Telemedicine in Sub-Saharan Africa - The Case of Rwanda
Collaborators: Boateng, R., Mbarika, V., Johnson, O. and Saiba, E.
Telemedicine, or the use of information and communication technologies (ICTs) to deliver health care and/or transfer medical information and provide medical training over a distance, has been argued to hold some promise of addressing the multi-prong health care issues in developing countries [1]. This project assessed the reality of this argument by exploring the efforts being made by a sub-Saharan country, Rwanda, to implement telemedicine in the health sector. The current health statistics of Rwanda are not encouraging. There is 1 doctor per 18,000 inhabitants and 1 nurse per 1690 inhabitants [2]. Government’s efforts to address the gaps include the use of ICTs to support health care delivery and community-based medical education and training.
The research examines the dynamics of contextual factors which influence the adoption of telemedicine in the Rwanda. The research studied the national telemedicine project which has been implemented in three hospitals –two of which are public hospitals and the other a private hospital. Three major constructs which influence adoption and use of telemedicine technologies were examined in this project: technology readiness (infrastructure and sophistication of use), organization readiness (financial support and hybrid medical and technical skills and knowledge), and government readiness (policy and strategy).
The findings suggest that, the commitment of government to telemedicine; the strategic choice of using low-cost and less complex technologies; and strategic partnerships with educational and technology companies are factors which have influenced telemedicine implementation in Rwanda. The visible role of the Government of Rwanda in establishing policies and agencies to support the use of ICTs for health care delivery played a key role in attracting the local and international strategic partners into the telemedicine project in Rwanda. The government’s leadership enabled the project to access other resources and expertise which could not have been singly provided by the government. The project adopted the path of least cost of adoption, choosing low-cost and less complex technologies, video conferencing and store-and-forward networks, to train health professionals in surgical procedures and to facilitate community-based medical education.
However, only healthcare professionals who had access to the requisite technologies for their medical discipline or those who were able to adapt the available technologies to their medical practices have had a more rewarding experience. Other medical practitioners including ophthalmologists have had a less rewarding experience with respect to their discipline. Thus, the inability to provide the requisite ‘tele-ready’ medical equipment for the respective medical disciplines may contribute to abandonment or poor commitment to a telemedicine initiative.
The research concludes that future research, strategies and polices should aim at developing telemedicine capabilities overtime, starting from simple/basic capabilities and moving towards more complex or advanced capabilities as a country’s technological and health care infrastructure and telemedicine expertise develops.
Cite As
Boateng, R., Mbarika, V., Johnson, O. and Saiba, E. (2010). ‘The Challenge of Taking Baby Steps’ - Preliminary Insights into Telemedicine Adoption in Rwanda, Proceedings of the 3rd International Conference on ICT for Africa, March 25-27, Yaounde, Cameroon. Baton Rouge, LA: International Center for IT and Development.
References:
[1] V. Mbarika, “Is temedicine the panacea for sub-Saharan Africa’s nightmare?”, Communications of The ACM, vol. 47 no. 7, 2004, pp. 21-24.
[2] Rwanda Ministry of Health Telemedicine Rwanda Project, “Laparoscopic surgery records success”, Rwanda Ministry of Health Newsletter, no. 3, 2005. Available at: www.moh.gov.rw/news_letter2.html#1 [Accessed May 13, 2009].
Acknowledgement
This research is based upon work supported by the National Science Foundation (NSF) under Grant Nos. 0644305, 0927688 and 0929837. Any opinions and recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.
