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  • South Africa Innovates Healthcare with Prepay Phone Vouchers

    South Africa Innovates Healthcare with Prepay Phone Vouchers

    By David South, Development Challenges, South-South Solutions

    SOUTH-SOUTH CASE STUDY

    Pioneers in Africa are experimenting with new ways to fund the delivery of healthcare that is affordable and sustainable and not dependent on foreign aid and donations. A South African company is prototyping the selling of pre-payment healthcare services through mobile phones with a range of vouchers that can be bought and downloaded at the tap of a keypad. They are priced at between US $12 and US $49 and cover medical and dental check-ups, tests, treatments, chronic care and medicines. They are flexible and can also be sent to friends and family who need help.

    In South Africa, poverty is still widespread. The majority black population has a median income of US $2,000 a year (New Internationalist) and many still live in crowded townships and poor rural communities. Poverty has also increased for many white Afrikaner South Africans (http://en.wikipedia.org/wiki/Afrikaner). A study by the Standard Bank of South Africa found the number of whites earning less than US $80 a month grew from 2000 to 2004 by more than 50 per cent. In the government capital of Pretoria, 50 Afrikaner squatter camps have emerged in recent years. For many, affordable healthcare is a critical issue.

    The story of healthcare in Africa is not a linear one of constant progress. The continent as whole achieved its lowest child mortality rates in the 1970s. But after that, the quality of healthcare declined as a result of various factors including economic crises and the HIV/AIDS crisis – both of which overwhelmed public systems. In sub-Saharan Africa, health systems reached rock bottom in the late 1990s.

    “Few people could afford annual check-ups, medicines or user fees at hospitals,” wrote Dr. Ebrahim Malick Samba in the paper “African health care systems: what went wrong?” for News Medical (www.news-medical.net). “One result was the resurgence of infectious diseases such as malaria, tuberculosis and cholera.

    “Prior to the 1980s, the district hospitals, community health centres and other outreach health posts provided medical services and essential drugs free of charge. With reforms, user fees and cost recovery were introduced, and the sale of drugs was liberalized.

    “Many governments discontinued budget support to the health sector which paralysed the public health system. There was no money for medical equipment and maintenance; salaries and working conditions declined.”

    Things have been steadily improving from this low base through the 2000s, the result of increased aid funding for public health systems and greater national investments in staff, facilities and equipment. There is still a long way to go, but Africa is becoming a world leader in developing and deploying mobile phone applications for health and healthcare.

    Despite dramatic improvements to the quality of hospitals and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

    Research has shown it is better and fairer to develop pre-payment mechanisms for healthcare than to just hit patients with fees when they are ill. With pre-payment, a person can buy care services when they are financially able to and bank up care for when they become ill and not able to work and save.

    This is a crucial issue for people with low incomes who can quickly be devastated by their illness or that of loved one or family member.

    The World Health Organization (WHO) has taken a firm stand against so-called out-of-pocket payments and encourages the growth in pre-payment methods. The World Health Report 2000 found that “Fairness of financial risk protection requires the highest possible degree of separation between contributions and utilization.”

    South Africa’s Yarona Care (www.yaronacare.co.za/prepaid.html) – a health insurance provider network – is rolling out prepaid mobile phone vouchers, allowing patients to see doctors or dentists and even traditional healers for treatment. When a patient visits, the healthcare worker redeems the mobile phone voucher to get paid. One product, Impilo Go, allows people to pay for one visit to a doctor and seven days of medicine for R230 (US $34). For people on a tighter budget, there is Impilo Care for R80 (US$12). A patient can visit a nurse practitioner for a medical check-up and receive tests.

    Impilo One offers medicines alone for R100, while Impilo Plus for R195 (US $29) is aimed at people with chronic conditions. They can get a prescription from the doctor and then go to a pharmacy participating in the scheme to receive medicines.

    Dental work is also covered by the vouchers.

    An online demonstration shows how the mobile phone process works (www.yaronacare.co.za/cellphonedemo.html).

    The service is marketed at a mix of customers, from individuals to corporate clients looking to cover large numbers of people to government and NGOs. They can purchase services by voucher, payroll schemes or mobile phones.

    Prepaid by mobile phone as a concept is already well established across Africa. It is a simple way to make payments and sell services. In the case of Yarona’s offering, the customer or patient uses their mobile phone to dial a code to pay for a service. When at the doctor or dentist’s office, he or she spends the voucher for the service by giving a unique code to the healthcare professional. Once this is done, Yarona Care pays the healthcare provider for the service.

    The voucher approach allows customers to buy health services for family members for a defined period of time. Vouchers can also be sent to family members for emergencies.

    Published: April 2011

    Resources

    1) South Africa’s Afridoctor mobile phone application claims to be Africa’s first personal mobile health clinic. It lets patients use its “SnapDiagnosis” system to submit photos of their ailments and in turn receive advice from a panel of medical professionals, or use the mapping feature to find doctors, clinics and health industry-related services nearby. Website: http://twitter.com/afridoctor

    2) Ghana’s mPedigree uses cell phones to build networks to tackle and identify counterfeit drugs. Website: http://mpedigree.net

    Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

    Creative Commons License

    This work is licensed under a
    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2023

  • Safe Healthcare is Good Business and Good Health

    Safe Healthcare is Good Business and Good Health

    By David South, Development Challenges, South-South Solutions

    SOUTH-SOUTH CASE STUDY

    Many people have been shocked by recent stories about the proliferation of counterfeit drugs and the rate at which they are killing and harming people in Nigeria. The International Narcotics Control Board found that up to 50 percent of medicines in developing countries are counterfeit. This has driven home the point that without the presence of legitimate players in the African drug market, the illegal sharks will step in to make large profits – and a literal killing.

    To counter this negative trend, what is most needed is support for reliable Africa-based companies: businesses that are long-term, sustainable and not living from one grant to the next. But as experience has shown around the world, nurturing businesses requires certain fundamentals: they must work to be profitable, they must find a market and exploit it, and they need cash infusions that are timed to the company’s growth, not to the cycle of international donors. This role, often served in developed countries by venture capitalists, who want a fast return of 35 percent – is too onerous a burden for most African businesses. What African companies need is a more conservative, long-term approach; one that expects returns of between five and 10 percent.

    Kenyan company Advanced Bio-Extracts (ABE) is one good example. Only 18 months old and based in Nairobi, the company produces one of a new generation of low-cost anti-malarials known as artemisinin-based combination therapies (ACTs). The drug is produced from the green leafy plant Artemisia, or sweet wormwood. The company is the first in Africa to make this drug, and employs 7,000 local farmers in Kenya, Tanzania and Uganda, as well as scientists.

    ABE has received two infusions of cash from non-profit social venture capitalists Acumen, as well as investment from Swiss drug giant Novartis. Acumen has so far invested US $9.6 million in 11 active investments focused on a diverse set of health challenges, including basic healthcare access in rural areas and treatment for malaria and HIV/AIDS.

    “We are commercializing a product that had never been commercialized,” said ABE’s owner, Doug Henfrey, to the New York Times. “Those little windows of support make these things happen. We could not have done it otherwise.”

    Acumen’s Kenya country director, Nthenya Mule, said “there are positive things happening in Africa, but they are not happening overnight, and some are happening quietly. ABE is exemplary. You will not see it as front-page news, but in 18 months they set up a factory with 160 people interfacing with 7,000 farmers and supplying one of the major pharma companies in the world.”

    Stimulating private sector solutions to African healthcare problems is receiving an additional boost from a new fund established by the World Bank’s private sector arm, the International Finance Corporation. To be launched later in 2007, it will offer cash and loans totaling US $500 million to commercial healthcare projects in Africa. According to its own statistics, 60 percent of health expenditure in sub-Saharan Africa is privately funded, and the market, excluding South Africa, is worth US $19 billion.

    Published: May 2007

    Resources

    • Roll Back Malaria Partnership: Launched in 1998 by the World Health Organization. UNICEF, UNDP and the World Bank to coordinate the global campaign, to fight malaria.
    • Malaria Atlas Project (MAP): An online map showing up-to-date information on high-risk areas for malaria.
    • A paper on the global threat of counterfeit drugs: Click here

    Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

    Creative Commons License

    This work is licensed under a
    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2023

  • Mapping to Protect Kenya’s Environment: the eMazingira Solution

    Mapping to Protect Kenya’s Environment: the eMazingira Solution

    By David South, Development Challenges, South-South Solutions

    SOUTH-SOUTH CASE STUDY

    Powerful new grassroots crowd-mapping tools have sprung up in the past few years across the global South, from Brazil’s Wikicrimes (www.wikicrimes.org) real-time crime mapping technology to the now famous Ushahidi (http://ushahidi.com) – a non-profit company making the free and open source Ushahidi software for information collection, visualization and interactive mapping – from its base in Kenya. They share some common features. All draw on the widespread use of mobile phones in the global South combined with growing access to the Internet, either through 3G mobile phone services, WiFi wireless connections, Internet centres or increasingly available broadband Internet services.

    They then connect the mobile phones to the new mapping services available either on the phones or on the Internet. One example is Google Maps (http://maps.google.com).

    These mapping services are revolutionary in what they bring to poor communities. They allow people to quantify in real time what is happening in their area, as well as see what is happening around the world. Where in the past this sort of mapping and statistical data collection was chiefly the domain of government departments and private services for wealthy corporations, individuals can now participate in the collection of data and map what is happening in their area. This can include mapping actual crime as it occurs, or slum-mapping, where a visual snap-shot of a slum area is made to better target aid and development.

    This is a game-changer for human and sustainable development. It has the potential to close the gap between the collection and analysis of data and action. Accurate, real-time data makes it easier to push government agencies to deliver on their promises, especially during a crisis.

    Kenya’s eMazingira website (www.emazingira.org) is showing the difference these tools can make. It allows people to identify potentially destructive practices that harm the environment – unregulated forestry, pollution, dangerous animals, land degradation, climate change – and alert others to what is happening. This level of awareness, it is hoped, will in time reduce the destruction of local environments and improve the quality of life for both humans and wildlife.

    Mazingira means “environment” in Swahili. The website’s motto is “Keeping the environment clean for the future generation”.

    The eMazingira website is a visually simple affair with a leafy banner image and an interactive map showing what is happening. It is in its first iteration and future upgrades are on the way. A rolling list of incidents keeps readers briefed on what is happening, from “Fire burning” to “Sewer burst” to “Rogue elephant”. There are five main categories to choose from and users can file reports by text message, email, sending a Tweet (www.twitter.com) or filling in an online form on the website.

    “We got to know about Ushahidi during its first deployment which was in Kenya, when it was used to map post-election violence incidents in early 2008,” explains Dunston Machoka, director of BTI Millman Limited (www.btimillman.com) inNairobi,Kenya, a custom software development firm leading the project.

    “We were inspired to develop eMazingira, on one hand, because of the passion we had for environmental conservation and on the other hand, from the success stories we had observed of Ushahidi deployments inKenya,HaitiandJapan.”

    Machoka believes this is a critical time forKenya’s environment: “eMazingira comes at a time when environmental conservation is a huge concern inKenya. Our key observation was that there was no effective reporting mode for environmental incidents for citizens.”

    The website hopes to better engage citizens in tackling the country’s environmental problems and sees this as a way to spur further government action.

    One of eMazingira’s proudest moments came when it won the World Summit Youth Award as the 2011 Runner Up for the use of ICT towards attaining the United Nations Millennium Development Goals.

    But how easy is it to work with this technology? Machoka advises those starting out to turn to the Ushahidi team for support.

    “I would advise them to get in touch with the Ushahidi team through their website and by doing so the deployment will be easy, fast and there will be adequate assistance in case of any challenges,” he said.

    For the next two years, eMazingira will be focusing on rolling out the service to the country, from the main towns to rural areas.

    “At the end of the period we hope to start similar programmes in East Africa based on the lessons learnt inKenya,” confirms Machoka.

    And that isn’t where the eMazingira story will stop: its creators also want to deploy the technology globally, if countries have the right conditions.

    “The key necessity for the application would be good mobile and Internet infrastructure and government that can promote citizen participation in environmental conservation,” Machoka said.

    Published: December 2011

    Resources

    1) With less than five years until the 2015 deadline to meet the Millennium Development Goals, any tool that can make development decisions more precise is a benefit. Website:http://www.undp.org/mdg

    2) The Map Kibera project uses an open-source software programme, OpenStreetMap, to allow users to edit and add information as it is gathered. This information is then free to use by anybody wanting to grasp what is actually happening in Kibera: residents, NGOs, private companies and government officials. Website:http://www.openstreetmap.org

    3) NGO called Rede Jovem is deploying youths armed with GPS (global positioning system)-equipped (http://en.wikipedia.org/wiki/Global_Positioning_System) mobile phones to map the favelas of Rio de Janerio. Website: http://www.redejovem.org.br

    4) Mobile Active.org: MobileActive.org is a community of people and organizations using mobile phones for social impact. They are committed to increasing the effectiveness of NGOs around the world who recognize that the over 4 billion mobile phones provide unprecedented opportunities for organizing, communications, and service and information delivery. Website: http://www.mobileactive.org

    https://davidsouthconsulting.org/2020/12/04/big-data-can-transform-the-global-souths-growing-cities/

    https://davidsouthconsulting.org/2020/12/11/cyber-cities-an-oasis-of-prosperity-in-the-south/

    https://davidsouthconsulting.org/2020/12/04/data-surge-across-global-south-promises-to-re-shape-the-internet/

    https://davidsouthconsulting.org/2022/02/17/digital-mapping-to-put-slums-on-the-map/

    https://davidsouthconsulting.org/2022/10/25/indian-city-slum-areas-become-newly-desirable-places-to-live/

    https://davidsouthconsulting.org/2021/03/04/indian-id-project-is-foundation-for-future-economic-progress/

    https://davidsouthconsulting.org/2022/10/31/mapping-beirut-brings-city-to-light/

    https://davidsouthconsulting.org/2021/03/31/new-weapon-against-crime-in-the-south/

    Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

    https://davidsouthconsulting.org/2021/03/05/southern-innovator-issue-1/

    Creative Commons License

    This work is licensed under a
    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2022

  • East Africa to get its First Dedicated Technology City

    East Africa to get its First Dedicated Technology City

    By David South, Development Challenges, South-South Solutions

    SOUTH-SOUTH CASE STUDY

    An ambitious scheme is underway to create a vast technology city on the outskirts of Nairobi, Kenya.

    With information technology proliferating across Africa after decades of stagnation and underinvestment, a host of exciting new technologies have had to exist within structures not built for the 21st century.

    One attempt to change things is Konza Technology City (konzacity.co.ke), an ambitious project that aims to build the infrastructure to host the companies of the 21st century for Kenya and East Africa. Konza Technology City joins a growing network of technology cities and parks across the global South. If the links between these centres of technological innovation and smart thinking can be strengthened, they have the potential to contribute to exceptional gains in human development.

    Konza Technology City will be built on 5,000 acres (2,023 hectares) of land 60 kilometres south of Kenya’s capital, Nairobi.

    The lead agency on the US $10 billion project is the Ministry of Information and Communication (http://www.information.go.ke/). The Kenyan government is seeking partners and investors to help with funding the project, whose components include a business process outsourcing (BPO) (http://en.wikipedia.org/wiki/Business_process_outsourcing) zone – where specific business functions are contracted to third party providers. There is also a financial district and a commercial district with office space.

    This will be combined with the other side of Konza: hotels, hospitals, a sports stadium and other support services necessary to support a city. The idea is to develop the site over a period of 20 years, with the BPO and IT Educational and Science Park taking up 23 per cent of the site.

    Kenya plans to expand its business process outsourcing sector and has been hosting conferences in Europe to gather the best advice. The sector has experienced double-digit growth in the past three years, rising on the increasing capacity brought by new undersea cables like TEAMs, Seacom and EASSy.

    The idea is to put in place the building blocks of a 21st century Kenya and to become the leading hub for the whole of East Africa. Kenya has an ambitious plan to become a middle-income country by 2030 (http://www.vision2030.go.ke/).

    There is scepticism about large projects in Kenya, with some fearing they will be abandoned before they are finished. But it does seem this project has galvanized a wide community of support. According to IT Web’s (http://www.itweb.co.za/) Ken Macharia, opponents of the project make various arguments. People in the information and communication technologies sector would like to see greater local capacity in place before such massive investment in buildings goes ahead. Others oppose the idea of having a planned city and would like to see things evolve organically. Still others question the government’s capacity to undertake such an ambitious scheme.

    According to Macharia, the ‘if you build it, they will come’ argument is winning the day. The scope and ambition of the project has both excited many players within and outside government and focused their efforts.

    Macharia even believes the public sector is way ahead of the private sector.

    “The government is light years ahead in terms of the vision and drive of developing the ICT sector in the country, while the private sector is trying to catch up,” he said.

    Kenya will become the first country in the region to build a technology city. It can look to China for some examples. One is Shenzhen City and its Science and Technology Park (http://www.ship.gov.cn/en/index.asp?bianhao=20). Or Cairo, Egypt’s Smart Village (http://www.smart-villages.com/).

    Macharia also says the focus solely on technology is missing the bigger impact Konza can have.

    “The city’s concept has financial, educational, commercial and industrial implications, which have not been sold as aggressively as the tech aspect has. Perhaps the better name for the proposed city would be Konza Special Economic Zone, where the key pillars mutually benefit from each other’s presence. Technology, after all, is a means to an end, not the end itself.”

    The timing for a place like Konza City is excellent: undersea cables are being placed around and to Africa. The continent was notorious for being the most underserved continent on the planet and is in a furious transition from this information technology wasteland to a potential oasis of prosperity.

    The undersea cable projects are promising a bandwidth explosion for the continent of Africa. The WACS cable (http://wacscable.com/index.jsp) is being put in place to link South Africa and Britain, and is due to be completed in 2012. It runs up the West Coast of Africa and will become the first direct connection to the undersea cable network for Namibia, the Congo and Togo.

    It will increase South Africa’s bandwidth by an estimated 23 per cent.

    Various technology investors, including the search engine giant Google, are also planning to build an undersea cable linking the so-called BRICS countries by 2014 – Brazil, Russia, India, China and South Africa. The cable will also link them all to the United States. The technology group i3 Africa is leading the project (http://www.i3-mea.com/africa/), which should open up 21 additional African countries to the world’s undersea cable network.

    Konza Technology City could make Kenya a significant beneficiary of all this new connectivity and bandwidth.

    Published: July 2012

    Resources

    1) Center for Innovation Testing and Evaluation: CITE will represent a 20th century American city with a population of approximately 35,000 people and be built on roughly 15 square miles. CITE’s test city will be unpopulated. CITE will be a catalyst for the acceleration of research into applied, market-ready products by providing “end to end” testing and evaluation of emerging technologies and innovations from the world’s public laboratories, universities and the private sector. Website: http://www.cite-city.com/index.php

    2) Dubai Internet City: Since its official opening in 2000, Dubai Internet City (DIC) has grown to become the Middle East and North Africa’s largest Information and Communication Technology (ICT) Business Park, hosting both global and regional companies. Website: http://www.dubaiinternetcity.com/

    3) Songdo International Business District (IBD) officially opened on August 7, 2009 as a designated Free Economic Zone and the first new sustainable city in the world designed to be an international business district. With its strategic location just 15 minutes driving time from Incheon International Airport and 3 ½ hours flying time to 1/3 of the world’s population and regional markets such as China, Russia and Japan, Songdo IBD will position South Korea as the commercial epicenter of Northeast Asia. Website: http://www.songdo.com/

    4) Nasrec Smart City: South Africa’s own ‘smart city’ is in development. Website: http://www.businessday.co.za/articles/Content.aspx?id=168466

    Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

    Creative Commons License

    This work is licensed under a
    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2023