Recently, we had the opportunity to chat with Carolyne Njuguna, a 2023 East Africa Leadership Journey alumna and the East Africa Hub Director and Kenya Country Director for PATH. Our discussion centered on navigating leadership and technological innovation to advance digital health for the attainment of Universal Health Coverage while also speaking on her WomenLift Health leadership project; W.I.R.E.D designed to provide support, mentorship, coaching, and networking opportunities for women leaders.
Can you share a bit about your background in IT and Computer Science and how it has influenced your role as the East Africa Hub Director and Country Director for PATH in Kenya?
I hold a B.Sc. in Computer Science and have taken certifications and professional courses to specialize on networks. I did practise as a field and Network engineer early in my career starting off in the telecommunication Industry for a couple of years; worked with Access Kenya now known as Internet Solutions as well as Safaricom- the largest telecommunications provider in Kenya, and one of the most profitable companies in the East and Central Africa region.
Given that we were providing technology solutions to all manner of businesses across sectors from media, agriculture, health etc that exposed me to technology not as a support function but an enabler of any business to address real life issues. This also meant getting involved and understanding various facets of an institutions and how they intersect for a common goal and objective. I later did a master’s in strategic management as I continued to rise the career ladder and that blended in well with the exposure and experience, I had acquired. I did transition to the development sector and currently in public health. In my current role, the technology and strategy background did prepare me in so many ways than I ever imagined. As I said earlier, the exposure and interactions with all facets and functions of an institution by virtual of coming from a function that is cross cutting. That makes one very well rounded but also dependent on your level of curiosity to want to know more and understand details.
I have a heavy inclination on the use of data for decision making which is a best practise and has come in handy in my role and other leadership roles I have held but this is not to mean that there is no place for intuition when making decisions. There is a lot I could say about how this background has influenced my leadership but for me the most exciting is to see the evolution and integration of digital and technology in health services and given that we are a health organization, being at the centre of working with Ministry of Health and other partners to drive the digital health agenda.
How do you envision the role of technology, including artificial intelligence, in advancing healthcare and health promotion for the attainment of UHC?
Technologies such as tele-health and self-care apps can make health services more accessible and personal, and lower the barriers and inefficiencies to help promote the quality of care. Through technology, patients can use digital devices to monitor their health, while healthcare workers can access medical records from anywhere connecting patients to their providers without the need of an actual physical visit to the hospital.
Technology has also made it easier to collect near real-time health data with Electronic Medical Recording (EMR) systems enabling the collection, storage, analysis and sharing of high-quality health data improving decision-making, targeted interventions, and resource allocation.
Digital payment systems like M-Pesa make it easier to pay for healthcare thus reducing administrative costs and ensuring transparency.
AI predictive modelling is already being used in the health space in many fronts e.g. identify health trends, simulate disease outbreaks, and high-risk populations. Artificial Intelligence (AI) algorithms are now being deployed to analyze medical images (such as X-rays, MRIs, and CT scans) and support diagnostics with remarkable accuracy for early detection of diseases like cancer, TB etc. For example in the TB space, there are existing AI tools in use for diagnostics e.g.CAD4TB, Qure AI and they do aid enhanced accuracy in diagnosis and improving case finding.
At PATH Kenya through one of our projects funded by UNITAID dubbed TIMCI (Tools for Integrated Management of Childhood illnesses) and in partnership with Ministry of health at national and county levels, we deployed an electronic clinical decision support algorithm (CDSA). CDSA helps organize patient information and symptoms through digital applications and connect that information to the relevant Integrated Management of Childhood Illness guidelines. CDSA promotes adherence to guidelines, strengthen their implementation, and help enhance health care workers’ ability to accurately manage sick children. Some of the outcomes with the use of this tool was reduced prescription of antibiotics and accuracy in prescriptions.
How is your leadership project with WomenlIft Health as a 2023 East Africa alumna member impacting your organisation?
My leadership project is hinged on women leadership in health given the gender divide we see in global health. Despite majority of the health workforce being women, (constituting 70% of the entire workforce) only 25% hold leadership roles. My project is really to dig deeper and understand the barriers for women to rise into leadership in global health and explore how we can address some of these barriers.
The project is dubbed W.I.R.E.D (Women Inspired Resilient Engaged and Disrupting) and is designed to provide support, mentorship, coaching, and networking opportunities for Women at PATH, East Africa Hub. Through this platform, women will authentically connect, network, establish a common understanding on why women leadership in health matters and is urgent, learn from each other internally but also externally, share feedback on proposed enablers for empowerment at the institutional level.
The targeted initiatives such as mentorship programs, leadership exchanges, and networking events, will also create an environment where women can flourish, nurture their leadership skills in their current roles with confidence and competence. I am truly grateful to see the institution buy -in into this initiative (W.I.R.E.D) which is a testament to the PATH’s commitment to gender equity, inclusion and diversity.
What are some of the key challenges in leveraging technology for health promotion?
A key challenge is the cost of the Technology infrastructure, both systems and hardware initial cost is usually high. This includes costs associated with training of healthcare workers on how to deploy the new technology, as well as change management and routine updates.
Data security, privacy and confidentiality is also a potential challenge. If not well managed, data breaches can lead to sensitive patient data falling into the hands of the wrong people, thus eroding trust that patients have with the system. This can however be cured by putting in place data access protocols needed to safeguard personally identifiable information (PII).
Other challenges we have seen is the proliferation of multiple siloed systems by different programs /disease based digital systems that are not interoperable with each other and cannot exchange data. So, we end up having disease centric systems as opposed to patient centric systems. Remember a single patient could have multiple diseases e.g. have a non-communicable disease e.g. Diabetes, have HIV and so on and so forth. So, systems ought to be hinged on the patient and not the disease area to ensure a holistic approach to care for the patient. With the planned rollout of the Kenya Digital Health Superhighway by the MOH, this will be addressed.
What do you envision as the future trajectory of technology and Artificial Intelligence in health?
AI will continue to revolutionize how healthcare is delivered. AI and machine learning algorithms will increasingly be used to analyze large data sets to improve diagnostics and create personalized treatment plans. AI and machine learning algorithms will be deployed for predicting diseases, identifying patterns in medical imaging, and providing personalized medicine.
Interoperability of systems and patient data portability. There will be a growing need for systems interoperability and exchanging of data across systems. Bidirectional sharing of data between Electronic Medical Recording systems with community health information systems, financial systems, claims management system, logistics & supply chain management system among others. . Patients will be able to move with their electronic health record across systems and across facilities to ensure continuity of care.
There will be continued uptake of telemedicine and self-care apps by patients who have limited time at work or in school to connect remotely with their doctors, schedule appointments and review of vitals for remote monitoring. Internet of Things will bring about inter-connected medical devices and sensors to collect and exchange data, facilitating remote monitoring and improving patient outcomes. Wearable devices, such as fitness trackers and smartwatches, will play a significant role in monitoring health metrics.
Technology evolution, advancement in AI , pandemics such as covid and many other factors have accelerated the pace of unprecedented changes across sectors; health included. This therefore calls for embracing approaches that drive innovations so that we sustain the gains made so far in advancing health equity as well leveraging on emerging technology advancement to build resilient health systems.
As Steve Jobs aptly put it, “Innovation is the ability to see change as an opportunity, not a threat.” As leaders, we must embrace change to pave the way for innovation.
