Recent pandemic and epidemic outbreaks have cast a harsh light on the standard of primary healthcare in emerging markets.
In the last three years, more than 11,000 of the nearly 29,000 people infected by Ebola have died, and thousands of infants have been born with birth defects and neurological problems as a result of the Zika virus.
Scientists predict a possible outbreak of Ebola this year and economists believe that a major flu pandemic could cripple the economies of affected countries.The harsh reality is that we are not doing enough to prepare for future infectious outbreaks, despite knowing quite clearly what causes them. The main causes of poor health in Africa are poverty, its associated unhealthy living conditions, and a lack of access to primary healthcare.
According to a report by the UN International Labour Organization almost half of the world’s population does not have access to healthcare. This report shows that 56% of people living in rural areas worldwide cannot access healthcare. In Africa, the number of rural people without access to healthcare spikes to 83%.
In Sub-Saharan Africa, four in 10 people have no access to health facilities or healthcare workers, and for those that do have access, the quality of services is often low.
Our research shows that a high percentage of the existing primary healthcare centres in Sub-Saharan Africa currently lack access to clean water, electricity, medical equipment, health, IT, and trained staff. Many do not even have a bank account.
During pandemic outbreaks, primary healthcare is the first line of defence, but reactionary approaches to recent outbreaks highlight just how much the global health community has neglected the primary healthcare system.
If we want to successfully prevent or manage future outbreaks, we must invest in primary healthcare.
I firmly believe that investment must be concentrated in three key areas:
· The expansion of public-private partnerships (PPPs);
· The adoption of new technologies;
· The training of healthcare workers.
A three-pronged approach
Responses to past pandemic outbreaks have been fragmented. Instead of pooling resources, governments and business set up isolated programmes.
In order to fight infectious diseases effectively, we must collaborate. Health Ministries must take advantage of innovation in the private sector, and in turn educate business about the effects of pandemics on their bottom line.
Business has access to a portfolio of new and evolving technologies. Their research and development divisions give them deep insight into local needs and they have the ability to produce health solutions at scale.
We only need to look at how PPPs have driven innovation in financial services to see the impact it can have. Healthcare in Africa must embrace mobile technology in the same way financial services has.
By connecting patients and care providers with public health workers via mobile telecommunications, we can effectively detect and act against infection outbreaks and develop valuable insights to prepare for future outbreaks.
This so-called disease surveillance involves the collection, analysis and interpretation of large volumes of data originating from a variety of sources. It helps us predict, observe, and minimise the harm caused by outbreak, epidemic, and pandemic situations, and it increases our knowledge about which factors contribute to such circumstances.
To effectively implement surveillance through technology, we must turn primary healthcare workers into data gatherers. This will take a major investment in skills development. By training staff to recognise symptoms and to collect data for epidemiological reasons, we will be building an extra layer of defence against pandemic outbreaks.
The spread of infectious diseases is often accelerated by communities who refuse to seek treatment or put in place the correct measures to prevent the further spread of an infectious disease. Trained staff not only ensure accurate data collection, but also play an important part in educating these communities about their role in pandemic management.
Real world impact
Not all of this is theory. We have real world examples that demonstrate the power of PPPs in delivering quality healthcare at a community level.
In June 2014, we opened our first Community Life Centre (CLC) in Kiambu County, Kenya. At the time, Kiambu was struggling with high maternal and infant mortality rates. Today, more than 4,000 patients a month visit the centre and the number of children being treated has quadrupled from 533 to 2,370. More than 600 babies, at an average of 36 babies a month, have been born at the facility.
This CLC, a PPP between us and the County Government of Kiambu, provides a community-driven, sustainable approach to strengthening primary healthcare. It is an example of a successful PPP, with the country, government officials, health workers, community members and other key stakeholders being involved in the entire development process. A crucial part of the success of our CLC platform has been training staff and mobilising the community in the areas surrounding the facility.
How to fight future outbreaks
The lessons we have learned rolling this model out across Sub-Saharan Africa can be used to build equitable, quality primary healthcare, which will help prepare for future outbreaks.
We have found that strengthening healthcare must start with primary healthcare for people in individual communities. By providing greater access to quality care, we are able to diagnose and pick up early warning signals and symptoms, and react faster in the case of infectious outbreaks.
We have also learned that a lack of infrastructure can be overcome by using technology - mobile devices in particular – linked to a regional hospital or call centres. Technology has a key role to play in fighting pandemics, as do well trained and well equipped medical staff.
Most importantly, we have learnt that establishing new ways of delivering care will build stronger and more resilient communities and make healthcare much more accessible and affordable.
A strong primary healthcare structure will not always prevent pandemics or epidemics from occurring, but it will help manage them more effectively, limiting their socio-economic toll.