In Tanzania, giant pouched rats are trained to sniff out tuberculosis in human sputum samples. Dubbed HeroRATS, the animals can evaluate 40 samples in just seven minutes, equal to what a skilled lab technician can do in a full day.
In northern Kenya, health services—including family planning services—are being brought to 36 remote, underserved communities by four-wheel drive vehicles, bicycles, camels and good old-fashioned human feet. And in Malawi, durable e-health hardware—even touch screen computers—that are significantly more robust in harsh environments with erratic power supplies are being manufactured by Malawians.
These are some of the really out-of-the-box ideas private sector organizations are applying in an effort to improve health by bringing affordable and high-quality health services to low-income people in Africa. While imported Western technologies certainly have their place, these ideas acknowledge local realities and tend to mix high and low tech in surprising ways that are appropriate to their environments.
In South Africa, Unjani Clinic-in-a-Box prefers to stay totally in-the-box, by providing trailer houses that are made and fitted according to the specific needs of the site. It takes only four weeks from order to arrival at site, and another day to have it up and running. The clinics are part of a primary health care social franchise model equipped to deal with a range of the most non-threatening ailments that account for 50% to 60% of consultations in under-served communities of South Africa.
These projects—all drawn from the crowd-sourcing platform of the Center for Health Market Innovations (CHMI)—are revolutionizing health care around the world by applying local solutions to local problems. The CHMI platform currently profiles 1,250 such private sector health programs in developing countries.
APOPO—which originally trained rats to sniff out landmines—evaluates samples from 10 TB centers in Dar es Salaam, Tanzania. The HeroRATS sniff a series of holes under which human sputum samples are placed and identify samples that contain TB bacteria. Their correct indications on known positive samples are rewarded with a food treat. Indications on unknown samples, if pinpointed by two or more rats, are confirmed by humans using microscopes. Positive samples are reported to hospitals, who follow up with patients. The rats have already detected over 2,300 TB-positive patients that were missed by microscopes. APOPO’s TB detection program is in a research phase, and is now working towards further validation before full implementation.
The Community Health Africa Trust (CHAT) is a community organization that supports people living in remote, underserved poor communities of northern Kenya to have healthy lives. It does this through mobile clinics that use vehicles, bicycles, feet and camels—depending on the terrain and infrastructure—to visit 36 communities per month. CHAT provides services in basic medical care, reproductive health, malaria and TB treatment, HIV counseling and testing, AIDS treatment, child immunizations and health education, including information on the dangers of female genital mutilation.
The Baobab Health Trust says it is “committed to using technological innovation to change lives in the developing world.” It appears they are doing just that by developing software, touch screen computers, bar codes and alternative energy sources in health facilities in Malawi.
Most notably, Baobab has developed low-cost and long-lasting power back-up systems that have allowed more than 1 million antiretroviral therapy sessions for 18,000 patients, registration of 800,000 patients and 160,000 HIV counseling and testing sessions. Baobab has also developed touch screen-based user interfaces designed for users with limited technology experience and low-cost information devices that stand up far better in harsh conditions than traditional computers.
The Unjani Clinic-in-a-Box is designed to provide primary health care services at affordable prices to under-served communities in South Africa. The 12-meter-long clinic provides consultations at about $15 per patient, including medicines, which is very competitive with other forms of private health care. Each clinic has an outside reception area, an examination room, a medicine dispensary, a registered nurse practitioner and an assistant.
The model aims to empower black women. All clinics are managed and owned by an experienced and community-based registered nurse. Start-up costs are around $20,000. There are currently seven fully franchised units in different parts of South Africa. Each clinic sees between 180 and 400 patients per month, a figure which is growing every month.