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RAFT: Telemedicine in Africa

The RAFT-Network provides telemedicine in African Francophone countries. The main challenge adressed is the de-isolation of care professionals working in remote areas of developing countries. The core activity of RAFT is the webcasting of interactive courses targeted to physicians and other care professionals. Courses are webcast every week, freely available, followed by hunderds of professionals who can interact directly with the teacher.


Project/Initiative Outline:

First Name
Antoine
Last Name
Geissbuhler
Name of project or intiative RAFT: de-isolation of care professionals in developing countries
1st country of focus Mali
Additional countries of focus Sub-Saharan Africa and Latin America
Relevant to the conference theme Health information and technologies
Summary Continuing education of healthcare professionals and access to specialized advice are keys to improve the quality, efficiency and accessibility of health system. In developing countries, these activities are usually limited to capitals, and delocalized professionals do not have access to such opportunities, or even to didactic material adapted to their needs. This limits the interest of such professionals to remain active in the periphery, where they are most needed to implement effective strategies for prevention and first-line healthcare.

In order to address these needs, the Geneva University Hospitals have developed a telemedicine network in Africa (the RAFT, Réseau en Afrique Francophone pour la Télémédecine), first in Mali, then in Mauritania, Morocco, Cameroon, and, since 2004, in Burkina-Faso, Senegal, Tunisia, Ivory Coast, Madagascar, Niger, Burundi, Congo-Brazzaville, Algeria, Chad, Benin, Guinea and DRC.
The core activity of the RAFT is the webcasting of interactive courses targeted to physicians and other care professionals, the topics being proposed by the partners of the network. Courses are webcast every week, freely available, and followed by hundreds of professionals who can interact directly with the teacher. 70% of these courses are now produced and webcast by experts in Africa. A bandwidth of 30 kbits/second, the speed of an analog modem, is sufficient, and enables the participation from remote hospitals or even cybercafés.
Other activities of the RAFT network include medical tele-expertise, tele-ultrasonography, and collaborative development of educational on-line material.
The network is currently organized and run by more than 40 national coordinators throughout Africa, and by a coordination team based in Geneva. In each of the partner countries, the RAFT activities are supervised by the focal point, a medical authority (usually a university professor) that links the project to the national governmental bodies (ministry of health, ministry of education). A local medical coordinator (a junior physician) and a technical coordinator take care of the day-to-day operations, including communication with the care professionals, identification of training needs, technical training and support of the various sites within the country.
Key partnerships include the Université Numérique Francophone Mondiale (UNFM) and the World Health Organization (WHO). The RAFT is recognized as an official WHO collaborating center for eHealth and Telemedicine.
The current priority is the large-scale deployment of these telemedicine tools along with IT-enabled diagnostic devices such as portable echography, to the regional and district hospitals in Africa. These infrastructures could also be used to facilitate public health activities including the collection and communication of surveillance and healthcare indicators to the ministries. The usefulness of these tools to support isolated care professionals has been demonstrated, as well as the sustainability of the implementation in large hospitals who can integrate the recurring connection costs in their operational budgets. Given the high costs of satellite connections (about 500 USD per month), which are the only options in remote areas, it has been evaluated that sustainability can currently be achieved down to the district-level hospitals who usually serve populations of 50’000 to 200’000, and operate as the first level of reference for dispensaries and rural hospitals.
In parallel, the network is extending to other linguistic areas: educational sessions have been produced in English since October 2008, and are available to hospitals in English-speaking Africa and the Middle East. Since 2011, the project is being implemented in Latin America.
What challenges does your project address and why is it of importance? The main challenge addressed is the de-isolation of care professionals working in remote areas of developing countries. In most countries, remote areas are understaffed, with a suboptimal use of existing resources, while main cities retain most of the skilled professionals and have overcrowded care facilities.
How have you addressed these challenges? Do you see a solution? The RAFT network provides distance education and tele-expertise services to isolated care professionals, by establishing South-South collaborations between reference hospitals and regional/district hospitals.
How do you know whether you have made a difference? We have many anecdotes showing that these tools are effective both for professional and social de-isolation, and help maintain skilled and motivated professionals in remote areas, thus strengthening thelocal health systems.
Have you or the project mobilized others and if so, who, why and how? The RAFT network has many partnerships in order to provide quality contents and mutualize technical and organizational resources. These include WHO (HUG is a WHO collaborating center for eHealth and telemedicine), UNFM (Université Numérique Francophone Mondiale), AUF (Agence Universitaire de la Francophonie), UNESCO (University of Geneva has a UNESCO chair for distance education), Université Senghor...
When your donor funding runs out how will your idea continue to live? In most countries, the network is supported by the MoH or hospitals within two to three years of the initial deployment in that country.

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