Bridging the Digital Inclusion

Healthcare Systems in South Africa (Photo: SAP)

Providing better healthcare in emerging economies, such as Brazil, Russia, India, China, and Africa, is one of the main concerns of the United Nations (UN). Three of its eight Development Goals address health issues.

SAP Research in South Africa

SAP Research and its partners in South Africa have taken the initiative to provide supporting Information Technologies to small rural clinics that are often the first point of service for rural communities. In a collaborative research project called PatHS (Patients Health Systems), SAP Research, the WITS University’s School of Public Health in South Africa under the leadership of Prof. Sharon Fonn, and Inathi Technologies are investigating how Information Technology could leverage the efficiency and quality of medical treatments in such clinics. The study was conducted in and supported by the Mpumalanga Province located near the Kruger National Park and the mega-city of Durban.

A primary healthcare clinic in rural South Africa (photo: SAP)


SAP has been providing world-class technology for the healthcare industry for many years. With PatHS, and in support of the UN development goals, SAP has already started to expand its focus to include the primary healthcare market in emerging economies. The major goal of PatHS is to develop patient-oriented user-friendly software solutions for managing chronic lifestyle diseases.

Rural healthcare clinics generally have only a few nurses that provide the most basic medical treatment. Only the more severe cases, for example, suspected HIV, hypertension, or tuberculosis, are referred to doctors based at district hospitals. The doctors’ services are provided in an environment with limited infrastructure. Problems experienced on a daily basis include erratic power and water supply, high staff turnover, low computer literacy levels, and problematic referral follow-up from district hospitals.

“We want to ensure that we understand the environment very well and develop the right “recipe” for deploying healthcare solution in this challenging environment” says Danie Smit, project manager of PatHS at SAP Research CEC Pretoria. The first important step in improving healthcare here is to get good quality information from the ground-up.

Project PaTHS, which started two years ago, currently evaluates new clinical processes for diabetes and hypertension and implements SAP Business Objects solutions to allow healthcare users better and more flexible access to the underlying data. This includes new user interfaces for rural clinic applications and an ICT framework that responds to user needs in diversified rural communities.

However, the first step to implementing new healthcare systems on-site was to provide the local healthcare workers with basic computer literacy training for a week.

Three healthcare clinics in Agincourt, Xanthia, and Thokozani are involved in the project. They offer various types of health support services to the surrounding communities, ranging from pediatrics, maternal care, and the management of HIV/Aids and other chronic diseases. The healthcare workers are quite passionate about their profession and are very excited about getting in touch with computers for the first time. They share the common goal of being trained on how to use computers in their daily lives.

Thus, the week-long basic computer skills training course presented by young SAP trainers was accepted very enthusiastically by the staff at the three clinics. “Even our older employees didn’t take lunch or tea breaks; they just worked on the computers the whole day” says Sr. Mercy Sibiya, sister-in-charge at Agincourt CHC, about the passion of the healthcare workers.

The fascination that prevailed throughout the training indeed revealed that a digital divide still exists in our communities. The initiative also illustrates how big companies can play a major role in strengthening communities by introducing systems to assist working processes. In turn, the communities are empowered and exposed to technologies that they never thought they would be able to access.

Basic computer skills training at a rural clinic

Future Prospects

To improve the practical use of the clinics’ technologies, patients’ demographic details are captured through local client-server architectures at each clinic. In this context, patients’ fingerprints, for example, are stored for identification and verification during subsequent visits. Researchers are working on synchronizing clinic databases over pre-existing low-bandwidth GPRS data connections on the GSM mobile phone networks. This is seen to be a more feasible connectivity model for large remote areas in Africa already serviced by mobile phone operators. Software systems should be able to function on pre-existing connectivity infrastructure as far as possible. However, high bandwidth connections will improve synchronization between clinics.

Apart from enhancing the software functionality, SAP Research also addressed many further issues, such as physical security, backups, maintenance, remote support, change management, and continuous education to guarantee an ongoing success.

Related research activities include designing alternative data input modalities, such as touch screens, to enhance the user experience, alternative business models for telemedicine in emerging economies, and the usage of mobile phones in healthcare delivery – more than 80% of the South African population already uses mobile phones. SAP and its partners are currently following up on inquiries about these healthcare solutions from various countries in Africa. “There’s still a lot to be done, but our initiatives are already making a difference in many people’s lives”, explains Smit.

Millennium Development Goals (Source: United Nations, 2008)

  1. Eradicate extreme poverty and hunger
  2. Achieve universal primary education
  3. Promote gender equality and empower women
  4. Reduce child mortality
  5. Improve maternal health
  6. Combat HIV/AIDS, malaria, and other diseases
  7. Ensure environmental sustainability
  8. Develop a Global Partnership for Development

“Developing countries currently face two epidemics decreasing the quality of life and the life expectancy of their populations: AIDS and diseases of life style. Both these epidemics require urgent prevention and treatment interventions to mitigate their effects.”

Prof. Sharon Fonn
Head School of Public Health, WITS University