Afyaca in Tanzania

Access to quality healthcare is expensive and in the absence of national health insurance schemes often unaffordable for many. On the other hand, even for those who can afford, access to quality health care remains difficult and informed decision making for healthcare questions is often a challenge. Telemedicine can bridge this gap, enabling patients to make the right decisions early on, and therefore improve outcomes.

Afyaca wants to improve access to quality healthcare, increase the available workforce by virtual means and provide access to healthcare for the poor in a sustainable way in Tanzania.

The Afyaca matchmaking platform links patients to healthcare providers for online medical consultations independent of each others location. Total capacity of the platform is 50,000 calls per year currently which can be scaled as needed. A clinical decision making software is being used to ensure quality of online consultations. Patients can schedule an appointment from wherever they may be and have a video consultation with the provider at the scheduled time. Medical notes are stored in a secure, simple electronic health record according to international standards. Referrals to labs or clinics can be provided when needed and ePrescription will become available in Tanzania very soon. The proof of concept phase has demonstrated that 80% of all requests could be managed online without the need for physical referrals.

Afyaca has a built-in cross-financing component where some of the profit from private sector is used to sustainably support telemedicine consultations for those who can not afford access to healthcare otherwise. We have developed and implemented a short-term membership for tourists visiting Tanzania which gives them free access to our doctors when needed. Some of the profit is used to subsidize telemedicine consultations for those who can not afford otherwise.

This solution improves access to healthcare, especially for the rural population, but also improves access to healthcare in large cities, avoiding time in traffic and waiting rooms and therefore reduces opportunity costs. All components are certified for data management according to international standards, and are connected through APIs to give patients a seamless experience.

The solution is adaptable according to Ministry of Health guidance, and is scalable according to changing needs. Providers do not necessarily need to be in country, as long as they are licensed through the medical council of Tanzania. This provides the medical diaspora (Tanzanian healthcare workers who do not live within the United Republic of Tanzania) with the opportunity to provide their services within Tanzania without having to be in country physically. This increases the available human resource capacity by virtual means, and therefore improves access to healthcare in a sustainable way.

Specifically to highlight is an initiative to train midwives on online consultations to provide preventive services to pregnant and lactating women which is currently not part of the midwife training curriculum. This initiative had been well received by the Tanzania Midwife Association.

To make access to these services available even to those who can not afford, Afyaca has a built in cross financing component, where some of the profit from consultations to private sector (i.e. tourism) is used to subsidize telemedicine consultations for the poor, initially prioritizing pregnant women and small children.

The platform has been approved by the Ministry of Health in a multi-year process and is among the first ones of its kind in the region. Afyaca has just signed an agreement with the largest healthcare insurance in country to provide telemedicine services to their clients. Afyaca also has contracts in place with tour operators to provide services for their clients.

The telemedicine solution fits well into the larger strategy of the Government of Tanzania’s approach to achieve Universal Healthcare as one component to access primary healthcare even in rural settings. It is an opportunity to manage patients with chronic conditions (especially NCDs) by providing easy and convenient access to healthcare from the comfort of their homes and therefore improve compliance.