Project Kgolagano Harnesses Telemedicine to Plug the Gaps in National Healthcare Service Delivery
The World Health Organisation (WHO) prescribes the highest attainable standard of health as a fundamental right of every human being. The UN agency advocates for a human rights-based approach to health, this approach advances the right to health in international law and international development processes. The approach further stipulates that the right to health includes access to timely, acceptable and affordable healthcare of appropriate quality in order to achieve the best health outcomes.
The reality however is that rural communities and people of low socioeconomic status face barriers that make it difficult to obtain basic healthcare services. Vulnerable and marginalized groups in societies tend to bear an undue proportion of health problems. Poor access to healthcare comes at both a personal and societal cost as people who do not receive vaccinations, may become ill and spread diseases to others increasing the burden of disease for society overall in addition to the burden borne individually.
The scenario in Botswana is no different as demonstrated by the fact that while government has instituted a robust primary healthcare policy and invested substantially in building health facilities all over the country, quality healthcare and service utlisation remain a challenge outside urban centers. Medical care is rudimentary in rural areas mainly as a result of inadequate skilled health professionals and the logistical and economic challenges of delivering quality medicines to peripheral regions.
Botswana is an average sized country of just over 2 million people. The country is one of the most sparsely populated nations in the world with a density of 3.9/km2. Around 10 percent of the population lives in the capital city, Gaborone. With a thinly spread population sitting on a vast plateau that is divided into two distinct topographical regions comprising a hilly bush country and grassland eastern region, and the Okavango Swamps and the Kalahari Desert in the west, service delivery and infrastructure development are a logistical and economic challenge.
To remove the obstacle that deny rural communities access to quality and affordable healthcare, Botswana Innovation Hub in partnership with some of its stakeholders is leveraging science, technology and innovation to help solve social and epidemiological problems that remain a hindrance to the country’s healthcare service delivery. The company is harnessing the rapid spread of digital technologies to transform healthcare work and service delivery.
In its World Development Report of 2016, The World Bank Group defines the broader development benefits from using these technologies as digital dividends. These returns to digital investment have boosted growth, expanded opportunities and improved service delivery. The report’s, co-author Tim Kelly says, “It is widely acknowledged that the adoption and use of ICT’s for government and trade by countries can contribute significantly to the development and renovation of established economic and social sectors by reducing unemployment, especially among the youth and boosting efficiencies in service delivery.”
In its drive to develop advanced science and technology innovation capital and activities that advance the country’s productivity and contribute to its competitiveness, Botswana Innovation Hub offers a unique platform for scientific, technological and indigenous knowledge-based innovation. In the process, the company has identified ICT as one of its focal sectors. “The company’s focal sectors were defined by national needs and opportunities to fuel economic diversification and job creation, as well as support the exploration and advancement of solutions to pressing national and global issues,” states ICT and Marketing Director, Tshepo Tsheko.
Tsheko says, investment in science, technology and innovation is essential for economic development and social growth. He says one of the Botswana Innovation Hub flagship programmes, the pilot project on TV White Space (TVWS) broadband access service has been hailed as a resounding success one year after it was launched. Project Kgolagano as the project is officially known, was launched on 12th March, 2015 at Tsopeng Clinic in Lobatse and is already lauded for enhancing service delivery, through telemedicine and bridging the digital divide.
In telecommunications, TVWS denotes unused spectrum on the frequency range commonly used to deliver television channels. The frequencies allocated to a broadcasting service but not used locally enable the delivery of broadband using dynamic TV spectrum access. Project Kgolagano uses TV White Space technology from the free dynamic TV spectrum to provide hospitals and clinics with access to broadband internet and telemedicine services that facilitate a remote diagnosis network and support local healthcare service delivery.
“The project delivers online healthcare services to regions in Botswana with limited access to broadband and adequate specialized healthcare services using cutting edge technology for the delivery of broadband,” states Manager of the Microsoft Innovation Centre (MIC), Patel Barwabatsile. “Project Kgolagano connectivity enables access to specialised medicine in Gaborone and other locations around the world, with a specific focus on specialised healthcare services such as maternal medicine; cervical cancer screenings; dermatology screenings; HIV screenings and consultations; tuberculosis screenings and consultations; adult pediatric care and internal medicine consultations,” he says.
Kgolagano, is a Setswana word which means “to be connected or networked.” The project is a collaboration between Botswana Innovation Hub; Microsoft Corporation; University of Pennsylvania (UPEN); Global Broadband Solutions; Vista Life Sciences; Botswana Fibre Network (Bofinet) and USAID-NetHope. Barwabatsile states that the project is made possible through the support of the Botswana Communications Regulatory Authority (BOCRA) to transmit on TV White Spaces, and the collaboration of the Ministry of Infrastructure, Science and Technology and the Ministry of Health representing government.
The objective of the project is to demonstrate the efficacy of the cutting edge technology of TVWS equipment and service, assist the regulator BOCRA to come up with the licensing framework for the dynamic spectrum access and use of TVWS as well as deliver the telemedicine health programme through low cost and long range broadband over TVWS. The telemedicine programme allows medical staff to consult with patients in remote locations, with the primary objective to increase the potential scale and reach of health services across Botswana. Furthermore, the project aims to lay the groundwork for future low cost internet access that can assist in increasing education, healthcare, access to markets and small business empowerment throughout Botswana.
The Director of Microsoft’s Technology Policy Group, Paul Garnett says, “Using TVWS for broadband internet connectivity has several distinct advantages which include the technology’s ability to cover greater distances and penetrate common obstructions, with greater efficiencies and reduced implementation costs. The technology is ideal as it can work in areas where there is no electricity, and it can lower the cost of an access base station by a factor of 10. This is a cutting edge technology that has the potential of providing cheaper broadband internet connectivity to areas that were not connected before.”
Garnett goes on to say, this technology uses location-aware devices and online databases to deliver low cost broadband access and other forms of connectivity to consumers. The approach is rooted in the idea that devices with greater knowledge of their surroundings can opportunistically use available radio spectrum. There are many TV broadcast channels that are unused in nearly every location in the world, these empty channels (blocks of spectrum) are what is used in this internet connection.
Following the launch at Tsopeng clinic in Lobatse last year, the pilot project was later extended to run in Francistown and Maun. The hospitals connected to the service are Athlone Hospital in Lobatse, Nyangabwe Hospital in Francistown, and Letsholathebe II Memorial Hospital in Maun. In addition to these, Tsopeng clinic in Lobatse, Donga clinic in Francistown and Moeti clinic, Boseja clinic, Maun clinic, Sedie clinic and Maun General clinic were also connected.
ICT and Marketing Director, Tsheko is excited at the positive outcome of the pilot project and believes that telemedicine will transcends Botswana’s rough terrain and socioeconomic barriers to make quality and appropriate healthcare services affordable and accessible to all. He said while the pilot phase is focused more on the health sector, sectors such as education, agriculture, tourism and security services will all benefit immensely from this technology in future once it is rolled out.
In his post pilot project report, Barwabatsile concludes that Project Kgolagano has been successful in delivering broadband internet over the TVWS and in the process delivered healthcare services to the pilot sites and their catchment areas. He said the telemedicine programme included a monitoring and evaluation function that documented the socioeconomic impact of the project on the communities involved. The results clearly indicate that the communities reaped economic and social benefits from the pilot project.
“In order to move beyond pilot projects towards sustainable commercial deployments, the report recommends that BOCRA should come up with a regulatory framework for the adoption of the TVWS or dynamic spectrum access,” he says. Barwabatsile goes on to say recognition of the broadband technology will assist in speeding up the commercialization of the TVWS service as most organisations and government entities are willing to adopt or use the service if it is covered by a regulatory framework.
By Tigele Mokobi