College of of Medicine and Health Sciences READINESS OF TELEHEALTH IMPLEMENTATION IN RWANDA. J L NGENZI 1, A NISHIMWE 1 1 University of Rwanda College of Medicine and Health Sciences, Kigali 3286, Rwanda jngenzi7@gmail.com; aurorenshimwa@yahoo.fr,
Introduction Telehealth has been selected as a strategy to improve healthcare service delivery as well as training more healthcare personnel using few resources in Rwanda The term telehealth is defined as the use of: advanced telecommunications technologies to exchange health information and to provide health care services across geographical temporal, social and cultural barriers
Introduction : Over 10 years Rwanda has done progress The number of health professionals increased from 11 604 to 12 012 from 2008 to 2009, with the ratio of 1 doctor to 16046 people. The nurses and patients ratio is 1: 1227, 1: 18790 people for midwives. The required ratio to achieve millennium development goal is 2.5 while Rwanda has achieved only 0.6., Is on the good tract to achieve most of the Millennium development Goals
Introduction Specialized physicians represent only 28.3 % and are based in Kigali City 85 % of the population lives in rural area >= 70 % do have health Insurance However transport costs and living expenses in case of transfers are still high for most patients from rural areas. Access of CME is a challenge within the rural doctors
Policies The is a strong Political will to use ICT in all aspect of the development of Rwanda Vision 2020 to be a knowledge based economy and a Middle income country and IT Hub in Africa Economical Development and Poverty Reduction Strategy (EDPRS) 2013 2018 The second EDPRS focus on rural communities connectivity in terms of electricity and ICT use and electricity Smart Africa manifesto during the transform Africa conference in Kigali 2013
Policies National ICT Strategy and Plan (NICI III). NICI I was for ICT enabling environment, NICTI II was to create a world class ICT infrastructure NICI III focuses on e services delivery. In Rwanda E health strategic plan 2003 2009, telemedicine and e learning are recognized as strategy to train more nurses and improve capacity building for health professionals and reduce the number of transfers to referral hospitals. Rwanda Medical council recommend diversification of teaching methodology for continuous professional development including using of ICT. Some gaps related to telehealth clinical guidelines and legal and financial policies related to telehealth.
Infrastructure Fiber optic cables linking all administrative districts 30 District across the countries Mobile 3 G covers the whole of Rwanda Mobile 4 G LTD is in Kigali and in 2017 it will cover Rwanda at 95 % Mobile penetration is 70 % The majority of the districts Hospitals are on the fiber optic All teaching hospitals are connected to the fiber optic All campuses of the University of Rwanda, College of Medicine and Health Sciences are connected to the National Fiber Optic Health centers use Mobile 3 G internet to send reports Solar power and generator are being used in the case there is no electricity The stability of electricity is still a challenge especially in rural areas
Most nursing schools do have high definition videoconference facilities and some teaching hospitals do have high definition videoconference facilities as well Infrastructure
Human Resources and telehealth initiatives University of Rwanda, College of Medicine and Health Sciences, School of Public health offers Masters in Health Informatics where students learn a module of telehealth. Those students will be useful in managing and implementing some telehealth projects. The Nursing e learning program is using the learning management information system and the program has tasted the use of videoconference system. International medical case presentations have been conducted linking Rwanda with South Africa, USA and Europe.
Conclusion & Recommendation Rwanda is now ready to start offering telemedicine services due to the ICT policies in place, the availability of ICT infrastructure, Successful participated in several telehealth initiatives. Mobile phones can be used to monitor and manage patients with chronic diseases in communities; low bandwidth store and forward telemedicine systems can be deployed in all health facilities as well as low bandwidth secure desktop videoconference systems can be deployed in health center where the focus is primary care high definition videoconference systems can be deployed only at Districts hospital where there is availability of Fiber optic. Moving to clinical services using technology will a step forward. Efforts towards hospitals networking, capacity building of staff, integration of telemedicine in health financing policies and insurance and telemedicine guidelines will support the implementation.
Murakoze Cyane! Contact Information: NGENZI Joseph Lune jngenzi7@gmail.com