Digital health: the future of healthcare in Pakistan

Our efforts to grapple with the far-reaching impact of the Covid-19 pandemic has fortuitously opened up new avenues of healthcare delivery involving an increasing use of digital technology — an umbrella term that includes the use of mobile devices, health information technology, telehealth, and telemedicine.

At the start of the pandemic, the Society of Obstetricians and Gynecologists of Pakistan (SOGP), Aman Foundation, and the Population Council, with the support of the United Nations Population Fund (UNFPA), initiated telemedicine services by launching a helpline for women and men to consult qualified healthcare providers on a range of reproductive health issues. The helpline enabled callers from all over Pakistan, including some from remote locations, to seek free medical advice. With UNFPA support, the Population Council also tapped digital and social media to spread messages recorded by obstetricians and gynecologists in regional languages on how women could protect themselves during the pandemic and what pregnant women should do to deliver safely. During a time when there was a deluge of information, some accurate and some not, these messages played a critical role in providing credible information that people could act upon.

Telemedicine is now being used routinely by private and some public hospitals to provide home-based healthcare to Covid-19 patients, which reduces their in-patient load. This is a practice that could easily be scaled up to include other specialties as well.

The pandemic also brought to the fore the utility of the National Database and Registration Authority (NADRA), particularly for Covid vaccination. The NADRA database is helping to stratify the population by age; identify the nearest vaccination centres; issue codes to identify eligible citizens; calculate dates for second doses; and convey this information efficiently via mobile.

Strengthening NADRA’s current Civil Registration Management system by encouraging registration of vital events such as births, deaths, marriages, and annulments — either by making such registration mandatory or by incentivising it — would help in various health promotion activities. For instance, the database of registered births could be linked to calculate the immunisation schedule of every newborn and accordingly send text messages to parents informing them of vaccination due dates. Similarly, the birth database can be linked for scheduling post-natal care visits. This would help prevent missed doses. Similarly, after marriage registration, the NADRA database could be used to send family planning awareness messages to newly-couples. Subsequently healthcare providers could register family planning clients on a user-friendly digital platform by entering their CNIC, enabling clients to receive messages about when to return for replenishments and follow-up visits. By including cause of death for all registered deaths, the database could further help the estimation of maternal and infant mortality rates. Data on vital events would also help in preparing a real-time demographic profile of the population that would be useful in data-driven decision-making.

Under an ongoing research project, the Population Council has developed a mobile app that identifies beneficiaries of the Benazir Income Support Program (BISP) who may be eligible for family planning services. The app allows providers to store client data and counsel clients in selecting a method of their choice using a decision-making algorithm. The app also generates a voucher for reimbursing service provider fees and travel costs to the client.

The twin pressures of Pakistan’s growing population and limited infrastructure require that we embrace and scale-up innovative approaches to healthcare delivery, including digital health, for cost-effective healthcare solutions.

Published in The Express Tribune, April 21^st, 2021.

Like Opinion & Editorial on Facebook, follow @ETOpEd on Twitter to receive all updates on all our daily pieces.