Connected Pharmacies digitally improving health services in Bangladesh
Even without a pandemic, rural pharmacies in Bangladesh have been a hub for patients to get medicines and help. In places where health centres are sparse, the need for telemedicine has become a vital part of taking the pressure off medical services. The innovation team members, Dr Khaled Hasan of Digital Healthcare Solutions and Emranul Haq of Concern Worldwide share their experiences and hopes for connecting communities so that healthcare systems in the country can be more resilient.
As COVID-19 continues to ebb and flow through countries and present as variant strains, some areas more than others struggle to not only face the pandemic but to continue to serve their communities in terms of regular, ongoing and chronic healthcare. Dr Hasan and his team identified pharmacies as a key point of support that will benefit from tech support in order to keep people safe and well.
“Sometimes the pharmacy owners go beyond their jurisdiction and prescribe medicines based on patients’ symptoms,” Dr Hasan says, painting a picture of rural pharmacies in Bangladesh. “With the COVID-19 pandemic, the health system got overwhelmed. The hospitals that usually serve patients were stretched to their capacity. Moreover, going to physical doctor consultation escalated the risk of cross-transmission from patients to doctors and vice versa. Pharmacies are already an established and trusted hub for patients and so we are working to provide support and empowerment to respond to this pandemic and keep regular healthcare up and running.”
The design, distribution and provision of technologies can already seem like a steep hill to climb, but Dr Hasan says it is not just making tech solutions, but that a cultural shift is needed to help support healthcare systems. “It is important to change people’s behaviour so that they will accept the advice of a virtual doctor instead of physically going to a clinic,” he says.
Concern Worldwide — in partnership with Digital Health Solutions, mPower, and Sajida Foundation is leading the digital health project to transform pharmacies into “health hubs” using a Digital platform, allowing remote care provision in the community. Initially, it was not an easy assumption during the design stage of the project. Especially whether the patients will come to the pharmacy for a “virtual doctor” consultation or not. Moreover, the presence of another Concern Worldwide lead, in partnership with Sajida Foundation PROSHOMON project, paved the way to think about the mobile platform based digital health project and its implementation. The platform is for local pharmacy owners to connect individuals remotely with primary health care and specialist doctors). The platform uses a mobile phone-based information system to enable front-line health workers to collect data on clients, generate SMS reminders, and provide emergency medical support. The platform is also an e-learning app for pharmacy owners who act as first contact points for health services. As a result, pharmacy owners have become a significant part of the healthcare system along with doctors and health workers.
The innovative project on health services is supported by the UK Government’s Foreign, Commonwealth and Development Office to transform pharmacies into healthcare centres for all. As part of COVIDaction’s project, the Concern Worldwide partnership will adapt and scale the platform to include 100 urban and 20 rural pharmacies, potentially serving up to 40,000 patients in Chandpur and Feni districts in Bangladesh.
“Pharmacies are already an established and trusted hub for patients and so we are working to provide support and empowerment to respond to this pandemic and keep regular healthcare up and running.”
The problem appears to be a challenge for both patients and medical staff. A team of health experts is spending time training physicians to be patient listeners and show more empathy — vital skills for making telemedicine both appealing and effective. “We are committed to providing a better patient experience which can fill the gap of not seeing a doctor face-to-face or being physically examined,” he says. “Moreover, in the rural areas, some people do not regularly use the internet, are less tech-savvy or perhaps do not always own a smartphone to access telemedicine.”
The importance of being mobile with access to internet
In Bangladesh, 90% of people have mobile connection and the use of mobile phones with internet service is very common in both rural or urban areas. The availability and accessibility of technology and the internet created huge opportunities for the people, especially the poor to connect them with some essential services and mobile app-based services.” says Emranul. “Overall, Bangladesh has good mobile network and internet coverage across the country that is vital for digital healthcare service.”
“We would like to see all the pharmacies in Bangladesh performing as health hubs and one-stop health service centres where people can find primary healthcare services, advice on wellbeing, family planning and nutrition.”
Through a mobile app, people receive the required healthcare services close to their homes and free of cost. The telemedicine service offers video consultation and medical advice from both general and specialist physicians. “We have built the capacity of pharmacy owners and raised awareness among the community people to bring them into this health service and integrate communities with this technology. A group of community volunteers are engaged to connect community people with the mobile-based health services” added Emranul.
To continue offering this service Dr Hasan’s team and partners will be critically evaluating the work to find economically viable solutions and address any bottlenecks. Emranul added it is crucial to familiarize the people with tech-based service and scale-up digital health service across the country. More resources would be needed to scale the model to reach across Bangladesh.
“We would like to see all the pharmacies in Bangladesh performing as health hubs and one-stop health service centres where people can find primary healthcare services, advice on wellbeing, family planning and nutrition. We also envisage that this platform will not only be a curative service but offer access to health promotion materials, discuss health concerns with qualified professionals and book a physical consultation if needed all from their mobile phone.”
Dr Hasan cares passionately about digital healthcare of course but his own personal experience has had an impact on the way that he sees his work. In August 2020 he experienced five days of symptoms that sharpened his resolve. “The COVID pandemic is an unprecedented event in human history,” he says. “It exposed several weaknesses in the health system but at the same time it proved how dedicated healthcare professionals can be, how important basic public health measures are in preventing infectious diseases and how digital health can contribute to strengthening the health system.”
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