We recently spent time with our community-based teams in the Philippines and Cambodia, where we’re partnering with the government, healthcare providers and the private sector to deliver affordable healthcare in remote communities. These are regions characterized by tremendous challenges in last-mile delivery of essential health services. We know from our research that the barriers are not limited to out-of-pocket payments, but that the cost of travelling long distances to seek care, along with lost wages from missed work, can be equally debilitating.
Our approach involves empowering community members (a team of women in each village who we call access managers) to create individual health profiles of residents using proprietary offline-first apps. These access managers are then able to conduct tailored public health engagement and outreach campaigns, as well as ordering and delivering medicines and health services at affordable prices directly within the communities themselves. This enables local residents to overcome many of the traditional barriers to healthcare access, all while relying on support from a local peer to navigate the system. By merging mHealth solutions with an embedded community presence and last-mile delivery, we are able to create a holistic approach that overcomes some of the common limitations of telemedicine initiatives.
Under this innovative model, we recently engaged and onboarded 42,000 individual residents in two rural and remote municipalities in Western Visayas, Philippines. The resulting community health profile indicated that access to vitamin A supplementation was a serious challenge in these areas. Vitamin A supplementation is an evidence-based practice which reduces mortality and promotes proper development in infants and children. In response, we worked with the local government and NGO partners, to facilitate a programme to address this gap, using our detailed community data to identify the specific households that would benefit. As a result of these efforts, 1,221 infants aged 6-11 months old and 7,714 children aged 12-59 months were provided no-cost access to this vital intervention – 100% coverage.
These recent visits were a time to reflect on strategies to invigorate and enable faster adoption of digital health technologies, to address the persistent subnational health inequities which prevent many citizens from accessing essential services. What’s clear is that digital health is critical to hastening UHC progress in low and middle-income countries, but stakeholders need to work together to address some surmountable challenges.
While it’s fantastic to see digital health players address different unmet needs in healthcare systems, such as health worker training and mHealth applications, this can result in fragmented approaches which fail to create the systemic change needed to achieve UHC. Digitally enabled health systems are also dependent on telecom companies and the monopolistic nature of this industry in many markets creates an additional barrier.
Our determination to connect the unconnectable means we have had to embrace offline working for novice tech users. This has led to peer-to-peer syncing of devices, simpler user interfaces and using video instead of text. For any major player in this space, designing solutions for the limitations of the last-mile is of paramount importance. The digital divide must not create new forms of health inequities.
Under the theme, Innovating for India: Strengthening South Asia, Impacting the World, the World Economic Forum’s India Economic Summit 2019 will convene key leaders from government, the private sector, academia and civil society on 3-4 October to accelerate the adoption of Fourth Industrial Revolution technologies and boost the region’s dynamism.
When looking at our community-level data, a village’s health needs can be vastly different from another right next door. For example, our profiling has uncovered instances where Village 1 has an extremely high prevalence of diabetes, which is broadly non-existent in Village 2 next door, where we see that kidney disease is rampant. Analysing relevant data and uncovering the right insights will drive much more targeted and effective health solutions for local communities.