Setting an example: Rwanda as a digital health success story
Rwanda is set to become the first country in the world to have a digital-first universal primary care service, due to a government collaboration with Babylon Health. Allie Nawrat explores the transformation this African country has been through to make it a good location for implementing digital health innovations to benefit of its citizens.
he past 25 years have seen Rwanda transition from its legacy of genocide and war into a largely peaceful nation with a steadily growing economy, particularly in the agricultural sector. According to the World Bank, poverty declined from 59% to 39% between 2001 and 2014 and Rwanda’s economic growth has built upon previous success to exceed 10% in 2019.
Central to Rwanda’s economic success is government-led national growth strategies. The first of these was Vision 2020, which was launched in 2000 and aimed for the country to become a middle-income country in two decades. This relies upon diversifying the economy beyond the agriculture sector and upskilling its population in other fields.
Although Rwanda still faces significant challenges in meeting its development goals, one of its major successes has been the healthcare sector. Rwanda is one of the few developing countries in the world to have universal health coverage; its community-based health insurance programme – known as Mutuelle de Santé – reaches more than 90% of the population.
Another area of focus for Rwanda is technology. As part of nationwide digitisation efforts, the government has invested in a broadband infrastructure that now covers 90% of the country and mobile phone penetration has exceeded 75% of the population. This is a particularly impressive feat since most of Rwanda’s 12.5 million people are spread out in rural areas with incredibly difficult topography.
The government also worked with Partners in Health to develop electronic health records (EHR) for HIV patients and services in 2005; this has now been extended to include all clinical records.
Facilitating Rwanda’s digital health revolution
Building on Rwanda’s strong foundations in healthcare and technology – and to advance progress towards the country’s long-term development goals – the government signed a ten-year collaboration with UK-headquartered remote consultations provider Babylon Health.
Together they will create the world’s first digital-first universal primary health care service, in which everyone over the age of 12 in Rwanda will have access to consultations with doctors or nurses through their mobile phones within minutes. The system will thereby reduce delays in accessing appointments or the need to travel for many hours to see a medical professional.
This expands upon Babylon’s previous work in Rwanda through its subsidiary brand Babyl. Since its launch in 2016, this service has gained two million registered users and delivered more than one million consultations. Babyl has been supported by the Bill and Melinda Gates Foundation in scaling up its offerings across this overwhelmingly rural country.
The consultations provided by the Babylon system will be conducted via text and voice cells as much as possible to ensure this system is genuinely accessible to all, irrespective of their internet connection or the multimedia capabilities of their phone. The service will be paid for through Rwanda’s renowned Mutuelle de Santé community-based insurance scheme.
Patients can also use text messages to digitally book laboratory tests – the results of which will then be shared electronically with both the patient and their doctors – as well as receive codes for prescriptions, so they can pick them up from convenient, local pharmacies.
However, this partnership does more than just provide remote, digital consultations. In addition, Babylon will help the government further expand its EHR capabilities, and has created hundreds of digital health jobs for local people, thereby supporting the country’s ambition of creating entrepreneurial, digitally trained citizens.
A bright, healthy future for Rwanda
Rwanda minister of health Dr Daniel Ngamije stated: “Increasing access to our doctors will help stop self-diagnosis and self-medication, which lead to longer-term complications.
“With the reduced burden on health centres and other medical institutions, our medical professionals will be able to spend more time and resources on the most serious medical cases, further increasing the quality of healthcare delivery across the country.”
“Digital healthcare is a significant step towards ensuring that all our members can conveniently access doctors without fear of loss of income or worry about travel to a medical institution, added Dr Solange Hakiba deputy director general of the Rwandan Social Security Board, which runs the Mutuell de Santé programme. “Early intervention with easier access to healthcare will also reduce the burden on our universal healthcare scheme.”
“We are so proud to be helping make Rwanda a world-leader in digital health, and so humbled that the Government of Rwanda chose Babylon to help its ambition to provide universal primary care to all its citizens,” noted Babylon CEO and founder Dr Ali Parsa. “Rwanda is showing the world how we can sustainably tackle the challenges in healthcare and make it accessible and affordable for all.”
Beyond Babylon: other digital health initiatives
Babylon is not the only company to see Rwanda’s digital health promise. One example is Silicon Valley-based Zipline, which established a partnership with the Rwandan Government at the same time that Babyl first launched in the country.
Zipline uses drones to deliver blood, vaccines and other essential medical products to hospitals, no matter how remote, reducing the time it takes to supply products for emergency situations from hours or days to just minutes. It also means hospitals do not have to worry about maintaining their own supply of refrigerated blood or other rarer products, such as frozen plasma, which often require expensive machinery small, local hospitals cannot afford.
As a result of the success of its Rwanda programme, Zipline has expanded its global health efforts to Tanzania, and is eyeing up launches in Latin America.
More recently, in the context of the ongoing Covid-19 pandemic, Rwanda has utilised its own digital health prowess in its response to the coronavirus.
The country’s Covid-19 emergency response project, which is being supported by $14.25m of funding from the World Bank, will explore multiple digital health innovations to support its management of the pandemic.
These include real-time digital mapping of the spread of the disease and telemedicine to reduce the need for suspected patients from having to attend doctors’ surgeries.
Rwanda’s proactive, solution-driven response to an escalating driven pandemic, which is likely to wreck the economies of even the most developed countries is a real testament to how far this country has come in the past 25 years. Rwanda really is now a model to other developing countries, of how technology can support socio-economic growth and stability, particularly to improve the health of its citizens.
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