This is largely attributed to the limited budget ratio, coupled with the healthcare sector being over stretched due to the crisis in the health worker force. Today, the doctor to patient ratio stands at 1:10,000 meaning that one doctor handles 10,000 people. This grim picture becomes real in rural areas where many health facilities lack qualified medical personnel to attend to them.
In addition to the infrastructural challenges and health workers' negative attitudes, the Ugandan health system is characterised by a dual health system which comprises the modern or Western medicine and, the traditional and complementary medicine Practitioners (TCMPs). These TCMPs practise in both urban and rural areas with varying and inconsistent service provision.
Because a big proportion of the population lives in the semi-urban and rural areas, patients can easily gain access to traditional healthcare centres compared to modern healthcare. Hence, a high percentage of cases that reach modern healthcare facilities are likely to be emergency cases that have passed through the traditional medical system.
Telemedicine, where medical information is transferred through the phone or the Internet and sometimes other networks for the purpose of consulting, and sometimes remote medical procedures or examinations, has not gained ground in Uganda. And yet, over the years, the country has experienced fatal outbreaks of Ebola, Marburg virus, plague, cholera and yellow fever, among other epidemics.
It's quite evident that an increased practice of telemedicine would contribute to early diagnosis, treatment and preventive control at the premature stage of any outbreak.
Besides, telemedicine will enhance human resource capacity among health workers, especially the lower cadres in rural areas, through effective acquisitions of skills and knowledge via online education, research and remote expertise consultations.
Increased healthcare delivery is a national issue, gone are days of care at a distance or 'in absentia'. It's now a concern for all the people to effectively and efficiently receive healthcare regardless of their geographical locations, climate change, and differing economic situations. So, just like in the developed countries, the health sector in Uganda is expected to provide a clinical care environment with modern communication technology for remote diagnosis, prevention, research, training and education through wired or wireless networks. However, telemedicine in Ugandan health sector is still at small scale, with less sophisticated, off-the-shelf, low-cost communication technologies.
But due to the required high levels of investment for telemedicine, more sophisticated solutions such as Asynchronous Transfer Mode (ATM) and Virtual Reality (VR) call for adequate funding. Nevertheless, there has been a remarkable increase in the use of other solutions ranging from use of emails, telephones, fax, skype calls and chat rooms to transmit patient information to specialists in referral centres, either locally or internationally.
The Internet is an important tool in facilitating telemedicine. The unavailability of the internet largely affects clinical care. In rural areas, the health sector is reeling due to the unreliable internet service. Physical obstacles such as hills and valleys serve as a hindrance in extending the service to the furthest sites. As a result, despite a variety of internet service providers in Uganda, very few are able to extend to far rural communities. Those that do, exaggerate the bandwidth costs.
However, with the delivery of Uganda's fibre Internet backbone - National Data Transmission Backbone Infrastructure (NBI) amounting to 1,524km, the health sector stands to benefit. And through the Research and Education Network of Uganda (RENU), health workers even in the rural communities will be able to conduct research, connect with other experts for any consultations at minimal costs.
Besides, the technological solutions being developed to harness telemedicine should be adaptable to the Ugandan environment largely due to lack of skilled manpower in this area of telemedicine.
Telemedicine will create a connection with expert physicians both at national and international levels. More patients will then embrace the public health facilities motivating them to always seek medical attention. This will reduce the reliance on the traditional healthcare clinics where many people have developed complications due to being attended to by unqualified physicians.
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Autor(en)/Author(s): Vincent M. Kiberu
Quelle/Source: AllAfrica, 09.06.2013
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