The Africa Centre for Health Policy (ACeHP) is advising the government against substituting the medical drones with a robust infrastructure for the delivery of medical supplies.
ACeHP says the needed infrastructure for the delivery of medical supplies has been non-existent for ages, a situation that continues to stifle efforts to make medical services and products available to all.
“Our national ambulance service has barely been available to help citizens,” the health think tank observed.
“The challenge with the drone blood supply in Ghana is that we don’t have the blood and medical products available even at needed times to transport to critical locations. Rwanda became the second country to achieve step three accreditation, the topmost level by the Africa Society for Blood Transfusion (AfSBT) within the last two years. In laboratory practice, cross-contamination and wrong cross-matching of blood products have always been an issue due to human error.
“What happens when wrong blood products are delivered by a drone to a wrong patient? Many Standard Operating Procedures require confirmatory tests before dispatch. In an environment of lack of consistent standardization and regulatory frameworks in medical practice in Ghana, how does the drone blood/medical delivery services seek to address that shortfall? Human resource Ghana has a critical shortfall of her health workforce, most of whom are biomedical scientists, nurses, midwives, doctors, etc. at the hinterlands and hard-to-reach places,” ACeHP said in a release.
The release follows plans by the Health Ministry to use drone technology to deliver blood and other essential medical supplies to hard-reach-areas of the country.
An agreement on the project, between the Ministry and Fly Zipline, has courted controversy as it reaches Parliament for consideration.
Minority legislators perusing the terms of the agreement have raised a number of issues, key among them being their claim that the cost for the project is too high.
Read ACeHP’s full release on the drone project below.
DON'T SUBSTITUTE DRONES WITH OUR ROBUST MEDICAL SUPPLIES DELIVERY SYSTEM
ICT innovations provide opportunities for achieving UHC in Ghana and Africa, by adopting more advanced technologies rather than following slow, classic paths to address health workforce constraints and improve people’s access to quality health services and technology comes with a lot of benefits that we can leverage to achieve UHC.
In Ghana however, the needed infrastructure hasn’t been in place for ages. Hence, stifling efforts aimed at making medical services and products available to all. Our national ambulance service has barely been available to help citizens.
Rwanda as at 2017 before the drone blood supply service, had over two hundred (200) functioning ambulances distributed in all districts of the country and four (4) marine ambulances. In 2018, how many functioning ambulances do we have in Ghana?
The challenge with drone blood supply in Ghana is that, we don’t have the blood and medical products available even at needed times to transport to critical locations. Rwanda became the second country to achieve step three accreditation, the topmost level by the Africa Society for Blood Transfusion (AfSBT) within the last two years. In laboratory practice, cross-contamination and wrong cross-matching of blood products have always been an issue due to human error.
What happens when wrong blood products are delivered by a drone to a wrong patient? Many Standard Operating Procedures require confirmatory tests before dispatch. In an environment of lack of consistent standardization and regulatory frameworks in medical practice in Ghana, how does the drone blood/medical delivery services seek to address that shortfall? Human resource Ghana has a critical shortfall of her health workforce, most of whom are biomedical scientists, nurses, midwives, doctors, etc. at the hinterlands and hard-to-reach places.
Most healthcare personnel at these places fall within the categories of nurse assistants, community health nurses, community volunteers/workers, and lack the capacity to transfuse blood. The government must begin to look at the health workforce – patient ratio and fill that gap.
Though we still lack a lot more of health facilities, a recent Lancet Global Health Commission report on High-Quality Health Systems states that more mortalities are recorded due to poor quality healthcare delivery as compared with inaccessibility healthcare services. National bloodstock We have a poor stocking history of blood products and their availability.
Voluntary blood donations nationwide in 2017 was 36% which means it wouldn’t be an efficient allocation of drones to distribute blood that is always in a shortfall considering the cost implications to the nation. The government must begin to look at ways of boosting our national blood stock levels. Invariably, blood products availability means there wouldn’t be the need to acquire drones to transport blood where there is no blood. Patients are still made to pay for blood which discourages voluntary donors from donating. We must, therefore, ensure that all lower levels of healthcare delivery are adequately stocked with blood. Infrastructure Government should strengthen and upscale CHPS. The government has to put in place functional logistics and medical supplies delivery system. Equipped ambulances and not take drones as substitutes to our medical supply system.
Emergency medical situation According to the 2018 Health Risk Map by international SOS, Ghana is a high medical risk country with one of the worst emergency healthcare services. It placed Ghana in the category of countries whose local emergency and administrative barriers in health were unimpressive and negatively affecting the overall quality of healthcare delivery. Contributing to this quagmire is the inadequacy of functioning ambulances and EMTs.
There are only about 50 ambulances being used nationwide to serve about 30million population. Experts from the Disease Control Priorities in Developing Countries (2nd Edition) cite a minimum desired ratio approximately 1 EMS unit (i.e. ambulance and crew) per 100,000 population, in low-resource settings. 112 EMTs staffed 16 ambulances. However, in Ghana, the EMS unit to population ratio is approximately 1:325,000. An alternative to drones In healthcare delivery, allocative efficiency is key: optimising the use of limited available resources. In comparison with drones for medical supplies delivery is the Robinson R22 utility helicopter with a loaded weight of 417kg and a maximum takeoff weight of 622kg, speed of 188km/h within a range of 386km and can endure for approximately 3hrs and 30mins reserve as compared with less specs of the zipline drones. It comes at a cheaper price than the drones deal with Fly Zipline. It’s worthy of note that the R22 helicopter would require a pilot which would means more employment would be given to more people if more of the R22 is rather procured.
Conclusion The Africa Centre for Health Policy (ACeHP) reiterates that the government must remove barriers to healthcare access and make quality healthcare services available to all persons. Removing such barriers means no need for the drones. The use of drones certainly comes with some advantages which aren’t in contention.
We must, however, begin to make sure the necessary infrastructure is in place, the needed health workforce adequately equipped, availability of medical supplies and equipment. Ethical considerations such as privacy breach have to be looked at. Delivery drones use cameras whilst delivering the materials to target locations.
All events are recorded and corrupt drone users may exploit recorded information of their customers. With this, we may just be putting our medical details out to the work. Drones are also liable to hackers who can take control of the drone’s network and main control system without the knowledge of the operator.
The drone contract may mean that the government is simply working to avoid: 1. Creating the needed infrastructure and equipment in rural areas 2. Government is not committed to equipping and tooling health facilities.
Effectively, this drone contract amounts to outsourcing jobs in a country with trained professionals looking for work, to drones manufacturer/operator foreign company. In implementing such a policy, we can find better and cost-effective alternatives than what has been proposed. Demonstrably, there are verifiable and cost-effective alternatives that work for us in terms of saving lives. We should explore all options available and copying from another country whose circumstances differ from ours may expose us to avoidable problems.
Executive Director, ACeHP