Updated Oct 22, 2019

Telehealth for Rural Healthcare

https://www.kaarohealth.com

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Focus Areas:

Primary Care

Primary CareSEE LESS

Implemented In:

Uganda

UgandaSEE LESS

1
Country Implemented In

Problem

The major issue that our company addresses is the unusually high incidence of sickness and death resulting from lack of access to qualified doctors in rural Africa. This chronic health workforce shortage means that rural health facilities typically refer nearly all (up to 85%) of their patients, thus flooding larger health facilities with patients who present with uncomplicated conditions. This not only causes physician fatigue, drug stock-outs and low quality of care at referral hospitals, it also encourages bribery and corruption within the health system, further impeding already limited health access. For instance, at less than 0.01 doctors per 1,000 people, the World Health Organization estimates that physician shortage in Uganda alone leads to over 120,000 deaths annually resulting from either lack of access to a qualified health worker, or poor quality of service for those who eventually gain access. Indeed, sub-Saharan Africa has the world’s highest maternal mortality rates, which average 500 deaths per 100,000 live births. Further, frontline health workers operating rural health clinics receive little opportunity to hone their clinical decision-making skills over time due to low patient volumes, little interaction with other medical professionals, and running under-equipped facilities.

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Solution

Over its 3-year existence, Kaaro Health has demonstrated that optimising the time and efficiency of the available health workforce and proactively making their services remotely available in rural, hard-to-reach areas can lead to a dramatic reduction in the incidence of sickness and death in these areas. Thus we have created a telehealth platform that helps health clinics in Uganda’s rural areas to gain remote access to the few available doctors, whom they can’t otherwise afford to hire. Our platform consists of: i) A rapidly growing network of 71 energy-autonomous container clinics which are deployed in Uganda’s 28,000 rural villages with 2,000 or more inhabitants but which do not have a health facility within a 10km radius; and ii) A software platform through which our doctors deliver remote, life-saving diagnoses and prescriptions to patients attending rural clinics, and continuous medical education to frontline nurses and technicians serving these clinics. Since 2017, our rural clinic network, which serves about 1,100 patients each day, has already handled a combined total of 1,110,000 patient visits. Of these, over 106,000 were pregnant women living with HIV, over 40,500 of whom had potentially complicated pregnancies for which our intervention prevented development of serious postnatal complications and transmission of HIV to infants, and enabled early diagnosis of HIV in infants.

Target Beneficiaries

Our direct customers are owners/operators of privately-owned health clinics which are located outside major towns and cities, serving up to 50 walk-in patients daily, who are unable to afford to hire a full-time or part-time doctor. Clinics are typically operated by a full-time qualified registered nurse and laboratory technician. Average annual turnover ranges from $5,000 to over $30,000. We currently serve clinics in Ibanda, Kisoro, Bundibugyo, Kabale, Bushenyi, and Mpigi districts. Our typical beneficiaries, who are the patients visiting the clinics we serve, are mainly Sub-Saharan African women of childbearing age between 14 and 40 years with monthly incomes ranging between UGX 90,000 – 1m (about $25-$280). They are typically smallholder farmers or agricultural produce traders, and get pregnant about once every 2 years until age 35.

Innovation Description

Our innovation, which is a telehealth platform, makes it possible for doctors, who live and work in cities, to simultaneously serve the needs of up to 5 clinics without having to relocate to rural areas. Our digital platform helps doctors to connect to rural clinics, making each rural clinic in our network instantly capable of providing all the specialties that our 36 medical professionals are qualified to deliver. When a patient visits a clinic location within our network and presents with a condition that needs a doctor to review, instead of being referred to a distant health facility which may or may not have a doctor on staff, the nurse at the clinic conducts the necessary patient assessments and laboratory tests, enters results into our online electronic medical record (EMR) using the tablet computer provided, and initiates a remote consultation request to the appropriate doctor in our consultation system. The doctor, who is seated at one of our 2 remote hubs, accepts the request, reviews the patient’s medical records and laboratory test results, and initiates a live video, audio, voice, or text interaction with the nurse and patient before providing a diagnosis and prescription and/or referral. The patient then pays using mobile money or presents their micro-insurance details. This capability not only helps patients living in hard-to-reach areas to access primary health care easier and more affordably, it also results in a dramatic jump in rural clinics’ revenues.

Milestones

Date Unknown
New Country Implemented In
Uganda