VITAL: Virtual International Telehealth and Leadership
Summary
In 2023, Health Tech Without Borders (HTWB) , iDocta, and VSee commit to bringing together an international, collaborative effort to create a local, sustainable, culturally competent telehealth program to meet the health needs of forcibly displaced persons and those living in remote regions of Cameroon. Drawing from its network of experts, HTWB will empower, train and equip local programmers, clinics, and healthcare providers with technology focused to meet their needs, including digitalization education, telehealth essentials, satellite internet, and electronic health records. Fueled by a team of local programmers, clinicians and experts, HTWB will ensure the telehealth program model is viable and sustainable. Project VITAL (Virtual International Telehealth and Leadership) aims to improve access to health care for 5,000 individuals, support in strengthening the health systems through a sustainable training model, build healthcare worker capacity and initially train 27 new health professionals, promote skills underpinned by technology and innovation, build resilient communities, ensure equitable health, and empower youth.
Approach
Health Tech Without Borders commits to launch the Virtual International Telehealth and Leadership Project (Project VITAL) to create a local, sustainable, culturally competent telehealth program for the Cameroon/Sahel region. Project VITAL aims to improve access to health care, support strengthening of health systems through a sustainable training model, build healthcare worker capacity, promote skills underpinned by technology and innovation, build resilient communities, ensure equitable health, and empower youth.
HTWB will convene a high-level steering committee to perform a needs assessment and guide implementation of a sustainable telehealth model. Utilizing HTWB experts, VITAL will empower, train, and equip local programmers, clinics, and healthcare providers with technology focused to meet their needs including digitalization education, telehealth solutions, satellite internet, and electronic health records. Local community clinicians, leaders and entrepreneurs including iDocta, Pasteur Institute of Bangui, and Reach Out Cameroon, will mobilize a clinic/technology base of operations. VSee will bring the technology experts to help train the new generation of local programmers to ultimately self-sustain the technology. HTWB will also set up a revenue model to ensure long-term operability and aim to meet with ministries/governments to ensure compliance and support.
HTWB and their clinical advisory board will review the care delivered and create systems to improve care aligning with best practices and national and WHO guidelines. To ensure a secure technology platform and devices, HTWB will work with VSee and Medical Device Interoperability & Cybersecurity Program (MD PnP) to ensure secure technology and systems (cybersecurity) , protected patient health information, conformity to local health and bandwidth requirements, and optimal fit.
The VITAL pilot will reach an initial 5,000 individuals and train 27 new health professionals. After the initial pilot in Yaounde, HTWB aims to scale Project VITAL to the remote North/NorthWest regions utilizing the same steps as above with Yaounde as the principle base.
Action Plan
Project VITAL’s core objective is to create a new model for delivering telehealth across Africa, bringing together local partners, technology companies, and world experts to create a customized telehealth/EMR platform for the specific need of each region. HTWB needs capital to start this project and pilot it in Cameroon. They plan to make it fully sustainable both from a workforce and financial standpoint over the next 3-5 years, and then scale to other countries in the region.
Project VITAL plans to implement as follows:
Q4 2023 to Q1 2024: Convene steering group for Project VITAL to detail out the specific clinical, operational, and technological needs by iDocta to start a small, focused pilot in Yaoundé (Cameroon) .
Q2 to Q3 2024: Recruit, train initial group of local programmers and clinicians. Open initial brick and mortar office/site in Yaoundé. Work with VSee and MD PnP to create the first build of telehealth platform and EMR for pilot deployment in Yaoundé.
Q1 to Q2 2026: Start initial pilot in Yaoundé by connecting local clinicians with patients. Start collecting/ analyzing process improvement data for use in future scaling.
Q3 2026: Continue expanding Yaoundé clinician training, programmer training, and patient volume in the local Yaoundé area. Conduct a needs assessment in conjunction with local Cameroon/Sahel partners to determine target location for rural telehealth site in North/Northwest region of Cameroon.
Q4 2026: Start pilot of telehealth program in rural North/Northwest region of Cameroon.
Background
Globally, an estimated 148.4 million people require humanitarian assistance due to conflict and climate-related disasters (UN, 2021; UNHCR, 2021) . Conflict displaces an estimated 89.3 million people, most of whom do not have access to essential health care (UNHCR, 2021) . This, coupled with the increasing attacks on health workers/facilities, further challenges care access (WHO, 2022) . Africa is expected to have a severe shortage of health workers, with the need predicted to reach 6.1 million by 2030 (WHO, 2016) . In 2015, Africa had around 1.3 health workers per 1000 people, significantly less than the 4.5 needed to meet the UN’s SDG goals for sustainable access to healthcare (WHO, 2017; UN, 2015) . Cameroon/Sahel is a conflict-affected region with over 30 million people needing humanitarian assistance and mental health support (AFROWHO, 2022) . West and Central African regions have the highest maternal mortality rates globally while suffering from the effects of climate change, including extreme heat, droughts, degradation of agriculture, and security challenges (AFROWHO, 2022; World Bank, 2021) . Overall, this leads to displaced populations with poor and worsening access to healthcare.
With these challenges, telehealth is a viable and proven option to fill the gap for those forcibly displaced and remote regions in the Sahel by enhancing access to specialists, peer-to-peer consultations across countries/continents, tele-education, rapid triage, and identifying/reporting epidemics. Telehealth provides equitable, quality, and cost-effective care with the potential to achieve universal health care (WHO, 2022; Wamala D, 2013; Barbosa W, 2021) and decreases the carbon footprint of healthcare (Purohit A, 2021) . Investment in training workers is crucial to scaling up telehealth to increase healthcare access equity which has been challenging due to lack of funds and political support across Africa (Boum Y, 2021) . These challenges must be met with sustainable, safe, and secure solutions.
Progress Update
As we sought to advance our project, we successfully created a prototype. However, to support the work of coders, programmers, doctors, nurses, and the ongoing telemedicine initiative, additional funding was crucial. In discussions with our NGO partners, many shared the challenges of securing funding in the West Africa region. We remain committed to fundraising and will resume activities once the necessary funds are secured.
Partnership Opportunities
HTWB seeks financial resources to improve health equity in the Cameroon/Sahel region, which is experiencing one of the world’s most severe humanitarian and protection crises. Project VITAL is the only regional initiative focusing on telehealth and growing local engineers, designers, and training healthcare providers on providing remote and electronic health services.
To support staff, HTWB seeks financial resources to ensure the provision of year-round staffing to support its telehealth clinics. Its priority is to ensure access to the critical needs of patients in Cameroon/Sahel who are afflicted by forced displacement due to conflict and climate.
Lastly, HTWB seeks to expand connections with other implementing partners and stakeholders in the region, especially local governments, WHO, USAID, Minister of Health and Finance offices, other NGOs, and foundations interested in the region. Whether focusing on medical care, human rights, nutrition, education, or migration advocacy, their work encompasses all sectors.,HTWB offers an organizing/convening body, human resources (organization of academic partners and experts including from Harvard, Stanford, Yale, Boston Medical Center) , media support, implementing partners, operational resources, remote education, remote consultation, advisory, medical direction oversight, quality assurance procedures, training, academic resources, and staffing remote experts.
Implementing partners on this commitment also offer additional resources and services. iDocta offers operational resources, developers, local physicians, pharmacists, clinicians, local outreach, and access to patients and areas. The Pasteur Institute of Bangui’s Pasteur Network has institutes in 25 countries (7 in Africa) and offers implementation and expansion into other countries (Niger, Senegal, Guinea) . Reach Out Cameroon brings expertise in implementing humanitarian interventions in conflict-affected regions of Cameroon, as well as humanitarian access and negotiation. VSee offers a Telehealth platform, EMR build, tech support, programmers to teach and support locals to build sustainable telehealth platform/EMR and provides server costs/time. MD PnP offers end-to-end digital health data integrity, bandwidth, and cybersecurity.