Training members of the community to take on responsibilities enabled by technology is the first step towards reaching the ultimate goal of Universal Health Coverage (UHC).
by Michelle Tan
Making a trip down to the clinic whenever we feel unwell doesn’t seem like that big of an inconvenience to us – if anything, it is more of a vexation, knowing that our wait in the clinic’s waiting room will be anything but brief. Even for those of us who cannot afford our medical fees in Singapore, we are still able to receive medical support with the support of government schemes like the Community Health Assist Scheme (CHAS), offering us a sense of security which allows us to go about our daily activities as per usual. However, it is a well-known fact that not everyone has the privilege of feeling this way. A World Health Organisation (WHO) and World Bank Group report shows that 400 million people do not have access to essential health services and 6 percent of people in low and middle-income countries are being tipped into extreme poverty because of health spending. This report, published in 2015, resonated with people all around the world, reminding us that our goal of achieving Universal Health Coverage (UHC) is far from being accomplished.
To define UHC, it refers to all people and communities being able to use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Edward Booty, CEO of Allied World Healthcare, sees the potential of digitising primary healthcare in having the network and capability to connect more people to healthcare. In 2015, he founded Allied World Healthcare, an innovative social enterprise that uses a brand new service model, technology platform and financing mechanism to deliver essential, affordable healthcare services to low and middle-income countries.
Allied World Healthcare is currently focused on rural populations in South East Asia, delivering basic healthcare services to communities who are do not have sufficient access to healthcare. Edward Booty and his team trains women in rural areas of Cambodia to use offline apps that his team has built to gain medical information, attend outreach events, order medicine and deliver medicine back to their communities.
Edward Booty views strengthening primary healthcare to be the gateway to UHC. Through the digitisation of healthcare, people living in areas without basic infrastructure, where traditional healthcare services do not reach, are able to gain access to health services, significantly improving the quality of their lives. When asked what are some challenges that he faced in bring in technology into areas lacking basic infrastructure such as a stable internet connection, he simply said that more effort was needed to engineer around these specific circumstances. While Edward noted that such circumstances “massively inhibits [their] ability to deliver innovation”, his team was able to create “the oldest versions of Android, [with] low SPEC and low RAM”, tailored for use in an environment with no internet connection.
Apart from lack of access to healthcare, many rural communities are also isolated from governmental support. These offline applications designed by Allied World Healthcare also connect members of the community to government support and affordable private sector services, should they need it.
Sustainability is key to the longevity of any solution. As such, Allied World Healthcare strives to make all logistics managed by local communities themselves. “It’s all about having communities learning for themselves, the more you import services, the more you bring facilities from central locations, you just add operational overhead.” Said Edward Booty.
“You really have to focus on task-shifting strategies whereby you empower members of community so more community health workers or midwives or whatever it may be, can take on more responsibilities enabled by technology, as opposed to bringing in expensive resources or expensive logistic networks.” For example, their grassroots health access service is managed and run locally, creating jobs and income for people within the communities and making the solution more sustainable in the long run.
According to Sejal Mistry, Director of Research & Consulting, ACCESS Health Southeast Asia, infrastructure is the hardest piece to fit into the primary care puzzle. Indeed, lack of software and hardware is a barrier to bringing digital solutions to off the grid communities. Edward Booty also notes that regulations are “built for cities” and work against them in bringing medical aid to the rural communities. While the regulation that requires prescriptions for certain types of medicine is commendable, it is simply impossible to achieve in rural communities which are at least four hours away from the nearest pharmacy. Regulations in quality assurance mandate medicine to be stored under 25°C, which would be highly unpractical in areas which do not have access to electricity or a freezer. In such cases, being compliant with the law would translate into increased operational costs and additional barriers.
In the words of Gunilla Carlsson, Executive director of UNAIDs, “When communities are empowered, results follow. Empowering communities will be central to achieving good health for all.”
- Allied World Healthcare: Delivering Healthcare, Everywhere. (n.d.). Retrieved from https://www.alliedworld.healthcare/.
- Multilateral agencies launch a joint plan to boost global health goals. (2019, September 24). Retrieved from https://www.who.int/news-room/detail/24-09-2019-multilateral-agencies-launch-a-joint-plan-to-boost-global-health-goals.
- New report shows that 400 million do not have access to essential health services. (2015, June 12). Retrieved from https://www.who.int/mediacentre/news/releases/2015/uhc-report/en/.
- The case for Universal Health Coverage, and the critical role for the. (2019, October 7). Retrieved from https://www.uicc.org/blog/case-universal-health-coverage-and-critical-role-private-sector.
This article was derived from a panel discussion, Digitising Primary Care: Here and Now held at the SFFxSWITCH conference 2019