africa has seen a rise in interest from private stakeholders in the region’s ‘big data’ opportunities. Big data refers to both, structured and unstructured data, so massive that it requires special database and software techniques to process. Apart from the big five Internet players (Apple, Amazon, Microsoft, Google, and Facebook), plenty of others are taking advantage of the big data spoils to create products best suited to the current African market demands. IBM Research Africa has already invested up to $70 million to launch a Watson-powered platform for 25 million African youth, offering free skills development programs, including in big data and cloud computing and analytics. While some of these private investments take advantage of the market naïveté for business gains, there are generally very positive outcomes from the application of big data, predictive analytics and IoT (Internet of Things) in this region. Data-intensive paradigms, if also applied to the health care sector, could transform health service delivery tremendously.
For Africa, there needs to be a general migration from traditional paper record ‘bureaucracies’ to safe online and personalized patient-centric methods of data collection. This will inform the formation of new health strategies and influence better decision making and resource allocation for governments and private stakeholders alike.
Should global healthcare institutions invest in big data in Africa? How difficult would it be? Experts agree that the complications for stakeholders and policymakers for big data investments are not limited to any technological scarcity in the region. There is plenty of data which has already been collected from various sources and which can be harvested before we need to introduce new technologies for further data tailored needs. According to a 2018 GSM association (Global Systems for Mobile communications) Infographics report, the overall mobile phone subscriber penetration in Africa reached 44% by 2017, up from just 25% at the start of the decade. This means nearly half of the entire 1.2 billion people may have access to a working mobile broadband connection. Global healthcare stakeholders may thus find it easier to capitalize on this opportunity by thinking along the lines of mobile-phone-based health service applications and programs—a step in the right direction towards harnessing the computational power of big data analytics. Big data analytics in the confines of mobile-phone-based surveillance technologies have already been put to test in Africa and have worked remarkably well.
In Kenya, GAVI—a public-private partnership and vaccine alliance committed to increasing access to immunization in developing countries—funded a pilot program to map pneumococcal vaccine administration while monitoring the incidence of same disease occurrence using big data analytics. The results were impressive. There was a staggering drop of 70% in pneumococcal disease-related hospital admission rates only after a few months. Grace too, is a beneficiary of the GAVI surveillance program. She is finally relieved of the constant worry for the lives of her daughters and feels reassured of their safety. She, like many other residents in her village, was recruited in the study to help map the reach of the vaccination program.
Similar techniques were applied in West Africa to control the spread of the Ebola outbreak. Data scientists from CDC replaced traditional paper forms with a mobile surveillance network using the text messaging functionality of simple mobile phones. The reporting was quicker, monitoring steady and streamlined and they observed general success in containing the threat using a method that was both secure and cost-effective. So, what can governments in the region do? Beyond digitizing the entire health information system, data science should be introduced in health personnel training curricula. This will ensure that healthcare professionals are equipped to read trends and understand patterns as they inform themselves on efficient and effective healthcare strategy designs.
While the general African population would be positively receptive of the new interventions that disrupt age-old chaos, there is no shying away from the urgency and need to address data privacy in a rapidly shifting digital economy with relatively thin lines between regulation and governance. We do need to re-design the whole approach and welcome the participation of the general public so that we can win their confidence and trust. The intentions of the study, project, or venture need to remain transparent. Cultural conflicts can be eased by inviting local expert participation in programs with frequent human to human interactions. The general global standards, needless to say, have to remain the same on data privacy and user anonymity. Also, a good understanding of the history and motivations of the population in context helps a lot in designing products that make sense to them. The future looks promising for Africa. And the narratives are about to change. For good.