Implementation of a Telemedicine Network in Angola: Challenges and Opportunities
Background: The Angolan Ministry of Health is prioritizing the strengthening of the national health system at the district level. To attain this objective, the Angolan Ministry of Health decided to develop a national telemedicine network in partnership with the Geneva University Hospitals (HUG) and the Portuguese Institute of Hygiene and Tropical Medicine (IHMT). Methods: Telemedicine units were created in strategic locations to enable distance education and tele-expertise activities, using software developed by HUG adapted to local conditions. Selected participants in each site were trained with regards to the use of the tools. A survey using questionnaires distributed to all participants was conducted to evaluate user satisfaction and the impact of the tools. Data were analysed using a descriptive statistical model. Additionally, two working groups were held to discuss difficulties and find appropriate solutions. Results: Seven telemedicine units were established, and 107 health professionals were trained. Regarding distance education activities, over 70 courses were designed and webcast, and 95.6% of participants answered our survey showing a high level of overall satisfaction. Uptake of tele-expertise activities was poor. Only 3 cases were discussed, and 4.7% of participants answered the survey. This was explained by low levels of computer literacy and motivation among the participants. The lack of a legislative framework and internet access in some places also played a role. Financial constraints halted the process of extension of the network to additional sites. Conclusion: More research is needed to assess the impact of the network, to understand how to scale-up to other sites, and to conduct a cost-benefit analysis to justify the pursuit of the investments.
Telemedicine; eHealth; low- and middle-income countries; Africa; telemedicine network