May 30, 2017 -
Advances in biometric technology are on the horizon which could be critical to the delivery of health services to many Africans, an informational session dedicated to healthcare at last month’s ID4Africa 2017 in Windhoek, Namibia heard from a panel of experts.
Advances in fingerprinting which allow enrollment of children and even infants, biometrics capabilities in mobile devices, and open database systems are needed for a greater range of health services to be delivered to a greater number of people.
ID4Africa’s vision of legal identity for all in Africa as a driver for social and economic development takes in not just identity registration but service delivery as part of that development. Increasingly, that service delivery is being facilitated by biometrically established identity.
Sénégal began issuing biometric ID cards in 2016 for multiple uses, including in healthcare facilities and pharmacies. With a deal in place to supply the country of just over 15 million people with 10 million ID cards over five years, it plans to integrate the system and push it out to different services by 2018, says Mouhamed Mahi Sy, Coordonnateur, Cellule des services informatiques et du système d’information documentaire, Agence de la Couverture Maladie Universelle, Sénégal.
As in other countries, Sy says that closed identity solutions have been a problem for service delivery in Sénégal, but that the back-end systems currently being built are much more open, interoperable and capable of sharing data. Sy gives the information sharing within the financial system as a potentially instructive example for improving healthcare identity systems, and ultimately healthcare outcomes, through data sharing.
This could reduce the problem of incomplete information which Sy says continues to challenge Sénégal’s medical system, but better data capture technology is needed for children.
“It’s a real problem for us because we need to identify children from five years old. We are providing services for those children, and we have to be sure that those who benefit from our service are the correct ones,” Sy told Biometric Update.
The situation is similar in Kenya, but exacerbated by the difficulties of delivering HIV treatment to infants.
Advancements in HIV treatments make it possible for infants of infected mothers to avoid being infected themselves. This improves the length and quality of the individual’s life, and also saves the government from an enormous long-term cost burden, Paul Macharia, Data Manager, Ministry of Health, Kenya, told the gathering, as treatment for a hypothetical 50-year life span of a person with HIV far surpasses the cost of treating infants.
The increased availability of services through mobile devices, or enabled by them, is one key factor. Technology is another.
“There’s a need for people who are makers of technology to address this,” Macharia says. “They need to come up with technology that can potentially work for infants, because you can’t avoid it. Infants must be followed from 0-18 months to avert infection.”
Kenya is very interested in the potential of NEC’s high-definition fingerprint sensor, Macharia said. Dr. Anil Jain, a University Distinguished Professor of computer science and engineering at Michigan State University, announced at ID4Africa that tests with those sensors had shown that children as young as six months can currently be identified by their fingerprints with 99 percent accuracy.
Jacques Besançon, Product Manager, Security Components and Vertical Solutions, Arjo Systems, told the audience delivery of health services through biometrics-enabled smartphones in Africa has just begun, but has huge potential benefit.
Currently, mobile devices can be used in some places in Africa to find doctors and book appointments, to look up pharmacy locations and sign up for services, but more advanced services like remote consultation, remote health monitoring, and ePharmacy services, require biometric identity verification, according to Besançon, whether on smart cards or mobile phones. While new smartphones tend to be capable of supporting several biometrics, roughly 90 percent of mobile phones in Africa are currently not smartphones.
Another challenge for identifying people for healthcare purposes using the biometric capabilities of smartphones is the use of one device by multiple people, such as dependents, which may require an enrollment system flexible enough to switch the type of biometric it uses.
Dr. Ousmane Ly, Directeur Général, Agence Nationale de Télésanté et d’Informatique Médicale (ANTIM), Mali, spoke about the importance of portable data and open access to databases. The country uses the open source medical records management system OpenClinic to coordinate information between 1,370 healthcare centers, identifying patients using the biometrically-backed Système Numérique d’Information Sanitaire. The government is struggling, however, with the burden of too many identification systems with separations imposed by vendors or technology, and Ly said it that the Estonian model of scrapping everything and using a single, open database deserves consideration.
“We need to have open access to these databases, and we need the right to change our data as appropriate,” he told the audience.
Onesmus Kamau, Head, e-Health Development & Systems Strengthening, Policy Planning & Health Care Financing, Ministry of Health, Kenya, moderated an enthusiastic interaction between the audience and the panel of speakers. Audience members asked questions about de-duplicating large amounts of data from different databases, effective strategies for providing children with legal identity, and the money-saving potential of real-time mobile biometric data collection. In all three areas, gradual progress is being made.
“There has been a lot of discussion today, a lot of good debate,” Sy says, “but as of now there is no perfect answer.”
The panelists provided informative responses to each question, but many of those responses referred to answers coming now or imminently from technological advancements. The capabilities to enroll infant fingerprints, to architect databases for functionality and security, and to serve those far from urban centers and infrastructure is close. When they are gained by African governments, healthcare delivery on the continent could drastically improve for millions.