Implementation of a Telemedicine Network in Angola: Challenges and Opportunities

Background: The Angolan Ministry of Health is prioritizing the strengthening ofthe national health system at the districtlevel. Toattain this objective, theAngolan Ministry of Health decided todevelop a national telemedicine network in partnership with the Geneva University Hospitals(HUG)and the Portuguese Institute of Hygiene and Tropical Medicine(IHMT).Methods: Telemedicine unitswerecreated in strategiclocationsto enable distance education and tele-expertiseactivities, usingsoftwaredeveloped by HUG adaptedto local conditions.Selected participants in each site weretrained with regards to theuse of the tools. A survey using questionnaires distributed to all participants was conducted toevaluate user satisfaction and the impact of the tools. Data were analysedusing a descriptive statistical model. Additionally,two working groups were held to discuss difficulties and find appropriate solutions.Results: Seven telemedicine units were established,and 107 health professionalsweretrained. Regarding distance education activities, over 70 courseswere designed and webcast,and95.6% of participants answered our survey showing a high level of overall satisfaction.Uptake of tele-expertise activities was poor. Only 3 cases were discussed,and 4.7% of participants answered the survey. This was explained by low levels of computer literacyand motivation among the participants. Thelack of a legislative frameworkandinternet accessin some places also played arole. Financial constraintshalted the process of extension of the network to additional sites.Conclusion: More research is neededto assess the impact of the network, to understand how to scale-up to other sites,and to conduct a cost-benefit analysis to justify the pursuit of the investments