The objective of this demonstration project is to support the extension of health services in Africa through the use of satellite based technology in complement of other forms of Information and Communication Technologies.
In order to achieve this general objective, three intermediate objectives have been defined as follows:
First Objective: Medical eContent via Satellite for African Health Workforce
Second Objective: Satellite-Based Clinical Services for Remote Areas
Third Objective: eHealth Management Information System Pilot
The main strength of the SAHEL initiative is that it includes the complete value chain of actors from medical staff and contacts on the ground, to medical experts in Africa and technical partners in charge of the satcom based interconnectivity services.
Figure 1: The 3 objectives of the SAHEL project.
Users and their needs
SAHEL end-users can be classified in three groups:
- Medical staff: doctors, nurses, mid-wives clinical officers, and community health workers at hospitals, medical centres and remote healthcare facilities that will use eLearning and eHealth services.
- Medical students at medical universities that will use eLearning services.
- NGOs staff and local population for which the Internet connection can be made available in less busy periods.
Additionally medical experts from reference centers of excellence can provide their advice and their training through the SAHEL platform.
The SAHEL satellite-based telemedicine solution addresses two essential needs of Africa's people: decentralized medical care and better communications.
Service/ system concept
The technical solution to be introduced includes three types of e-health services:
medical e-Learning: to provide continuous training for healthcare professionals in rural settings.
clinical e-Services: to link dispensaries and treatment centres to medical centres of excellence that can provide assistance for diagnostics and the treatment of patients.
computerised health management system: to manage patients' files and collect medical data to monitor epidemics (such as AIDS in Kenya and malaria in Senegal).
Telemedicine is a burning issue and many separate initiatives are taking place. However, none of these initiatives takes as much care as SAHEL does in accomplishing the real needs of the end-users while at the same time proposing a complete and integrated platform.
Space Added Value
Satellite communications can fill the gaps in terrestrial networks by providing access to remote areas. They can contribute to bridge the "digital divide" and support countries to further develop their health system by improving access, quality and efficiency with the deployment of a light infrastructure of global coverage. Therefore, telemedicine via satellite can ensure equal access to medical expertise and irrespective of the geographical location. To do so, satellite-based broadband (fixed & mobile) is the most suitable way to deliver a host of eHealth services to remote areas as it is fast, efficient, reliable and cost-effective.
The expected benefits from the SAHEL initiative is to provide end-users with sustainable telemedicine services of quality that enable to deliver improved healthcare attention to sub-Saharan population living in remote areas.
As a result from the piloting phase, the SAHEL telemedicine services will have been tested and improved to ensure the quality of the solution both at application and communication level. Besides the Cost Benefit Analysis performed as well as the Sustainability Analysis will have prepared the transition from the piloting phase to the operational and commercial phase.
Based on the specific user and service requirements expressed by the health stakeholders, a number of generic network architectures will be designed.
The SAHEL baseline network architecture will comprise five main components:
Interconnectivity segment: it will comprise the space segment allowing to provide broadband connectivity to the targeted areas. Fixed and mobile broadband access solutions will be considered (for instance Astra2Connect and Inmarsat BGAN).
eHealth applications segment: this segment includes all the necessary network elements allowing to provide medical eLearning and eHealth applications to the targeted areas.
User segment: the user segment includes the different connection models that will be used to access the SAHEL services. End users can access the network:
o through a dedicated satellite access point (fixed or mobile); o through an access point shared between several users (local network, wired and wireless).
Network management segment: the SAHEL system shall include the necessary tools allowing to remotely survey the correct operation of the system, to monitor the traffic being transported over the end-to-end network and to coordinate the resources and applications being used. The integration with existing available ground operators and the interconnectivity with existing health care services will be addressed.
Power supply solutions: Electrical power is a critical precondition for the operation of telecommunication networks particularly in Africa where no more than 2% of population living in rural areas have electricity. It is therefore a natural part of SAHEL project to select a power supply system to power the remote medical centres and distant learning centres of the pilot sites.
Figure 2: SAHEL generic solution.
The SAHEL overall design will follow a modular approach to provide Satcom interconnectivity to end users. Scalability factors and security features will be included at each layer of the end-to-end network architecture. The generic solution will be adapted to meet the specificities of each targeted pilot site.
The SAHEL project proposes an efficient cooperation between technologies (industries, operators), health stakeholders (health workers, nurses, specialists), centres of excellence providing medical content for eLearning and NGOs for a local implementation with the support of regional actors.
The project has accomplished the first phase of the program devoted to the gathering and analysis of the user needs regarding the eHealth solutions in the Sub-Saharan region. In particular, the two pilot countries (Kenya and Senegal) have been taken as examples of the current situation in East and West Africa.
The user requirements were collected through an extensive survey carried out during the months of May and June. In Senegal more than 150 questionnaires were collected and in Kenya 453 health professionals and 80 Community Health Workers were interviewed. Medical staff from different health facilities across the country participated in the survey as well as medical experts in the capital. The result of this study have been reported in two project documents whose the Executive Summaries will be available for downloading from this website.
The activity was closed with the organisation of two public workshops (Dakar 10th October and Nairobi 17th October) organised and hosted by the project's African partners - Kinkeliba and AMREF. The objective was to present the survey result to the end users and to the authorities. By this mean, the SAHEL initiative insists on the importance of ensuring a user-driven approach integrated within the national Health strategies. The workshops were a success in terms of attendance and of the enriching exchanges between the SAHEL partners and the audience. In particular, more than 50 participants attended the events including health workers (nurses, midwives, and doctors), senior representatives from the Ministries of Health and Communications, medical university professors and relevant actors in the emerging eHealth sector in Africa.
The SAHEL project is entering now its more engineering-centred phase devoted to the tailoring of the SAHEL platform for the three services (medical eLearning, Clinical Services and eHMIS) to the expressed user needs.