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Health care: an information business

Africa is technologically advanced in several areas, but woefully unprepared for technologies that could revolutionise its health care.

Image showing doctor's medical tablet with stethoscope.
FUTURE OF HEALTH: Electronic systems will constitute an important part of developments in the global health industry in the future.
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The Health Informatics Training and Research in East Africa for Improved Health Care Programme (HI‐TRAIN) aims to do something about this. The programme has received funding under Norad’s capacity-building programme NORHED (Norwegian Programme for Capacity Development in Higher Education and Research for Development).

HI-TRAIN brings together specialists in the fields of public health and informatics from the University of Bergen (UiB), Makerere University in Uganda and Moi University in Kenya.

Although countries in East Africa are ahead in large‐scale Electronic Health Record Systems (EHRs) rollout, they remain far behind when developing the workforce needed to run such systems.

The three universities will work to help prepare the region for the potential that lies in EHRs. The three partners had their first meeting at UiB in mid October.

The HI-TRAIN programme is to provide Masters and PhD level training in Health Informatics (HI) and research with focus on health professionals and computer science personnel to help them become HI faculties at their institutions. The goal is to develop self-sustainable and replicable HI training and research programmes by the end of a five‐year grant period.

Going digital

“The use of paper forms is the norm in most African countries, both in health care and in research. In a health clinic, for instance, you commonly start with a blank sheet of paper every time a child comes in. The information is seldom stored at all,” explains Professor Thorkild Tylleskär from UiB’s Centre for International Health, which recently celebrated its 25th anniversary. “This might be OK for simple conditions like colds, coughs and pneumonia. But not for treating HIV.”

Tylleskär has long been a champion of the use of information and communications technology in health care and health research.

Medical personnel relentlessly collect, record and process data through patient history, physical examinations, by analysing their findings, deciding on treatments, and producing orders and reports. Unsurprisingly, good patient care relies on this information being available and that it is of high quality. In addition, good health information improves policymaking and helps the development of new health programmes.

“Having a system which can give you a better sense of who is doing what and when allows you also to improve governance and properly create an integrated health system,” explains Dr. Martin Chieng Were, Chief Medical Information Officer, AMPATH-Moi University.

A new field

Many countries in sub-Saharan Africa are now spearheading large‐scale rollout of Electronic Health Record Systems. Kenya, for example, will roll out a centralised system at 600 sites across the country by the end of next year. Uganda is currently evaluating different systems for a national roll‐out.

“The technology exists but few are using it in the field of health. There is a huge potential in improving health care and health research and that is why I find this project so exciting. My role is to pull people into exploiting this potential,” says Tylleskär.

With a special focus on attracting women and marginalised populations, the programme will result in 70 Master graduates and eight new PhDs. Moi University School of Medicine will serve as the foundation for the Masters and PhD programmes.

The setting for practical health informatics training will be with the Academic Model Providing Access to Health Care (AMPATH) program at Moi University. This care program serves a catchment area of 3.5 million people in Western Kenya, offering comprehensive primary, HIV and chronic disease care.

“Makerere and Moi are two of the leading institutions in health and computer science in the region. The longstanding collaboration between Makerere and the University of Bergen and Bergen’s expertise in informatics and public health makes us natural partners,” says Dr. Were.

Collaboration is vital

HI is a relatively new field and establishing credible programmes involves collaboration between multiple departments.

“The Department of Informatics and the Centre for International Health have collaborated for some time. We are looking forward to this collaboration. We do not have a Masters programme in Health Informatics, but this collaboration might lay the foundation for such a programme in Bergen,” says Associate Professor Khalid Azim Mughal at UiB’s Department of Informatics.

A new HI workforce includes a whole range of new professional categories, from specialised programmers and data managers, to medical information officers and regional and national HI coordinators, monitoring and evaluation specialists. There is also a need for developing capacity to address privacy and data security issues in this area.

“We believe that Health Informatics can improve the service delivery of health care in Africa where we often have personnel and infrastructure constraints,” adds Peter Khisa Wakholi, Lecturer at the Department of Information Systems at Makerere University.