Tele-ultrasound to prevent maternal and infant mortality in Togo

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Extract from the article: Au Togo, les autorités misent sur le numérique pour l’amélioration de la sante afin de progresser vers la couverture sanitaire universelle à l’horizon 2030. Dans la poursuite de ces objectifs ambitieux, le Togo travaille avec ses partenaires techniqu

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In Togo, the authorities are banking on digital technology to improve health and move towards universal health coverage by 2030. In pursuit of these ambitious goals, Togo is working with its technical and financial partners.  It is within this framework that the Pierre Fabre Foundation has been supporting the Ministry of Health, Public Hygiene and Universal Access to Healthcare since 2021 to formalize and operationalize a national e-health strategy. To this end, the foundation has initiated a tele-ultrasound project to improve maternal and child health in Togo. Over a 12-month period, the project aims to provide remote ultrasound interpretations by specialists for 4,000 pregnant women. Implementation will take place in 10 health centers. The project was launched on Tuesday September 05 by Dr Kokou Wotobé, Secretary General of the Ministry of Health.

The aim of the project is to improve maternal-infant health in Togo through the deployment of tele-expertise for the interpretation of ultrasound examinations carried out as part of prenatal monitoring and obstetric emergencies. 

According to lead trainer Dr Kousséma Agoda, with the technical and financial support of the Pierre-Fabre Foundation, remote ultrasound examinations will be able to be carried out from Togo for the examination of pregnant women. « This project was born to fill the gaps in areas where there are no specialists in mother and child health, and to bring relief to pregnant women.In some cases, pregnant women make it all the way to delivery without ever undergoing an ultrasound scan », stresses Dr. Kousséma Agoda.

The trainer explains that telemedicine refers to the provision of healthcare at a distance, using information and communication technologies to enable patients to consult healthcare professionals, without physically visiting a health center. « This program concerns obstetrical tele-ultrasound, which consists of health practitioners producing images and transmitting them to experts via the Internet for examination.What we're talking about here is tele-expertise in obstetrics, via ultrasound », he explains.

To this end, 20 health professionals from 10 health training centers in Togo's five regions have benefited from skills enhancement in obstetric ultrasound, and have been trained in the use of the « Bogou » tele-expertise platform. By the end of the 12-month project, 4,000 pregnant women should be able to benefit from an ultrasound examination interpreted remotely by a specialist.The beneficiary health centers are CHP Bassar, CHP Pagouda and CMS Pya in the Kara Region, CHP Mango and CHP Gando in the Savanes, CHP Djarkpanga and CHP Blitta in the Centrale, CHP Danyi and CHP Tohoun in the Plateaux and CHP Tabligbo in the Maritimes.

Togo's Ministry of Health, Public Hygiene and Universal Access to Healthcare is in charge of implementing the project, which is part of a broader program to achieve universal health coverage throughout Togo, and to develop information and communication technologies to strengthen the healthcare system. 

For Dr Kokou Wotobé, Secretary General of the Ministry of Health, this project supports the government's efforts to provide access to quality health care, especially for pregnant women living in remote areas who do not have access to ultrasound scans.For him, this project will improve the digital services provided by medical practitioners, and enable the Ministry to achieve universal health coverage across the country. « This project, which is about to get underway, will undoubtedly contribute to achieving the universal health coverage that the government is promoting. Telemedicine must be able to foster research and also require ongoing evaluation to improve practice and guarantee its effectiveness" », said Dr. Aristide Afèignindou Gnassingbé, National Coordinator of Digital Health.

Pierre Fabre Foundation coordinator Koffi Mawuéna Samboé reiterated his institution's commitment to supporting the monitoring and evaluation of the project.

What is tele-ultrasound?

Telesound is a term used to describe the use of ultrasound at a distance. It is an emerging technology that has the potential to revolutionize the way ultrasound is used in healthcare.Tele-ultrasound allows a physician with ultrasound expertise to interpret an ultrasound examination performed by another healthcare professional, such as a nurse or ultrasound technician. The expert physician can be thousands of kilometers from the patient, and ultrasound images can be transmitted via a secure Internet connection.

This technology can improve access to healthcare for patients living in remote areas or who find it difficult to get to an expert doctor, it can help reduce healthcare costs by avoiding the need for patients to travel to a specialized ultrasound center, and it enables expert doctors to share their knowledge with other healthcare professionals.

According to the results of the latest health surveys, as mentioned in the PNDS. The maternal mortality rate is estimated at 401 deaths per 100,000 live births, three-quarters of which are due to direct obstetrical causes. The neonatal mortality rate is 27% per 1,000 live births, and the infant and child mortality rate is 89 per 1,000 live births.  According to the 2020 activity report from the Ministry of Health's Human Resources Department, the country has only 7 specialists in radiology/medical imaging, including 3 in Greater Lomé, and 28 gyneco-obstetricians, including 15 in Greater Lomé. 

William O.