May 2007

e-Health and its Challenges for the African Media

The lack of transparency in the health sector always impedes the reportage on e-Health. In most of the cases, the health officials in Africa need to get clearance from their bosses before talking to journalists. Moreover, e-Health initiatives in Africa are mainly at the project level and ICT policies are still in draft form, which leaves very little room for the growth of newsworthy e-Health news. Furthermore, e-Health is a novel concept in Africa and the continent has only a handful of e-Health professionals, most of them being men.

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It is true that e-Health is gaining currency in the developed countries of the west, but the awareness of its enormous potential seems to be very limited in Africa. Reporting on information and communication technologies (ICTs) is not on the agenda of many news rooms in Africa and thus e-Health stories are seldom reported in the mainstream media.

Moreover. journalists in Africa, by and large, are not in any way specialised in reporting on ICTs and therefore find e-Health stories to be difficult to follow and cover. Political stories still overtake ICT stories in the African media with alarming regularity. Besides, editors feel ICT stories do not make news. At the end of the day, both journalists and editors in Africa play proactive roles in not allowing e-Health stories getting their due coverage in the media.

The journalists in Africa need to get basic ICT training, and those with interest in ICT and health should specialize in the subject area of e-Health reporting. This will enable them to analyse ICT issues and share knowledge; thereby amplifying marginalized voices, organizing political action, empowering participation and sustainability, and celebrating cultural and intellectual diversity . Finally the lack of transparency in the health sector always impedes the reportage on e-Health. In most of the cases, the health officials in Africa need to get clearance from their bosses before talking to journalists. Moreover, e-Health initiatives in Africa are mainly at the project level and ICT policies are still in draft form, which leaves very little room for the growth of newsworthy e-Health news.

dIgitalhealth

Furthermore, e-Health is a novel concept in Africa and the continent has only a handful of e-Health professionals, most of them being men. It is therefore still more difficult to have a woman’s voice on e-Health related issues unless when e-Health applications directly and obviously benefits the women eg. in the area of reproductive health. Journalists reporting an e-Health story should include the voices of the consumers (women and men). Gender issues also need to be incorporated in the e-Health reporting of Africa.

Moreover, new e-Health technologies should not be imposed on a community because many times there is a social and cultural resistance towards change. For this we need to make the consumer aware of e-Health, which is a new concept in Africa, and in this regard media can play a very proactive role by sensitising the uninitiated to the benefits of new technology, through dissemination of factual information, coupled with forceful analysis. In Africa, the media at large also lacks active ICT media networks, specialised ICT publications, and there is little exposure to e-conferences. These are effective platforms where e-Health stories stand a chance of being reported in the media.

There is an urgent need to popularise this innovative initiative called e-Health in Africa, especially among journalists, and also demystify e-Health issues as it is the answer to making quality healthcare accessible to the teeming multitudes of Africa, which is still a predominantly rural continent; characterized by constraint in healthcare infrastructure. The fact that Africa has suffered brain drain in the field of health, should also get due coverage in the African media. In a nutshell, there is a need for a concerted media campaign on e-Health issues, which would include production of visual printed materials in comprehensible languages, that share information on issues affecting men and women’s daily health.

There are many infrastructural constraints towards the smooth progress of e-Health in Africa, which should get adequate coverage by the African media. For example, many rural areas in Africa do not have electricity, and moreover electricity supply in rural Africa, by and large, is simply erratic, because of frequent power cuts. Other constraints towards e-Health include very limited accessibility to Internet among the African population, language barriers and lack of knowledge on e-Health in the society. Moreover, the equipment for telehealth is too expensive for poor African nations, which is another lacuna that needs adequate media attention.

Is Global Health Exchange a remedy?

There is greater realization that the developed countries including the UK should give increased emphasis to the use of ICT and other new technologies in improving health and health services in developing countries.

According to Lord Crisp, the former NHS’ Chief utive, the UK should do more to help support the health systems in developing countries as south-east Asian and African nations are struggling to tackle diseases due to a shortage of health workers and equipments. In his Global Health Partnerships report, Crisp suggests that new technology and approaches are still not central to international development and more needs to be done to encourage local entrepreneurs to use ICT to improve health services themselves.

Crisp writes: “International agencies in developing countries are already working with commercial organizations in ’emerging markets’ to provide investment in, for example, medicines, technology and infrastructure. There needs to be a parallel emphasis on supporting entrepreneurial activity at the local level, improving health as well as helping the people steeped in poverty.”

The report acknowledges that ICT and telemedicine are making some impact in developing countries. An example is the Swinfen Charitable Trust, which offers free medical advice based on images they receive from a digital camera in a medical centre. Another example cited was Computer Aid, which provides refurbished computer hardware.

However, the report also raises concerns about limitations on the use of ICT: “Broadband is still not widespread and is frequently of low density, suitable only for text and not images. Computers are not robust, maintenance is difficult, satellite expensive. In the health sector alone, the WHO has estimated that 50% of technology imported from developed countries is unused in developing countries, simply because there has not been any training.”

An unpublished paper, prepared for the Global Health Workforce Alliance, has shown that where “there are a wide variety of modalities for communication available paper, phone, fax, video, e-mail, discs and DVDs there is still a tendency to make most use of the traditional means and least of the new.” Despite these, Crisp believes that the potential for ICT in the future, as knowledge and experience grows, appears enormous-people in developing countries are trained to understand the benefits such technology can bring.

“I recommend the UK should give increased emphasis to the use of ICT and other new technologies in improving health and health services in developing countries by bringing the innovators in digital technology and its application to health, together with experienced development professionals, to understand the potential impacts and work with international partners to pilot and uate applications,” Crisp said.

The UK already contributes over 1bn a year to Africa for health and education, excluding regular charity collections. Crisp believes a more co-ordinated approach is needed and NHS hospitals should offer redundant equipment to these countries. Crisp adds that he would like to see an eBay-style website, called Global Health Exchange, established so that developing countries can advertise the need for certain resources. 

Besides, more African journalists should get better exposed to the global e-Health scenario. They should be invited to global conferences on e-Health, which besides giving them the opportunity to cover the event, can endow them with added knowledge and information about e-Health related issues. These conferences can also give them an effective platform to interact with other media people and keep abreast about this fast evolving arena, and also hone their reporting skills in covering e-Health issues; by getting acquainted with the nuances involved. There is also the need to identify journalists who are interested in reporting on ICT applications in the health sector and encourage them to cover such events. More importantly, there is also a need to form a d-group, even a blog or wiki, where journalists, in collaboration with health personnel in e-Health, can exchange questions and share knowledge and information about e-Health. All these initiatives can channelise African media’s attention towards e-Health.

The media in Africa has a role to play in e-Health reporting by educating and informing the public on e-Health related issues. Health personnel in the continent also need to partner with media and educate and inform them on e-Health issues and developments at national, regional and global levels. Journalists in Africa need to be trained in order to demystify e-Health issues in their writing so that the ordinary person can understand what e-Health means, as these technological terms simply put off readers who can be the potential consumers of e-Health.

There is also a need to develop an e-Health tool kit for both print and electronic media in Africa, which can be given to media houses for production of news stories, radio programmes and television programmes. The African media also needs to develop a resource on the Internet where journalists can get info on e-Health reporting, as currently we have access to very few relevant materials, pertaining to ICT applications in healthcare. 

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