AN OVERVIEW OF HEALTHCARE CHATBOTS IN AFRICA

History

The 21st Century has seen significant growth and development of Artificial Intelligence (AI) and its multisector use. In healthcare, the use of AI has significantly risen in the last 10 years and the upward trend is set to continue. According to Statista, the global Artificial Intelligence in healthcare market size has grown from $11.06 billion in 2021 to $20.65 billion in 2023 with a forecast that the market size will surpass the $187 billion mark by 2030 (1). Considering these developments, it is vital to comprehensively discuss specific elements of AI in healthcare and their importance; one example is Chatbots.

A chatbot (originally chatterbot) is a software application or web interface that aims to mimic human conversation through text or voice interactions.

Chatbots have tremendously evolved in the last 50 years; starting from the simple text-based ELIZA in the 1960s, to current AI-powered ones such as Open AI`s GPT Models and Alphabet`s Bard (2). The current chatbots utilize machine learning (ML) and natural language processing (NLP) to interact with humans in a human-like manner.

Chatbots Application in Healthcare

1. Scheduling of appointments and reminders for patients: Chatbots are currently being used in healthcare as intermediates between patients and providers. One of the most common uses is in the scheduling of appointments and reminders for patients; examples include Welltok and Siri. In facilitating the booking of these appointments, chatbots impressively save time and workload for providers and their staff whilst also improving convenience for patients.
2. Triaging and educating patients: Based on patient inputs, chatbots provide initial medical advice or direct them to appropriate medical services and resources.
3. Remote monitoring and management of chronic conditions and ailments: Chatbots aid in crossing the time and geographical gap between providers and patients including symptom monitoring and medication reminders. This is set to be a game changer in the management of chronic conditions that have significantly burdened populations. An example in this space is Ada which currently has 13.3 million users and has conducted 31.3 million symptom assessments to date (4).

Chatbots in Developing Countries

Chatbots facilitate efficient communication and engagement between patients and providers. However, their use in developing countries is still minimal compared to developed countries (5). Language considerations and limited user trust continue to impede the growth and development of chatbots in Africa`s healthcare space (6). They hold the potential to improve healthcare access in developing countries, especially in rural areas where there are shortages of healthcare professionals.

Several examples of current chatbots in Africa`s healthcare landscape include;

1. Educational chatbots targeted at the behavioral change in sex education, perinatal depression, and HIV. An example of a chatbot in this space is Kenya`s Zuri Health Chatbot (6). Facebook and WhatsApp chatbots have also been developed.
2. Counselling and testing. Chatbots are also being used in counselling and testing, specifically for HIV. People are becoming more comfortable with counselling services provided by Chatbots, especially the younger populations (7).
3. Diagnosis and recommendations. Chatbots such as Likita are being used in the diagnosis of common ailments in Africa, recommending common treatments, emergency departments, or healthcare provider visits (8).
4. Management of chronic illnesses. Some chatbots are also being used in the remote and continued management of chronic illnesses. One such example is the Cape Town GREAT4Diabetes WhatsApp Chatbot which aids in the remote monitoring and management of diabetes patients.
5. Maternal and Child Health Services. Chatbots are also being used to reduce maternal and infant mortality in Africa. An example of this is Helpmum from Nigeria which has developed a Helpmum vaccination chatbot to help nursing mothers prioritise immunisation for their children. In accessing the healthcare facilities for immunisation, the mothers also get access to their own healthcare services. Momconncect is also another example in this category. Launched by the South African National Department of Health, Momconnect sends over 400,000 health messages every week to pregnant mothers. Apart from the health promotion messages, Momconnect also provides an avenue for mothers to submit feedback on the quality of care received.

Nonetheless, several organizations have made significant steps in encouraging and supporting the development of Chatbots in Africa. One such organization is turn.io which is incubated at Reach Digital Health, formerly known as Praekelt.org (9). Turn.io provides support to social impact organizations in the development of effective and impactful software being used by these organizations. Majority of the organization's effort has been targeted at chatbots in the social and health environments. In 2023, Turn.io launched an accelerator program that will support 10 different organizations using Chatbots to improve healthcare across the globe (10). Three of the ten organizations are based in Africa; Access Afya (Kenya), Helpmum Africa (Nigeria) and Rocket Health (Uganda).

Undeniably, more organizations are needed to support the development of chatbots in Africa`s healthcare landscape; this will supplement governmental efforts put in place.

Challenges and Remedies

It is important to establish and improve the necessary supporting infrastructure for the development and growth of chatbot use in Africa`s healthcare delivery. Governments and other non-state actors should take deliberate steps to improve the required infrastructure which includes internet penetration and electricity (11). Data privacy and confidentiality are also another concern; governments across the continent should ensure that there is existing legislation and policies to guarantee the privacy and security of patient-identifying health information handled and processed by chatbots (12). There is also a need to integrate more African dialects and languages into chatbot systems for improved coverage (6).

Conclusion

In summary, there has been significant evolution and growth of Chatbots in healthcare, both globally and within Africa. Significant advancements including the utilization of more advanced ML and NLP are testament to the promoting future of Chatbots in advancing medical technology.

Chatbots are being used to implement critical functions in healthcare. However, their usage in Africa`s healthcare system has been limited due to different constraints including resource and infrastructure constraints. Nonetheless, the efforts of organizations like Turn.io demonstrate the potential impact of public and private sector collaboration in promoting the adoption of chatbots for healthcare in Africa.

As the healthcare challenges in the region persist, chatbots hold promise as valuable tools to enhance health systems, bridge gaps in healthcare access, and ultimately improve the well-being of African populations. The journey towards realizing this potential will require ongoing investment in infrastructure, resource allocation, and the nurturing of a supportive ecosystem for healthcare innovation.

Written By : Harrison Ochieng and Olutola Awosiku

For : Digital Health Africa Learning Series

References

1. Statista, (2023). Artificial intelligence (AI) in healthcare market size worldwide from 2021 to 2030(in billion U.S. dollars). Available at: https://www.statista.com/statistics/1334826/ai-in-healthcare-market-size-worldwide/

2. Safi, Z., Abd-Alrazaq, A., Khalifa, M., & Househ, M. (2020). Technical Aspects of Developing Chatbots for Medical Applications: Scoping Review. Journal of medical Internet research, 22(12), e19127. https://doi.org/10.2196/19127

3. Babylon Health, (2023). About. Available at: https://www.babylonhealth.com/

4. Ada, (2023). Health Powered by ADA. Available at: https://ada.com/

5. Mahajan, A., Vaidya, T., Gupta, A., Rane, S., & Gupta, S. (2019). Artificial intelligence in healthcare in developing nations: The beginning of a transformative journey. Cancer Research, Statistics, and Treatment, 2(2), 182–189.

6. Phiri, M., & Munoriyarwa, A. (2023). Health Chatbots in Africa: Scoping Review. Journal of medical Internet research, 25, e35573. https://doi.org/10.2196/35573

7. Adesina, M., Olufadewa, I., Oladele, R., Abudu, F., Oladoye, M., Ayorinde, T., & Adeyemo, F. (2021). Learning from digital health in curtailing coronavirus epidemic: a review of HIV/AIDS mobile apps or chatbots in Nigeria. In JOURNAL OF THE INTERNATIONAL AIDS SOCIETY (Vol. 24). THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND: JOHN WILEY & SONS LTD.

8. Oyebode, O., & Orji, R. (2018). Likita: a medical chatbot to improve healthcare delivery in Africa. HCI Across Borders (HCIxB).

9. Reach, (2023). About. https://www.reachdigitalhealth.org/about

10. Turn, (2023). Scaling Global Healthcare through WhatsApp: 2023 Cohort Unveiled for Chat for Impact Health Accelerator. https://www.turn.io/news/chat-for-impact-accelerator-cohort-2023

11. Owoyemi, A., Owoyemi, J., Osiyemi, A., & Boyd, A. (2020). Artificial Intelligence for Healthcare in Africa. Frontiers in digital health, 2, 6. https://doi.org/10.3389/fdgth.2020.00006

12. Naidoo, S., Bottomley, D., Naidoo, M., Donnelly, D., & Thaler, D. W. (2022). Artificial intelligence in healthcare: Proposals for policy development in South Africa. South African journal of bioethics and law, 15(1), 11–16. https://doi.org/10.7196/sajbl.2022.v15i1.797

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