Ethiopia: Stepping Up Tel-Med Services

ADDIS ABABA (HAN) February 24, 2016 – Public Diplomacy and Regional Stability Initiatives News. By Girmachew Gashaw.The health strategy number four also indicates that health education shall be strengthened generally and for specific target populations through media outlets, community leaders, religious and cultural leaders, professional associations, schools and other social organizations. Such an approach is instrumental in inculcating attitudes of responsibility for self-care in health and assurance of safe environment; encouraging the awareness and development of health promotive life-styles and attention to personal hygiene and healthy environment; enhancing awareness of common communicable and nutritional diseases and the means for their prevention; inculcating attitudes of participation in community health development; identifying and discouraging harmful traditional practices while encouraging their beneficial aspects; discouraging the acquisition of harmful habits such as cigarette smoking, alcohol consumption, drug abuse and irresponsible sexual behavior ;creating awareness in the population about the rational use of drugs.

After the onset of the aforesaid policy and strategy, private medical service institutions have been increasing both in quantity and quality. Of late, following the introduction of mobile technology, tel-med services are being introduced here in Ethiopia. Tel-Med is a public medical information service through phone. As it is a phone based service, a client could call to the service provider, ask about health service he needs, listen to a taped reply form that of medical organization and /or medical society.

Dr. Yohannes Wodaje is tele-med medical services Hello Doctor Ethiopia General Manager. As he said, previously, many people had consulted with informal practitioners for lack of basic information about the location and availability of health services. Right after the introduction of tel-med Hello Doctor medical service, people are getting medical consultation. Mothers, youths and other segments of the society have now a chance to know more about their and /or relatives health.

Family planning, sexually transmitted diseases, pregnancy, child health, chronic illness such as diabetics, blood pressure, among others are among the frequently raised health issues. Even, people with great depression call to understand the real cause and consequences of their health problem. Furthermore, those who take prescriptions after making diagnostic test crunch our numbers to have additional briefings. In addition to medical advice, users can request an ambulance or a home visit by a doctor or a nurse. By and large, people with medical disorder of every making call to know about their cases.

The service is not a free launch. It costs eight birr per minute. As it is a commercial organization we have to cover running costs and the like. Within five minutes, our doctors reply inquiries in a more elaborated way. Thus, on the average with not over 40 birr patients or clients can get services. Service is a crunch away. According to the survey we made so far, of the total beneficiaries of our service, 64 per cent live in the capital and 19 per cents of them in rural towns and the remaining are from urban towns such as Mekelle, Bahir dar, Dire dawa, Hawassa, Jimma and so on. We need to provide services not only for urban dwellers but also to people from rural areas. Of course, the service is being provided only in Amharic language. That is one problem in our service delivery. Thus, we need to include other languages but it is hard to apply soon.

Regarding quality and effectiveness, we had hired doctors that graduated from various universities and received professional certificates. But that is not sufficient, we monitor quality by listening recorded samples of doctor’s recommendations and given pieces of advice, and assess them from different angles. Top on the list of things we check our professionals’ convincing capacity of customers, listening capability, understanding knack of the problems of customers with a short span of time and advising capability of customers by relating things with the modern scientific knowledge. Thus, we have put in place quality monitoring system to supervisor service quality based on set parameters. Regarding medical professionals, we had hired some doctors. But in light of the variety of services demand their number is not enough. But there are others who,on part time basis, participate in our platforms. Presently, for instance, there are 14 active doctors working in the Hello Doctor programme.

Apart from this, there are some doctors who participate in the consultation Desk on a permanent basis. Though we are providing services to customers, we do not make a formal assessment to get feedback. So far, it is a promising feedback we get through phone. People have infinite inquiries and there are many things that surprised us even after we got the ball rolling. Many people are getting exited in having professional information. Because, when they have any inquiry at any time, they can get services via phone call.

In the future, we plan to expand the service and make it accessible to the public at large. To do this, two factors are decisive. The first is, we will take measures to expand the services. So far the government has been offering various assistance and other stakeholders should cooperate with us to ensure the quality of the service. When we begun the service for instance ethio-telecom has been renewing its facilities, there was a problem in service provision due to low network supply.

Dr. Raniya Ibrahim is Product Development Director at Tel-med Medical Services- Hello Doctor Ethiopia. She was one of the first employees there. She said, Hello Doctor service has come a long way. Almost a two -year-and- half time has elapsed since it begun the service. The phone-based service decreases the cost of accessing medical care doing away with the need to travel to a health facility to receive medical advice and information. By reducing the cost of receiving services, Tele med seeks to reach people who might not otherwise seek care or who might wait longer period to seek care.

Tele med plans to reach 800,000 clients with immediate medical advice and health information by June 2016. Approximately a quarter of the callers are extrapolated to be women of reproductive age and approximately 10 percent are expected to be pregnant women. A smaller percentage of callers will be those requiring an ambulance or home visit, and an additional impact of the service will be identifying emergency situations that might otherwise cause a loss of life or critical disabilities if not followed-up by a professional medical doctors.

Tele med will also reach clients who may not feel comfortable traveling to a health facility to ask questions or seek treatment, such as those with questions about gender identity or reproductive health disorders or patients with mental health conditions. Initially we used to receive 10 to 15 calls per day and 10,000 calls per year. But now we respond 100 to 300 customers per day. So this is a huge change with in the span of two years time.

Gaining the trust of the public was one of the challenges we were confronted with after we introduced services. It is slowly but surely they began to understand the value and appreciate it. But at the beginning people were very skeptical. They were not sure that our service was a trouble shooter. The second was the cost. There are a host of reasons why the service price is so expensive. Through time people have began to understand why our services are expensive. Normally in our country there is no regular or normal medical service information delivery. Patients spend a lot of time , money to get that service. What we have done is incorporating such services in about five minutes. Someone can spend 40 birr and get information from doctors ready to respond.

Dr. Zerihune Abebe is a Provost working at St. Pawl Hospital. After the introduction of mobile technology, listeners are demanding to hear immediate responses to the inquiries raised by clients regarding health issues. The establishment of Hello Doctor service in the country helps the society to get immediate response for such inquires. The service has its own peculiar features. Most of the doctors are ones that have accumulated a wealth of knowledge in treating patients in person. Tel med service, by its nature, is not an easy task. Previously treating people through phone was unthinkable.

Till recent time, we have not organized a system to do so. Thus, in mobile communication, doctors have to know possible questions which can be posed by patients, know methods of handling, not forget providing every advice to the patient. As much as possible the pieces of advice should be free from technical jargon. Hence, a Memorandum of Understanding(MoU) has been prepared to keep standards. The MoU has helped us to make the service identical. If the services provided differ from one doctor to the other, doubt on equitable treatment will arise. This forces patients to incur additional cost. The service will also get affected.

The medical protocol produced and distributed to medical doctors helps give identical services to patients.

More advertisement and awareness works are decisive to expand the programme. And working with many health professionals, telling the patient that this service is available as an option is decisive. If patients have more question and doubts, they can call a medical advisory instead of going to doctor and waiting all day, lined up and not getting satisfaction.

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