COVID RECOVERY AN OPPORTUNITY TO REDESIGN HEALTHCARE SAYS DELOITTE
“The recovery from Covid offers us an opportunity to rethink how we deliver health services to the areas of greatest need to improve equity, including preparing for future pandemics. It also allows us to use digitisation and virtual consultation to deliver healthcare in remote areas and cover larger proportion of the populations,” says Ashleigh Theophanides, the Life Science and Health Care Leader and newly appointed Chief Sustainability Officer for Deloitte Africa.
She is commenting on the findings of the Deloitte Global Healthcare Outlook 2022, a report that covers six major areas including health equality, ESG (environmental, social, governance), mental health and well-being, digital transformation and health care delivery model convergence, future of medical science and public health.
According to the report, the most pressing challenge facing health systems across rich and poor countries is improving access to health.
The authors note that the Covid-19 pandemic coupled with the global healthcare crisis has highlighted the need for the transformation of the healthcare sector, globally and across Africa. Focus must now be on improving health equity, building resilience towards climate change and accelerating the digital transformation of the sector.
The report notes that poverty, which rose worldwide in 2020 for the first time in 20 years, and lack of effective financing systems for basic services such as primary health care, drug coverage, mental health support and health screenings are significant barriers to health equity in much of the world, despite efforts to close gaps.
It found that India, with a high out of pocket spending of 63% and private insurance covering less than 10% of the population, is among developing countries such as Mexico, Malaysia and China and others that continue to roll out universal health coverage— even amid the pandemic—in their attempts to improve health equity.
HEALTHCARE IN AFRICA
South Africa is grappling with implementing the National Health Insurance (NHI) to achieve universal coverage.
Deloitte advises governments and large corporations with a large global workforce to take active steps to improve health equity. This starts by gaining a better understanding of its population or workforce. This should then be followed by defining a vision of health equity and drawing a roadmap towards its achievement, recognising that not everyone can be covered at once but rather incrementally.
“The major challenge on the African continent is access, which we define as both physical access and funding,” says Theophanides.
She notes that rural communities lack health care facilities and have poor infrastructure—roads, power (electricity), communication connectivity—to support the health care ecosystem. Urban areas are more likely to have better infrastructure, but the number of health care facilities remains insufficient to serve the population. A lack of health care professionals (HCPs) also imposes access constraints.
“Funding is the second major challenge. Governments do not have the funding to invest in major infrastructure projects like hospitals and clinics which would provide access,” says Theophanides.
Outside of South Africa, the majority of Sub-Saharan countries in Africa rely heavily on Official Development Assistance (ODA) to fund their health care systems.
“Due to high rates of unemployment or low income, the majority of the population is unable to pay for out-of-pocket expenses and, thus, rely exclusively on constrained public health care systems. Also, the majority of ODA funding is directed at specific communicable disease programs like HIV/TB and malaria. This leaves a large gap in the diagnosis and treatment of non-communicable diseases like cancer, diabetes, and heart disease, which we know are increasing on the continent.
As part of its contribution to improving Health equity, last year Deloitte launched the Health Equity Institutes in the United States, India and in Africa. The Deloitte Africa Health Equity Institute (DAHEI) has already been extensively involved in helping the South African government shape aspects of its response to the pandemic from developing modelling systems that were used to predict the spread of infections to tracking the demand for Personal Protection Equipment (PPE) nationally. Working in partnership with Right to Care, Deloitte also supported government with the Electronic Vaccination Data System (EVDS).
In Nigeria, Deloitte supported the Global Fund with a review of the Nigeria Supply Chain Integration Project (NSCIP). This was to ensure that Africa’s most populous country can effectively manage medicine stock levels to avoid running out or any wastage.
Theophanides, who has also just assumed the role of Chief Sustainability Officer at Deloitte Africa, says recovery from Covid also offers countries an opportunity to respond to Environment, Social and Governance (ESG) challenges. This is not just the drive for healthier populations, the very essence of sustainability, but also to respond to challenges such as climate change.
The report also notes that climate change is impacting what Deloitte calls the Drivers of Health: the conditions in which people are born, grow, work, live, and age, as well as the wider set of forces and systems shaping the conditions of daily life.
HEALTHCARE IN SOUTH AFRICA
Although South Africa appears to be over the worst of the pandemic, Covid 19 is still found to have led to rising patient numbers, healthcare worker burnout and pressure on infrastructure such as availability of beds and oxygen.
Theophanides says the pandemic has also taken a toll on people’s general mental health leading Deloitte to describe mental health as the hidden pandemic for this year.
She urges government and organisations to raise mental health awareness and companies to go a step further by encouraging employees to sign up for mental health wellness programmes and use every available solution, including digital, to monitor employee well-being.
Deloitte notes that “medical science is currently being transformed by scientific discoveries that will dramatically advance the way we diagnose and treat different diseases.” This will be in the areas of digital medicine, nano medicine, genomics, and artificial intelligence as well as big data.
Theophanides says Covid has forced a rethink in public health, where in South Africa’s case, at the height of the pandemic, patients with medical aid cover still struggled to access beds. This showed the need for improved private and public healthcare facilities to help cope with the case load.