Uganda’s healthcare system is not short of issues. Afrobarometer, a pollster, reports three quarters of Ugandans said they or a family member went without needed medicine or medical care at least once during the 12 months that preceded their 2021 survey.
The barriers to access healthcare were not just consultations, tests, and medicines costs but also transportation to the clinic or health centre. Could remote consultations or what is termed as tele-medicine, solve some of these problems?
It’s not a straight affirmative but shocks such as the Covid-19 pandemic showed it is a mix that we need in our healthcare accessibility plans. The suspension of public transport and restrictions on movement during the pandemic brought about delayed initiations into treatment and interruptions of treatment cycles, which resulted in increased disease progression and premature deaths.
This period also saw growth in remote consultations through mobile phone applications, including voice calls, video platforms, SMSs, WhatsApp, and other social chat spaces. In so doing, the use of telemedicine was able to support long-distance patient care.
Although the 2019/20 Uganda National Household Survey (UNHS) reports that 77 per cent of the population live within three kilometres or less from a health facility, there are still major inequities in the availability of these facilities especially in the rural and remote communities.
Road infrastructure in these areas remains so poor, increasing the cost of making it to the health facility. In towns and peri-urban areas, congestion at health facilities is deafening, putting a strain on the healthcare accessibility, and leaving a large portion of the population underserved, particularly in terms of medical expertise and timely care.
Remote consultations for the “not-so-serious” ailments mean these numbers can be brought to manageable levels. By reducing the impact of geographical distance and enabling patients to save time and money, telemedicine breaks down one of the major barriers to healthcare access.
It presents a chance to lower expenses while raising the standard of healthcare when coupled with a more effective use of human resources for health. In this way, out-of-pocket expenditures are also reduced with cost-effective consultations that are done remotely and on time to reduce the need for expensive treatments and allowing for remote monitoring and disease management.
However, while the benefits of telemedicine are undeniable, its implementation in Uganda comes with its own set of challenges. Reliable and affordable internet connectivity remains a hurdle. In 2021, for example, the internet penetration rate in the country was only 26.2 per cent, an indication of the urgent need for digital literacy if gains from telemedicine are to be attained.
The country needs to invest in digital infrastructure to support telemedicine initiatives, including building robust networks and ensuring access to necessary technologies. A comprehensive regulatory framework, particularly regarding data privacy and security, is essential to protect patients’ information and ensure ethical telemedicine practices.
The private sector’s role is pivotal as well, especially concerning innovation, investment and the expansion of telemedicine services. This is because collaboration between the public and private sectors can facilitate the seamless integration of telemedicine into Uganda’s healthcare system.
There is also the need to strike a balance between virtual consultations and physical examinations, as some medical conditions require in-person assessments.
Despite the potential cost savings and convenience that telemedicine offers, it may disproportionately affect the poor with limited technological resources. Afrobarometer says almost all those who experienced high-lived poverty say they went without health care at least once, while none of those with no lived poverty experienced lack of care.
This means healthcare access is an economic empowerment issue as well. It is important to address limitations such as internet connectivity, digital infrastructure, regulatory frameworks, and fostering public-private partnerships for telemedicine to thrive.
Also, boosting ordinary persons’ incomes will certainly determine whether one accesses healthcare or not – physically or by call.
The author is a research associate at the Economic Policy Research Centre
This article was originally published in Observer Newspaper on October 18, 2023
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