The South African eHealth Strategy 2012-2016
In 2012, the National Department of Health (NDoH) launched a landmark strategy, the first eHealth Strategy for South Africa, with an accompanying roadmap to guide its implementation. Not only is this strategy aligned with the NDoH's strategic objectives in the Negotiated Service Delivery Agreement (NSDA), but with the priority areas of the NDoH's 10-point Plan. The roadmap includes key activities such as combating HIV/AIDS and TB; monitoring and evaluation systems for voluntary counseling and testing and the antiretroviral treatment rollout in South Africa; as well as to implement innovative technologies to support health workers reporting functions and educating the public.
The word “strategy” was originally used to describe the art of planning and directing high-level military operations and movements in a war or battle. The word “strategy” is now used in all spheres of life and is broadly accepted as a high-level plan that aims to achieve one or more goals within the context of given constraints and limited resources. Strategies often also include a roadmap which provides a framework of how and when the strategy will be implemented.
South Africa’s eHealth Strategy
A national eHealth strategy is a high-level plan for the development and implementation of information and communication technology (ICT) solutions that will address the goals and challenges of the country’s health system. The South African Department of Health (NDoH) published the country’s first eHealth Strategy in 2012 (NDoH, 2012). This strategy aligns itself closely with the strategic objectives of the Department of Health, specifically those objectives expressed in the Negotiated Service Delivery Agreement 2010-2014 (NSDA) (NDoH, 2011a), and the Department’s 10 Point Plan 2009–2014 (NDoH, 2011b).
In 2005, the World Health Organisation (WHO) broadly described eHealth as the electronic process through which health care and resources are transferred (WHO, 2005). Therefore, in the South African strategy eHealth is defined as a broad domain which includes eHealth, telemedicine, mHealth, Consumer Health Informatics and Health Knowledge Management. This covers the use of all ICTs that are used in the promotion, support and strengthening of healthcare. Emphasising its alignment with the NSDA, the strategy adopts the vision: “eHealth: enabling a long and healthy life for all South Africans” (NDoH, 2012, p1). The mission of the strategy is to establish eHealth as an integral part of the transformation and improvement of healthcare services in the country.
A key set of principles is adopted by the strategy and these include getting the basics right, taking an incremental approach, building on what already exists and looking for early wins.
The short and medium term priorities of the NDoH as expressed in the NSDA (NDoH, 2011a) are:
- Increasing life expectancy.
- Decreasing maternal and child mortality.
- Combating HIV and AIDS and decreasing the burden of disease from tuberculosis.
- Strengthening health system effectiveness.
The strategy explores pragmatic and innovative ways eHealth can be used to address needs in these four priority areas. The resulting list of specific interventions falls into three groups:
- Short-term objectives that involve building on what is already in place.
- Medium-term objectives that may involve significant implementation effort and expenditure.
- Medium to long-term objectives for which in-depth planning is needed.
In order to deliver on the strategy work needs to be done in ten priority areas. These areas are all linked to each other and cannot be addressed in isolation.
- Political, executive and clinical leadership and buy-in for the realisation of the strategy.
- Stakeholder engagement and collaboration with all groups affected by eHealth.
- Standards for data interoperability as well as for hardware and infrastructure.
- Governance and regulation to guide implementation of the strategy.
- Ensuring affordability and sustainability of eHealth projects.
- Benefits realisation activities which include change management.
- Building adequate human resource capacity to deliver on the strategy.
- Establishing eHealth foundations such as reliable connectivity and identification of patients.
- Obtaining the best eHealth applications and tools that will support healthcare delivery.
- Ongoing monitoring and evaluation of implementation of the eHealth strategy.
A roadmap for implementation
The strategy includes a relatively detailed roadmap where key eHealth activities are grouped according to these ten priority areas. This roadmap includes several planned activities which will support the NDoH priority to combat HIV and AIDS and decrease the burden of disease from TB.
In order to scale up HIV counseling and testing, development of a system for monitoring and evaluation of the HCT programme will be completed and implemented. In addition, a national system for monitoring antiretroviral treatment (ART) and TB treatment will be implemented nationally. This system, combined with appropriate interfaces with pharmacy and logistics support systems, can support the requirement to increase the number of patients on ART.
Treatment follow-up and adherence can be supported by enabling community health workers to send and receive patient data via mobile phones. In this way treatment will be integrated with support at a primary healthcare level.
To improve public health education on HIV/AIDS and TB for the community, an improved communications infrastructure can be used for educational information channels for the public in clinics, community areas and schools. Education can be done using videos, television, satellite broadcasting, mobile phones, podcasts, community radio and Internet web sites.
- National Department of Health (NDoH) (2011a). The Negotiated Service Delivery Agreement for Outcome 2: A long and Health Life for All South Africans. [Online]
- National Department of Health (NDoH) (2012). eHealth Strategy South Africa, 2012-2016. [Online]
- National Department of Health (NDoH) (2011b). Progress Report On The Implementation Of The 10 Point Plan Of The Health Sector 2009-2014. [Online]
- World Health Organisation (WHO) (2005). WHO World Health Assembly 2005 resolution on eHealth WHA 58.28. [Online]
Author: Dr Rosemary Foster, eHealth Research and Innovation Platform, MRC
Reviewed by: Hendra van Zyl (MPH)
Date: May 2013
Foster, R. (2013) The South African eHealth Strategy 2012-2016, AfroAIDSinfo. Issue 13 no. 5, Policy (Open access).
2 May, 2013