As part of IICD’s participation at the ICT4D 2015 Conference (CRS) in Chicago, US, which brought together experienced professionals from around the world to share methods for systematically integrating ICT innovations into development programmes, IICD’s Managing Director, Suzanne van der Velden discussed the topic of sustaining health innovations across Africa beyond donor-dependant approaches.
IICD has been implementing technology-enabled health innovations since 1996, and has seen many changes over the years. Technology evolution, increased availability of local capacity to design and support tech solutions, pull factors at national level calling for data and data-driven solutions, and the ability and willingness of healthcare service providers to finance tech-support services, are all influencing the way IICD and its African health partners see the future viability in eHealth services provision.
“The question is how do we achieve scale and quality assurance across countries while being driven by responsiveness to individual markets’ needs? That’s what AeHS International is here for. It aims to harness the value provided by local companies experienced in deploying and servicing eHealth solutions to healthcare providers, while ensuring quality control, software development and operational support management across the various local ventures and countries joining this pan-African initiative”, said van der Velden.
Over the past years, the hospital management information system AfyaPro, the first product developed by AeHS, has been implemented in hospitals to tackle the lack of accurate and timely data, an issue faced by many African hospitals. Examples documented in Malawi, Tanzania and Zimbabwe, show that since the implementation of AfyaPro more costs have been recovered per-patient, fewer patients are being lost to billing, and overall revenue has grown.
Despite the reported success at facility level, this combination of large numbers of deployments, with very needs-driven local tailoring of the systems, has led to challenges in sustaining the quality and value of the solutions for client facilities over time.
“Where deployments and technology support staff have mainly been financed by donor budgets, once the funding period is over, salaries for on-site tech staff are often not integrated in the overall organizational budget, leading to their dismissals and loss of critical 1st line operational and maintenance support. This ultimately leads to usage going down, systems becoming outdated, and so forth.”
On the software development front, diverse approaches have been tried out along the way, from financing programmers to work directly with facilities to outsourcing to software development companies in other countries like India, which have brought about more challenges than positive results. As IICD returned to investing directly in programmers associated with the various solutions, it needed to find a way to create co-ownership of the solutions, ensure quality management across the different deployments and provide financially sustainable implementation support. This led to the creation of AeHS – a joint venture between IICD and local e-health and technology providers.
“Under this model, hospitals and facilities pay their national service provider monthly fees for technical support services. A percentage of which goes to AeHS International, for access to new software updates, 3rd line technical support, training and certification renewals, and access to research and expertise from other countries“, said van der Velden. “Our first experiences are promising. There can be new challenges ahead but we feel that with the structure we have now in place, we will be able to overcome them while creating value for both healthcare provider clients as well as national enterprises.”