Africa Telemedicine Outlook and Opportunities

Africa Telemedicine Outlook and Opportunities

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Executive Summary

The report titled "Africa Telemedicine Outlook and Opportunities" provides a comprehensive analysis of e-Health scenario in Africa covering market challenges and success case studies by countries and at multinational levels. The report discusses about the current health scenario of different countries such as South Africa, Kenya, Ghana, Nigeria, Uganda, Botswana, Cameroon and Ethiopia. The report also provides current e-health scenario and future government plans for development of e-Health space in all countries. The report also includes trends & developments, growth drivers and major restraints, and challenges within the industry to understand current market dynamics in the industry. The report also serves as a benchmark for existing players and for new players who wish to capitalize on the market potential and investors who are looking forward to venture into the e-Health space in Africa by providing information on success and failure case studies and optimal business model in the region.


Current Scenario:
Albeit recent improvements in the country's health care services, the health of large proportion of Africans is still not at par. Sub-Saharan Africa has ~ % of the global population; however, it carries ~% of the world's disease burden. The continent is deprived of the healthcare conditions which could be justified by the basic indicators of health with high child and maternal mortality rates, low birth weights of the children, and poor sanitation and healthcare access. Moreover, Africa has only ~ physicians per 1000 people with widespread communicable diseases which is low as compared to other countries.

It has been observed that the Government has been playing supportive in implementing the e-health policies. The same could be advocated from the fact that a number of National e-Health policies such as RAFT, m4RH and others have been initiated by the government. Rising level of mobile and internet penetration and increasing number of awareness programs run by the government and NGOs is further assisting in improving the healthcare scenario in Africa with the help of telemedicine. However, this has not helped much in providing a positive impetus to the growth of eHealth sector in the country. The main reasons for the same could be listed as lack of proper infrastructure pertaining to ICT, problem of collating data through several platforms due to lack of uniformity of the data, incomplete health records from the lowest level of health facilities, lack of technical staff for supporting the eHealth initiatives.


Key Observations-

With foreign players entering into the Kenya telemedicine market coupled with efforts of the government of country, telemedicine market in Kenya is expected to grow at rapid pace during the future. The government plan to establish eHealth in five hospitals all across the country, which would improve the healthcare system of Kenya by increasing the probability of accurate diagnosis and providing information and accessibility to available treatment options.

South Africa
Inspite of the slow start, telemedicine in South Africa still holds opportunity as a tool to support the delivery of healthcare especially in rural regions of the country. Though the regulations don't allow people to doctor conversation through telemedicine platform, but conversation between doctors in rural hospital with specialist doctor in specialized hospital would also help in better diagnosis and treatment. Moreover, telemedicine had attracted considerable interest in innovation among academics, researchers, private enterprises and health professionals, which could be advocated by the noteworthy achievements made by public health domain in South Africa.
mHealth could be considered as most successful telemedicine type in South Africa which has revolutionized healthcare in the country. With the mobile penetration rate of ~% in the country, the telemedicine market is expected to record high growth in South Africa in future also.

It has been observed in various cases that a successful effort would require the indulgence of both public and private sector. For instance, current investment in the telemedicine space such as the setting up of teleconsultation centers (TCCs) has been sponsored by the Novartis Foundation. However, government investment is the key to develop this across the country. Moreover, Government support is also required for the regular payments of the staff and the maintenance of the equipment.

All the eHealth projects implemented were initiated as small scale pilot projects in the country. On the gloomy side, none of the programs were able to successfully correspond to other health systems or share information across geographies or technologies. Most of these projects were discontinued or not running sustainably on the back of poor enabling environment, lack of involvement of the stakeholders in all the stages, low funding and deficiency of a common system to integrate multiple systems in the country among other reasons.

Uganda is one of the least developed countries in the world. The country has around ~ pathologists which work in key regional referral hospitals. For improving the healthcare situations in the country, government is continually making efforts towards improvisation of telemedicine. mTrac has been one successful project in telemedicine industry in Uganda which is a scalable solution to the challenge with health service delivery. mTrac would work on any mobile platform, broadening the process of data collection by leveraging SMS to simplify the process of reporting through a series of keyword codes and fields.

Key Topics Covered in the Report:

  • Current Health Condition of Africa level as well as on country level for South Africa, Kenya, Ghana, Nigeria, Uganda, Botswana, Cameroon and Ethiopia
  • Investment requirements for telemedicine in Africa
  • Growth Drivers, Trends and Developments, and Challenges in Africa E-Health Market
  • Current E-Health initiatives on country level for South Africa, Kenya, Ghana, Nigeria, Uganda, Botswana, Cameroon and Ethiopia
  • Future government Plans for South Africa, Kenya, Ghana, Nigeria, and Uganda
  • SWOT Analysis for Africa telemedicine market
  • Success case studies on country and regional levels
  • Analyst Recommendations and Optimal Working Model

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1. Executive Summary
2. Appendix
2.1. Market Definitions
2.2. Research Methodology
Final Conclusion
3. Current Scenario of Healthcare in Africa
4. Kenya
4.1. State of Healthcare in Kenya
Scenario of Healthcare Providers
Country Profile
4.2. Telemedicine So Far
4.2.1. National Telemedicine Initiative
4.2.2. Colombia Africa
4.2.3. Telepathology
4.2.4. Sema-Doc
4.2.5. Pan-African e-Network Project
4.2.6. AMREF Project
4.2.7. Medishare Africa
4.3. Trends and Developments in Kenya Telemedicine Market
4.4. Challenges in Kenya Telemedicine Industry
4.4.1. Lack of Electricity
4.4.2. Confidentiality of Information
4.5. Future Plans of Government for eHealth Sector
4.5.1. Vision 2030
Specific Objective
General Objective
Investment Model for Implementation of ICT Model in Selected Hospitals under Vision 2030
4.5.2. GlobalMed Telemedicine Solutions
4.6. Conclusion
4.7. Success Case Studies in Kenya
E-Learning for Nurses
Use of MIMS
5. South Africa E-Health Market
5.1. State of Healthcare in South Africa
Public and Private Healthcare System
National, Provincial and Local
National Health Insurance
Burden of Disease
5.2. Country Profile
5.3. Telemedicine Projects So Far
5.3.1. Teledermatology
5.3.2. Teleradiology
5.3.3. Mindset Health Channel
5.3.4. Primary Health Care Telemedicine Workstation
5.3.5. South Africa / China Bilateral Agreement
5.3.6. Rapid Deployment Field Hospital / Mobile Pathlab
5.3.7. KwaZulu-Natal Telemedicine Project
5.3.8. Project Masiluleke
5.3.9. MomConnect
5.3.10. FOLUP
5.3.11. Primary Health Care App
5.4. Regulatory Landscape
5.4.1. POPI ACT and mHealth
Principles of POPI Act
5.4.2. Telemedicine Solutions
5.4.3. State Information Technology Agency (SITA)
5.4.4. The Minimum Information Interoperability Standards (MIOS)
5.5. Conclusion
5.5.1. Key Opportunities for mHealth in South Africa in Future
5.6. Recommendations
6. Nigeria E-Health Market
6.1. State of Healthcare in Nigeria
Country Profile
6.2. Current Scenario
Healthcare IT in Nigeria
6.3. Current Policy Implementations
Other eHealth Initiatives
6.4. Major Challenges for the Health Care Sector in Nigeria
6.5. Government Policy Implementations for Future
6.5.1. Recommendations to Improve Health ICT Enabling Environment
6.6. Success Case Study in using ICT in Nigeria
7. Ghana
7.1. State of Healthcare in Ghana
Country Profile
7.2. Snapshot of Telemedicine Pilot Project in Ghana
7.3. Challenges in the Establishment of the Telemedicine Centers in Ghana
Requirement of Constant Government Support
Training of the Workers
Payments from National Health Insurance Scheme
Shortage of Electric Power Supply
e-Health Initiatives in Ghana
7.4. Success Case Studies in Ghana
Graphical Representation of MOTECH working Model
8. Uganda
8.1. State of Healthcare in Uganda
Country Profile
8.2. Current E-Health Scenario- Telepathology and Second Opinion
Use of DHIMS2
8.3. Challenges Faced in Implementing E-Health Policies
8.4. Current Situational Analysis
8.5. Government Future Policy Objectives
8.6. Success Case Study: Uganda's Approach for Health Service Delivery Through mTrac
9. Botswana
9.1. State of Health Care in Botswana
9.2. Country Profile- Botswana
9.3. Snapshot of Teledermatology in Botswana
10. Cameroon
10.1. State of Health Care in Cameroon
10.2. Country Profile- Cameroon
10.3. Current e-Health Scenario
10.3.1. ICT in Healthcare
10.3.2. MTN Health
10.3.3. eHealth-Cameroon
11. Ethiopia
11.1. State of Health Care in Ethiopia
11.2. Country Profile- Ethiopia
11.3. Current e-Health Scenario
Electronic Medical Records via SmartCare
Telemedicine Pilot Project
11.4. Ethiopian National E-Health Strategy
12. SWOT Analysis
13. Multinational E-Health Initiatives in Africa (Case Studies)
13.1. m4RH
13.2. RAFT
13.3. Prerequisites to Start a Telemedicine Centre
14. Recommendations
14.1. Working and Business Model Selection
14.2. Partnerships
14.3. Return on Investment
14.4. Government Support
14.5. Awareness Campaigns
14.6. Optimization of ICT Infrastructure
14.7. Improving the Training and Maintenance of Infrastructure
14.8. Use of Updated Technology
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Figure 3-1: Life Expectancy at Birth in Africa, 1993 and 2013
Figure 3-2: Under Five Mortality Rate per 1,000 Live Births in Africa, 1990-2015
Figure 3-3: Maternal Mortality Rate per 100,000 Births in Africa, 1990 - 2015
Figure 3-4: Leading Causes of Death as a Percentage of Total Deaths in Africa, 2012
Figure 3-5: Distribution of Burden of Diseases as a Percentage of Total Disability Adjusted Life Years in Africa, 2012
Figure 4-1: Distribution of Causes of Deaths in Children under 5 in Kenya out of Total Number of Deaths in Percentage (%), 2013
Figure 5-1: Distribution of Causes of Deaths in Children under 5 in South Africa out of Total Number of Deaths in Percentage (%), 2013
Figure 5-2: Typical Tele dermatology Procedure
Figure 6-1: Nigeria Basic Indicators for Healthcare
Figure 6-2: Distribution of Causes of Deaths in Children under 5 in Nigeria out of Total Number of Deaths in Percentage (%), 2013
Figure 6-3: Nigeria ICT and E-Health Environment
Figure 7-1: Distribution of Causes of Deaths in Children under 5 in Ghana out of Total Number of Deaths in Percentage (%), 2013
Figure 7-2: Calls on Pilot Telemedicine Project in Ghana, 2011-2015
Figure 7-3: Working Model of MOTECH
Figure 8-1: Distribution of Causes of Deaths in Children under 5 in Uganda out of Total Number of Deaths in Percentage (%), 2013
Figure 9-1: Distribution of Causes of Deaths in Children under 5 in Botswana out of Total Number of Deaths in Percentage (%), 2013
Figure 10-1: Distribution of Causes of Deaths in Children under 5 in Cameroon out of Total Number of Deaths in Percentage (%), 2013
Figure 11-1: Distribution of Causes of Deaths in Children under 5 in Ethiopia out of Total Number of Deaths in Percentage (%), 2013
Figure 14-1: Sources of Revenue and Expected Return to Provide Online Access to the Health Services

Table 4-1: Kenya Basic Indicators for Healthcare
Table 4-2: Proposed Investment for Implementation of ICT Model in Selected Hospitals under Vision 2030
Table 4-3: Kenya Success Case Study for use of E-Learning for Nurses
Table 4-4: Kenya Success Case Study for use of MIMS
Table 5-1: South Africa Basic Indicators for Healthcare
Table 5-2: Recommendations for South Africa Telemedicine Industry
Table 6-1: Program launched under the Collaborative Efforts of NASRDA and FMOH
Table 6-2: Challenges for eHealth in Nigeria
Table 6-3: Recommendations to Improve Health ICT Enabling Environment in Nigeria
Table 6-4: Use of Mobile Phones in Nigeria to Tackle the Problem of Data Collation
Table 7-1: Ghana Basic Indicators for Healthcare
Table 7-2: Diverse E-Health Projects in Ghana
Table 7-3: Success Case Study on use of DHISM2 in Ghana
Table 7-4: Case Study on use of Mobile Technology for Community Health
Table 8-1: Uganda Basic Indicators for Healthcare
Table 8-2: Uganda Situational Analysis for E-Health Implementation
Table 8-3: Government Future Priority Areas and Strategies for E-Health
Table 8-4: Uganda's Approach for Health Service Delivery through mTrac
Table 9-1: Botswana Basic Indicators for Healthcare
Table 10-1: Cameroon Basic Indicators for Healthcare
Table 11-1: Ethiopia Basic Indicators for Healthcare
Table 11-2: Ethiopian E-Health Strategy
Table 12-1: SWOT Analysis of Africa E-Health Industry
Table 13-1: Mobile for Reproductive Health (m4RH) Case Study
Table 13-2: Telemedicine and Distance Learning Platform- RAFT, Case Study
Table 13-3: Investment Cost required for setting up a Telemedicine Centre (Private and Government) in Nigeria, FY'2015
Table 13-4: Variable Costs in Operating a Telemedicine Center in Nigeria, FY'2015
Table 13-5: Financial Indicators Related to the Establishment of Telemedicine Center in Nigeria

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