Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability.
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Date
2015-01-08
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Abstract
Effective health care delivery is significantly compromised in an environment where resources both human and technical are limited Botswana s health care system is one of the many in the African continent with few specialized medical doctors thereby posing a barrier to patients access to health care services In addition the traditional landline and non robust Information Technology IT network infrastructure characterized by slow bandwidth still dominates the health care system in Botswana Upgrading of the landline IT infrastructure to meet today s health care demands is a tedious long and expensive process Despite these challenges there still lies hope in health care delivery utilizing wireless telecommunication services Botswana has recently experienced tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices This growth inspired the Botswana UPenn Partnership BUP to collaborate with local partners to explore using mobile devices as tools to improve access to specialized health care delivery Pilot studies were conducted across four medical specialties including radiology oral medicine dermatology and cervical cancer screening Findings from the studies became vital evidence in support of the first scale up project of a mobile telemedicine solution in Botswana also known as Kgonafalo Some technical and social challenges were encountered during the initial studies such as malfunctioning of mobile devices accidental damage of devices and cultural misalignment between IT and healthcare providers These challenges brought about lessons learnt including a strong need for unwavering senior management support establishment of solid local public private partnerships and efficient project sustainability plans Sustainability milestones included the development and signing of a Memorandum of Understanding MOU between the Botswana government and a private telecommunications partner the publication and awarding of the government tender to a local IT company and the development and signing of a Memorandum of Agreement between the Ministry of Health Clinical Services department and the local tender winner The initial system scale up is scheduled to occur in 2014 and to ensure the project s sustainability the system is aligned with the national eHealth strategy and local ownership of the project remains at the forefront 1