By Sharon Atieno Onyango
Despite the healthcare workforce being a critical building block of health system strengthening, Africa continues to struggle with acute shortages.
According to World Health Organization, the African region has less than three skilled healthcare workers per 1,000 people. This is less than the estimated threshold of 11-13 for the same population.
“With the shortage of healthcare workers, the question becomes, how can we make sure that the people at the frontline facilities, whether we are talking about our doctors, nurses, clinical officers or pharm techs are able to do the very best they can for that patient in front of them? How can we make sure that more patients are being seen at the primary healthcare facilities so that we reduce the number of patients who need to be referred?” Dr. Caroline Kisia, Africa Director, Project ECHO posed during a media roundtable in Kenya’s capital, Nairobi.
Dr. Kisia observed that the solution lies in using technology to enable the limited number of specialists—often concentrated in urban areas—to remotely and continuously mentor frontline healthcare workers, ensuring patients receive high-quality care at local facilities.
One such innovation is Project ECHO, a virtual learning and tele-mentoring platform that uses a case-based model. Healthcare workers present real patient cases to subject matter experts, who then offer guidance and practical recommendations to improve care delivery. The platform is present in 35 African countries and running over 300 health programmes.
According to Dr. Teresa Loile Lotodo, consultant pathologist and senior lecturer, Moi Teaching and Referral Hospital and AMPATH, Project Echo and Ampath have been able to work together for over many years to be able to impact sharing of knowledge from the higher-level facilities to the lower level facilities.
“We realize that the lower level facilities level 1, 2 and 3 have limited capacity to make diagnosis of diseases. Through this project Echo, some of these patients are able to be presented through the virtual platform. And then the specialists are able to advise on what test can be done at that facility,” she said.
“Those that are not able to be done at that facility, the sample can be referred to the referral hospital. This has enabled our patients to get early diagnosis and treatment across the board.”
Dr. Jennifer Njuhigu, Tele-ECHO national coordinator, Telementoring, Equity, and Advocacy Collaboration for Health through Antimicrobial Stewardship (TEACH AMS) Kenya, says the initiative has driven practical improvements in patient management, particularly in the appropriate use of antibiotics.
“We have seen a lot of improvement with the clinicians whereby they are not prescribing antibiotics empirically or by assumption but they are following the laboratory results. So, we are also seeing collaboration between the teams. They have come to realize that a patient does not belong to one person but it belongs to a team,” Dr. Njuhigu noted.
However, Prof. Gunturu Revathi, Head, Clinical microbiology, Aga Khan University Hospital notes that there is need for knowledge and resources to work hand in hand.
“This is an excellent virtual learning platform which will enhance the knowledge base. It will increase the knowledge, networking, information and surveillance. Yet it cannot provide physically the vaccine which we need and the philosophy of diet, lifestyle change and discipline,” Prof. Gunturu said.
The discussion came ahead of the World Health Summit (April 27-29), which will convene global and African leaders in Nairobi to chart the future of health systems on the continent.
