Is Kenya Ready for Telemedicine?

The COVID-19 pandemic accelerated the adoption of telemedicine across the globe, and Kenya was no exception. With physical distancing rules in place to curb the spread of the virus, telemedicine became a critical tool for providing healthcare services to Kenyans. The country’s response included swift measures by the Kenya Medical Practitioners and Dentists Council (KMPDC) to enable health facilities to offer virtual medical services. However, despite the progress made, the question remains: is Kenya truly ready for telemedicine?

The Rise of Telemedicine in Kenya

In March 2020, when the first case of COVID-19 was reported in Kenya, many people avoided visiting healthcare facilities for fear of contracting the virus. In response, the KMPDC issued provisional approvals to various health institutions, allowing them to offer virtual consultations. To date, over 20 health facilities have received approvals, with many more seeking to join the list. This shift was not merely a stopgap measure but a deliberate step towards increasing access to healthcare in line with the Universal Health Coverage agenda.

Kenya’s initial foray into telemedicine revealed both opportunities and challenges. The use of mobile devices, which are widespread in the country, provided a platform for virtual consultations and other remote health services. As of 2019, there were over 816 million mobile phone connections in Africa, with projections suggesting that number will reach 1.05 billion by 2025. This penetration of mobile technology made telemedicine not only feasible but also essential for increasing healthcare access in underserved areas.

Furthermore, the Daktari Smart program launched in November 2021 by Gertrude’s Hospital Foundation exemplifies the potential of telemedicine. Through a combination of telehealth tools and training for health workers, the program aims to improve access to specialist care in remote counties like Samburu and Baringo.

Regulatory Readiness and the Road Ahead

Kenya’s regulatory framework for telemedicine is still evolving. Although the country lacks specific telemedicine laws, KMPDC established e-Health guidelines in 2019. These guidelines are currently undergoing review to align with emerging technologies, including AI and online-based medical education. However, the absence of comprehensive regulations has left gaps, especially concerning data protection and liability in the event of malpractice.

The draft e-Health regulations prohibit hosting telemedicine platforms outside Kenya, a rule intended to safeguard patient data. Yet, the vast nature of the internet poses significant challenges for enforcing these regulations. Regulatory oversight is essential, but it must be balanced with efforts to create a conducive environment for innovation in the healthcare sector.

The Challenges

For telemedicine to be sustainable in Kenya, several barriers must be overcome:

1. Inadequate Infrastructure: Despite a high number of mobile connections, internet quality remains inconsistent, particularly in rural and underserved areas. High-speed internet, a requirement for certain telemedicine services like real-time video consultations, is still limited. Programs such as Daktari Smart, which can operate with low bandwidth, offer hope, but nationwide infrastructure improvements are necessary.
2. Cultural Resistance and Limited Awareness: Many Kenyans are still unfamiliar with telemedicine or are skeptical about consulting doctors online. This is particularly true among older populations who are less tech-savvy. There is also resistance among healthcare providers, with concerns about telemedicine undermining traditional patient-doctor interactions. Cultural shift and widespread awareness programs will be essential for overcoming these barriers.
3. High Initial Setup Costs: Establishing telemedicine platforms can be expensive for both public and private health facilities. Investment in equipment such as electronic stethoscopes, ultrasound devices, and reliable internet connections is a significant financial hurdle. Additionally, the cost of training healthcare workers to use new technologies further strains already limited budgets.
4. Legal and Regulatory Challenges: Kenya’s regulatory framework for telemedicine is still in its infancy. There are ongoing efforts to create more comprehensive guidelines that address issues such as liability, data security, reimbursement models, and ethical considerations. However, without a well-defined legal structure, both providers and patients may hesitate to fully embrace telemedicine, fearing potential legal repercussions.

Opportunities and the Way Forward

The potential of telemedicine in Kenya is vast, especially for addressing healthcare disparities. Kenya’s doctor-to-patient ratio is alarmingly low, with only one doctor for every 6,355 people, a figure that worsens in remote regions. Telemedicine can help bridge this gap by allowing doctors in urban areas to consult with patients in rural locations.

Training and Capacity Building: Continuous training for healthcare workers will be essential to successfully integrate telemedicine into routine practice. E-learning platforms offering online courses and workshops can help equip health workers with the skills needed for telemedicine.

Improving Internet Access: The government and private sector need to collaborate on improving internet infrastructure, especially in rural areas. Internet access should be considered a component of healthcare infrastructure to ensure equitable access to telemedicine services.

Incorporating Telemedicine into Insurance Packages: Including telemedicine in health insurance plans will promote its adoption. Insurance companies should cover virtual consultations just as they would in-person visits, providing a financial incentive for both providers and patients to use telemedicine.

Is Kenya Ready?

Kenya has made commendable progress towards telemedicine adoption, but readiness is not yet uniform. While infrastructure and regulatory frameworks are catching up, issues around accessibility, cultural acceptance, and legal structures remain. To harness the full potential of telemedicine, Kenya must invest in building robust internet infrastructure, enact comprehensive e-Health regulations, and work towards a cultural shift that embraces technology-driven healthcare.

The pandemic may have provided the push, but it is now up to stakeholders across the board—government, healthcare providers, and technology companies—to drive telemedicine forward, ensuring no Kenyan is left behind.

Telemedicine is not just a response to a global health crisis; it is the future of healthcare. The question is not whether Kenya is ready for telemedicine, but how quickly it can adapt to fully leverage this transformative technology.