A digital mobile health platform increasing efficiency and transparency towards universal health coverage in low- and middle-income countries

Abstract

In low-and middle-income countries, achieving universal health coverage remains challenging due to insufficient, temporary and fragmented funding as well as limited accessibility to quality healthcare. Leveraging a mobile health platform can be a powerful tool to address these problems. This paper demonstrates how analysing data collected from a mobile health platform helps optimize healthcare provider networks, monitor patient flows and assess the quality and equitability of access to care. The COVID-19 pandemic reinforces the importance of real-time data on health-seeking behaviour. Between 2018 and 2019, as a Kenyan universal health coverage pilot was being planned, Kisumu County, with support from PharmAccess Foundation, implemented household-level digital registration for healthcare and collected socio-economic and healthcare claims data using the M-TIBA platform. In total, 273,350 Kisumu households enrolled. The claims data showed many patients visit higher-level facilities for ailments, that can be treated at primary care levels, unnecessarily. High-level estimate of the disease burden at participating facilities revealed rampant overprescription of pertinent medicines for highly prevalent malaria and respiratory tract infections, exemplifying clinical management deficiencies. M-TIBA data allowed tracking of individual patient trajectories. Analyses of data are shown at the aggregate level. The paper shows how mobile health platforms can be used to generate valuable insights into access to and quality of care. Funding for healthcare can be united through mobile health platforms, limiting the fragmentation in funding. They can be useful for funders, health managers and policymakers to improve the implementation of universal health coverage programs in low-and middle-income countries.

Digital health systems strengthening in Africa for rapid response to COVID-19

“…It provides ample examples of how ongoing digital health systems strengthening efforts in Africa can be used to rapidly develop responses to emergency outbreaks, such as the COVID-19 epidemic. Apart from the general advantages of digitization of African health systems (real-timeliness, quality, transparency, efficiency) (41), this proven epidemic preparedness is an important additional asset. Based on our experiences with implementing multiple digital COVID-19 add-ons to ongoing health systems strengthening interventions, we can distill a number of lessons learned per WHO health strengthening building blocks and provide recommendations to further enhance the resilience of African health systems.…”

“…Digital mobile health interventions enable patient-centered approaches, the democratization of health knowledge, therefore increasing social equity, social inclusion, and patient empowerment. Finally, using digital approaches the current fragmentation and duplication of healthcare financing efforts in LMICs can be counteracted, working toward Universal Health Coverage (UHC) (41). Importantly, the flexibility, scalability, and timeliness of digital interventions make them very suitable for emergency responses to epidemics, transcending geographical and economic barriers.…”

“…Many of the above interventions were supported by the mobile healthcare exchange platform M-TIBA, which is providing real-time insights in healthcare transactions and has been described elsewhere (41).…”

Invisible illness: The consequences of limited health insurance in Africa

“…Technology‐based solutions, such as mobile technology, are being used to facilitate the enrollment and payment of health insurance premiums. For instance, the M‐TIBA platform in Kenya enables users to save and access funds for healthcare services, facilitates the payment of health insurance premiums, and provides a digital record of healthcare transactions 25 …”

“…For instance, the M-TIBA platform in Kenya enables users to save and access funds for healthcare services, facilitates the payment of health insurance premiums, and provides a digital record of healthcare transactions. 25 While progress has been made in expanding access to health insurance through various strategies, future efforts should focus on several key areas. There is a need to strengthen healthcare infrastructure and systems, particularly in rural and underserved areas.…”