In recent years, the digital world has become increasingly intertwined with hospitals in Ethiopia, particularly in the private sector, where patients can have their information registered digitally both at the registration desk and in the doctor’s office.
However, the public health sector continues to rely primarily on pen and paper, resulting in lengthy wait times and low efficiency. John Snow, Inc. (JSI), a public health care and health systems consultant, launched the Digital Health Activity (DHA) as part of a USAID-funded project to improve and enhance the delivery of health and healthcare in Ethiopia. It has collaborated with the Ethiopian Ministry of Health to implement these cutting-edge digital methods in public hospitals and healthcare facilities throughout Ethiopia.
Oli Kaba, head of the digital health systems and services desk at the Ministry of Health, points out, “In the past, there wasn’t much focus on digital health.”
However, over the past two years, Oli says digital health systems have been developed and registered as part of a project known as the digital inventory system. “These systems are subsequently implemented in hospitals and clinics.”
The DHA is one of the projects that has been preparing these systems, which are being implemented with the assistance of the Ministry, to ensure a more efficient and effective method of providing care via digital solutions. Ethiopia is implementing the DHA project, which began in October 2019, in 11 regions and two city administrations. It intends to provide targeted assistance in 100 woredas across the country.
DHA intends to digitalize everything from patient information registration to physician diagnosis and pharmaceutical availability, from the smallest health posts to the largest public hospitals and health centers within these woredas.
“The DHA project, which was influenced by the Ethiopian health sector transformation plan, had an information revolution agenda that ran concurrently with the digital project. The agenda had three main pillars: digitalization, data use and governance, and capacity building,” explains Biruhtesfa Abere, the DHA’s chief technical advisor.
Biruhtesfa says the project’s digitalization component develops digital tools and software to enhance the quality of care across all facilities. One is the digitization of medical records, which can help facilities become paperless by having patient information and data digitally imputed.
In addition to reducing the use of paper, the system can aid in improving the quality of care, the management of patients, the rate of medical and medication errors, and access to patient records and histories for more efficient care.
The DHA has already begun implementing the electronic medical records system in 10 health facilities throughout Ethiopia, including five in Addis Ababa.
In addition to the Ministry’s implementation of an electronic medical record system, the DHA is developing a more efficient supply chain management system that will aid in the distribution of health commodities such as medications.
The Vitas system tracks the movement, expirations, losses, and adjustments of health commodities in real time and manages the warehouses. Biruhtesfa claims this information enables the Ethiopian Pharmaceutical Supply Services to forecast, procure, and distribute health commodities across health facilities. “This system can aid in avoiding drug shortages, expiration dates, contraband, and counterfeit medications.”
Regarding the reception of the digital system, Biruhtesfa stated that it was initially difficult for people to accept it.
“Patients found it rude when their doctors used computers to input or check information instead of focusing on them, and it took some time for the systems to gain acceptance.”
The DHA collaborates not only with health centers and hospitals but also with health posts, which are typically small locations where patients who cannot access health centers or hospitals receive early treatment.
In these regions, an electronic community health information system has been implemented. Health extension workers primarily utilize this community-based health information system during household registrations, service delivery, and referrals.
Because it is difficult to place advanced computers and devices in health posts, which are typically located in agrarian or pastoral areas, the DHA has devised a solution consisting of providing health workers with tablets and mobile devices that use a USSD system or a simplified system that is available in any language they require.
In addition to creating digital systems that they intend to implement with the Ministry, they wish to ensure that the work continues beyond the scope of the project. They have begun collaborating with local universities and colleges of health sciences to establish centers of excellence and academies for diverse digital health tools and data practices, as well as to sustainably support pre-service and in-service training programs.
Digitalization, according to Biruhtesfa, is merely a means for the DHA.
“The objective is not limited to developing and deploying software. The objective is to enhance the quality of care. “Digitalization is merely a means to the end of providing proper treatment, medication, and services to in-need patients,” he explained.