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How is Ghana looking at healthcare in a technological world?

Many, myself included, have often wondered about the huge health human resource gaps in sub-Saharan Africa and efforts being made to address these. In many of these conversations, reality has stared us in the face that with the best will in the world, these gaps will never be bridged in the next three decades even if training numbers were tripled.

For example, Ghana with a population of 30 million will need to train about 26,000 doctors to bring its ratio to 1 doctor to 1000 citizens – assuming none of the current pool of doctors was lost to attrition.  With our current training numbers, anyone who believes this is doable is living on the crest of a cloud.

With such information, it is easy to just resign one’s self to fate and accept that our health human resource will never be adequate in our lifetime. In recent times, however, I have come to believe that there are ways to bridging this gap in a manner that will enhance efficiency. In my view, the answer lays in harnessing the huge potential data and information technology afford us. As conversations around Artificial Intelligence (AI) have been of serious concern to many developed countries due to the potential job losses that may ensue, I have come to believe that Africa stands to benefit most if our leaders begin the process of creative thinking. Fact is, many of the jobs that may be lost never existed in our countries in the first place.

More importantly, an information-driven health system will afford professionals access to accurate up-to-date information over a wide scope that none of these; their brain, expertise or willpower allows them to retain over the entire span of their professional life.

To start with, considerable research indicates that many aspects of jobs doctors, pharmacists, nurses and other health professionals do today can and are being automated. Such actions are freeing them up to concentrate on other aspects of their vocations that require real human intervention. Also, thanks to health technology support systems, other health professionals are taking up roles that previously were the preserve of doctors. These developments afford us the option to improve the efficiency of our health professionals in ways that have never occurred to us and thus improve the quality of human-centered care citizens receive. It may even help decrease the amount of time patients spend in hospitals and thus reduce their risk to hospital-acquired infections.

More importantly, an information-driven health system will afford professionals access to accurate up-to-date information over a wide scope that none of these; their brain, expertise or willpower allows them to retain over the entire span of their professional life.

It will also enhance decision making and allow professionals to rely less on their mental capacity and more on networks to provide better healthcare to the citizenry. It will also ensure that the culture of personal knowledge retention that is pervasive in Ghana’s health sector and frowns on spreading intellect is addressed and curtailed.

Though I see this as a viable venture, I have considerable concerns that if steps are not taken this huge opportunity may pass us by. To start with, any such venture would require a wealth of health data accumulated over the years. Meaning, we may have to find a way of cataloguing much of our manual health records. Sadly, I see this as the biggest obstacle we may be confronted with.

I do because, not too long ago, I was having a conversation with a friend who indicated that he went to a hospital in one of the old public universities in Ghana in an attempt to retrieve his historic health records. To his amazement, he was informed that the information which was held manually had been disposed of. This is an indication that even in our institutions of higher learning where research value could have been placed on this information, no effort had been made to digitally archive the data. If this is reality then one wonders what would have happened to all the health data that has been accumulated since independence. Do we realise that in this information lie a huge number of data points that could aid in building a simple health decision support system? Does it not occur to us that this was a huge wealth of knowledge that had been needlessly lost?  If we do not, then someone please take notice.

We need to come to a consensus that like the steam engine and motor vehicle, AI is the new general-purpose technology that will transform humankind and decide whether we want to leverage it locally for the benefit of the next generation or we are content with our lot and will stay put.

Another obstacle is our general attitude to conversations around technology and the approach we must take as a nation. Often, we expect our government to be the main driver of these ventures. I am a strong believer that this should not be the case. It is my belief that the government should create the enabling environment for the private sector to leverage this space through policy direction and tax incentives. On the other hand, the private sector should not go into these ventures thinking their products and services should be contracted to the government alone. This opportunity cannot be another extension of our procurement gig driven democracy.

We need to come to a consensus that like the steam engine and motor vehicle, AI is the new general-purpose technology that will transform humankind and decide whether we want to leverage it locally for the benefit of the next generation or we are content with our lot and will stay put. Whatever we decide, truth is we cannot bury our heads in the sand and train health professionals for jobs that will be non-existent in a few decades if not less. To do that will not only be irresponsible but outright foolish. Our training regime should reflect our ambition and intentions to leverage technology. It should demonstrate our determination to leapfrog and become relevant as a country that is self-sufficient in the health space.

In their birds’ eye, these systems are way beyond the reach of Ghana. To those who live in this illusion, I advise them to read on the history of Luddites, British weavers and textile workers who objected to the increased use of automated looms and knitting frames. To them, this was a risk to their profession. Try as they did, they lacked the ability to stop technological innovation in its track and were swept away irrespective of how violently they opposed the change. I see the synergy between man and technology as the answer to our health human resources question and will advise policymakers to refrain from being Luddites; lest they get swept away and rendered irrelevant.

Our current health system is neither loving, compassionate or human. I will be blunt by saying, in some countries even animals have access to better healthcare provision than we do. This is the case because we have failed to invest in thinking and planning into health and are not wired to want to feel healthy. Rather, we have become accepting of our health records being used to wrap all sorts and sold to us for next to nothing without appreciating the cycle of waste we have become enablers of. In this era of deep learning, these behaviours are not only irresponsible but should be made outright criminal. We cannot continue down this path if we seriously intend to leverage technology.

When Alan Turing one of the pioneers of AI argued that, “he believes at the end of the century the use of words and general educated opinion will have altered so much that one will be able to speak of machines thinking without expecting to be contradicted; little did he know that in these words lay potential answers to the considerable health human resource disparity Africa has historically been saddled with. It is, therefore, our responsibility to give meaning to his opinion in a manner that will defy his own imagination. This is why I believe we should all invest in rewriting our health social contract.

By Kwame Sarpong Asiedu

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