Rwanda’s healthcare system is undergoing major changes, with technology at the fore of ensuring resilient systems and a healthy population
How is Rwanda using digital technologies to improve the well-being of its citizens and the resilience of its health systems?
Rwanda’s ambition to be a proof-of-concept innovation hub lies in its track record of nurturing and attracting investors and innovators to develop, test and launch digital solutions locally before they can be replicated in other countries. Two clear examples of this are Zipline, the first company to use autonomous drones to deliver critical medical supplies, and BioNTech, which is building its first modular mRNA vaccine manufacturing facility to promote sustainable vaccine production and end-to-end vaccine supply in Africa.
Rwanda has prioritised digital technologies as key enablers for various industries particularly driving positive health outcomes. Our Healthcare Digital Transformation Strategy and the e-Health Enterprise Framework have been major guiding strategies for realising an inclusive and integrated digital transformation of the health sector. The World Health Organization describes Rwanda as among the few countries in Africa that are efficiently using information and communications technologies and have a high likelihood of reaching the Sustainable Development Goals on health thanks to specific in-country interventions.
Integrating digital technology with our national health insurance scheme has been a priority. Using technology, the government has improved the efficiency of claim submissions, processing and payments. Citizens can manage their health insurance through a centralised digital platform, eliminating challenges related to multiple information channels.
Rwanda has extensively adopted electronic medical records across its healthcare facilities. EMR systems hold detailed patient records and are directly accessible to clinicians in their consultation rooms. EMR systems in health facilities have streamlined access to information and reduced the number of lost records and clinician-reported errors.
Rwanda has also embraced mHealth initiatives such as RapidSMS, leveraging mobile phone technology to expand citizens’ ubiquitous access to healthcare services and information. Through mobile apps and SMS services, individuals can now access vital health-related information, such as case alerts, prevention measures, treatment options and appointment reminders, improving health awareness and citizen adherence to healthcare and sanitation practices.
And Rwanda has embraced telemedicine and e-consultation platforms to provide remote healthcare services, particularly in rural areas with limited access to healthcare facilities. Citizens can get access to healthcare professionals digitally, reducing the burden associated with cumbersome trips to see them in person where unnecessary.
Rwanda’s robust health information system includes the Integrated Health Management Information System, the Health Resource Tracking Tool and the District System Strengthening Tool. These allow for securely exchanging clinical data about patients and their care and are integrated with health insurance companies to enable automated billing and claims management related to diagnoses, treatments and medications. The aim is to allow for seamless and secure data exchange among many heterogeneous systems. This enables real-time monitoring and analysis of health trends and enables effective decision-making and resource allocation for preventive and responsive healthcare interventions.
Digital technologies are informing the country’s emergency response and surveillance. Rwanda has deployed tools for citizen reporting on health emergencies and response. Systems such as the Global Pathogen Analysis Services are used to monitor and respond to infectious disease outbreaks, strengthening the overall resilience of the health system and improving emergency preparedness.
Rwanda has also implemented e-Pharmacy platforms to streamline the medication supply chain. This digital integration ensures efficient procurement, distribution and inventory management. It prevents resource shortages and ensures the availability of essential medicines to citizens.
How is this leadership inspiring more – within Africa and beyond?
The healthcare challenges Rwanda grapples with are not unique. Across the continent, challenges of accessible, affordable and patient-centric health care persist. Our government has chosen to ensure that healthcare services, through universal health coverage, are a basic right for every citizen. Most governments want the same for their citizens, and learning from Rwanda’s success story makes it possible.
Through different platforms, we have been able to unlock the appetite and capacity for close collaboration and knowledge sharing with other African countries on advancing health care through technology. This work has been also highly facilitated by the efforts of regional centres and international organisations with mandates that include accelerating using digital technologies to improve health care and strengthen health systems across the African continent. There are many examples, such as Smart Africa, the Africa Centres for Disease Control and Prevention, and the East African Community.
Successful innovations and developments in Rwanda are scaling to other African countries and thus improving health outcomes for an even larger number of communities. Zipline began commercial operations in Rwanda and now has scaled its operations to Kenya, Ghana, Nigeria, Cote d’Ivoire and other countries outside of Africa; BioNTech has committed to build similar mRNA vaccine facilities in Senegal and South Africa.
With the Covid-19 pandemic, African countries have realised the need for close collaboration for health emergency responses. There are clear gaps in our ability to mount responses to health crises with no support from advanced economies. Epidemics and pandemics do not recognise national borders, particularly in a highly interconnected modern world. This reality has increased the desire in Africa and around the world for greater international collaboration and investment in national health systems. The shortages in protective equipment, vaccines, diagnostics and therapeutics experienced in Africa were linked to limited local manufacturing, but have resulted in prioritising conversations on how African countries can work together to ensure our health systems are resilient.
What results have been achieved, and what tasks await?
For Africa, our journey from fragmentation to integration has made significant headway.
Regional integration has been a major driver of cross-collaboration and coordination among African countries in health care. Organisations such as the Africa CDC, the East African Community and Smart Africa are leading the charge to develop frameworks and programmes to advance digital health in Africa, with a strong focus on developing capabilities for pandemic prevention, health analytics, portability, interoperability and the governance of health information systems.
Africa has the benefit of not having legacy systems. This unlocks opportunities for governments to take advantage of advancements in technology and create agile, responsive policy and regulatory environments that enable Africa to leapfrog in healthtech solutions.
Nonetheless, challenges still lie ahead. Maintaining and strengthening the appetite for collaboration on health among countries is crucial, as the immediacy of the pandemic fades and other pressures build. Socio-economic disparities and exclusion as pertains to access to technology also remain. Africa has the largest gaps in mobile internet coverage and usage, restricting the ability of many to fully benefit from digital/virtual health systems and services, and necessitating costly investments in infrastructure and access expansion. Finally, significant efforts are needed to develop and harmonise comprehensive legal frameworks to address cross-border issues, encourage fair practices, safeguard privacy and security, and regulate the use of emerging technologies such as blockchain and artificial intelligence in health care.