Google and Facebook have told most employees to keep working from home for the rest of the year as part of a response by the tech giants to the deadly coronavirus pandemic.
Chief executive Sundar Pichai told Google staff at an all-hands meeting that its remote work policy will be extended until 2021, the Silicon Valley giant confirmed Friday.
Any return to offices was expected to be incremental and staggered, according to the company.
The news came along with US media reports that Facebook is also letting workers tend to their jobs remotely for the rest of this year.
Google employees who need to return to offices will be able to do that in the next month or two, with added safety measures in place due to coronavirus concerns, but most of the staff will continue working from home.
Facebook’s updated plan is to re-open offices in early July, but let people work from home if they prefer until 2021, according to reports.
Evidence from low- and middle-income countries suggests that digital and mobile communication technology can improve management of diseases. It is also particularly useful in medical emergencies. It has the potential to increase access to healthcare where resources are scarce and systems are under stress.
One aspect of this technology is “mConsulting”: mobile phone consultation with healthcare providers. mConsulting has been found to improve management of chronic and non-chronic communicable diseases. Other research shows that it increases use of maternal and neonatal services and expands vaccination coverage among hard to reach communities.
We conducted a study to explore whether mConsulting has the potential to improve healthcare in Nigeria, where the use of mobile communication technology has expanded rapidly. We looked at what’s already available and how users and providers perceive this mode of healthcare consulting. We interviewed mobile consulting providers, policy makers, users of mobile health and other stakeholders. The study explored perceptions, availability and operations of mConsulting services in Nigeria.
We found that mConsulting is likely to improve accessibility to healthcare. But it was introduced into Nigeria without a policy and regulatory framework to assure quality.
Mobile health consulting in Nigeria
The concept of mConsulting is still relatively new. But various forms of healthcare delivery through electronic platforms have been gradually introduced into the Nigerian scene with labels such as eHealth, ehealth4everyone, digital health, telemedicine and others.
In Nigeria, there are 15 functional mConsulting services operated by groups of private doctors. There are different ways of using the services. These include web chats, text messages, specialised apps, video calls and audio calls. The services include drug prescriptions, patient referrals, patient follow-up and provision of information about hospitals.
Only a few of the mConsulting services in Nigeria do not charge fees. Charges range from as low as N147 ($4) to as high as N344,000 ($950).
Respondents in our study perceived mConsulting to have a number of benefits. Access to healthcare was one. This is not only about getting medical help at any time: it’s also about the availability of quality and specialist services and bringing emergency care within reach.
Some stakeholders said that health facilities and resources were overstretched. They believed that mConsulting could reduce the burden on health workers and increase the income pipeline of physicians. This could strengthen the healthcare system.
It could also reduce the costs of using medical services, such as transport to facilities and waiting time.
They said it could contribute to better health outcomes, with better diagnosis and management of conditions. It could also reduce exposure of patients to risks associated with hospital visits, such as infections.
Perceived risks and barriers
Despite the benefits of mConsulting, participants mentioned some barriers too.
Some expressed distrust about this approach to medical consultations. They believed that physical interaction between physicians and patients was the most credible and reliable way of assessing a person’s health.
Lack of technology infrastructure and the digital divide, especially in rural communities, was another barrier. Where the facilities for mConsulting were not available and affordable, only a limited segment of the population would have access.
The human resources capacity for mConsulting was another concern. Many service providers rely on doctors who split their time between regular and mobile consultations. With the shortage of doctors in the Nigerian health system, dividing the time of the hospital workforce with mConsulting engagement puts more pressure on existing human resources. Some service providers also opened their platforms to both local and international clients, making it difficult to supply the demand.
The danger of misdiagnosis was seen as a barrier to mConsulting. Important information could be missed and errors could be made. Also, clients could mislead mobile consultants by not divulging all the relevant information. Even when using mConsulting in emergency care or for first aid, there could be a danger of receiving the wrong advice.
Data security and privacy is a major problem in Nigeria. Some participants believed that online materials and platforms were susceptible to abuse.
There were variations in stakeholders’ awareness of policy and regulations governing mConsulting in Nigeria. There have been suggestions at the National Council of Health that states should introduce eHealth into their healthcare delivery framework. Yet, after more than a decade of deliberations about it, policies are yet to be formulated specifically to govern this sector of healthcare.
Policy gaps and the way forward
The participation of the private sector has made it an imperative to have clear-cut policies to protect the public as users of mobile consulting services. The entrepreneurs who invest in these services also need protection.
mConsulting policies must cover training, credentialing, quality control, maintenance of electronic infrastructure, remuneration and protection against fraud.
Training curricula for healthcare professionals, especially doctors, nurses and pharmacists, must incorporate digital literacy and interaction with patients at remote sites. In the interim, short term training programmes can be organised for those already in the workforce. The agencies that regulate different cadres of health professionals should have clauses in their codes of ethics about mConsulting and eHealth in general.
Adequate remuneration is vital to sustaining mConsulting services and protecting members of the public against fraud or price gouging.
An effective policy environment is key to ensuring that mConsulting expands equal access to healthcare. A vision for mConsulting and eHealth needs to be integrated with the framework of the Abuja Accord to drive the achievement of healthcare for all.
Funke Fayehun, Senior lecturer, University of Ibadan, University of Ibadan; Akinyinka Omigbodun, Professor of Obstetrics and Gynaecology, University of Ibadan & Professor of Reproductive Health Sciences, Pan African University Life & Earth Sciences Institute (PAULESI), University of Ibadan, and Eme Theodora Owoaje, Professor , University of Ibadan
Mukuru, one of the largest international money operators and remittance companies in Africa, has confirmed that it has acquired Zoona’s operational assets in Malawi along with the technology systems that support its Malawian operations.
Mukuru did not reveal how much it paid to acquire Zoona’s Malawian technology systems or assets.
Zoona, which has worked with Mukuru for four years as a partner, is an Africa-based fintech that enables entrepreneurs to bring safe and reliable financial services to underserved communities in Malawi and elsewhere.
In a statement yesterday Mukuru CEO Andy Jury said the acquisition will extend Mukuru’s African footprint deep into the urban and rural areas cross Malawi.
“This acquisition will bring the benefits of our extensive products and cutting-edge technology to the citizens of Malawi – giving them better options and safe mechanisms to send money to loved ones and ultimately uplift their communities,” he said.
Following the acquisition, Zoona Malawi’s agents will operate as Mukuru agents benefiting from a wider product range to offer customers backed by Mukuru’s trusted and established brand name.
In addition, agents will benefit from being part of the Southern African Development Corporation (SADC) regional network, increasing their regional exposure and potentially boosting earnings over time.
Vantage Capital, announced that it has fully exited its investment in Vumatel, the largest fibre-to-the-home network provider in South Africa. The company was established in October 2014 by Niel Schoeman and Johan Pretorius, industry veterans who had previously started up the Birchman Group and Conduct Telecom before creating Vumatel.
Vumatel started out its life rolling out South Africa’s first fibre optic network to homes in Parkhurst by partnering with internet service providers who provided connectivity to their residential customers whilst Vumatel remained the owner and operator of the infrastructure.
At the time of Vantage’s investment in 2016, Vumatel had deployed its open-access fibre optic network across fourteen suburbs in Johannesburg, passing 16,000 homes and had secured around 4,000 subscribers. It had also received an equity investment from Investec Equity Partners.
Whilst banks were unwilling to fund the company at this early stage in its life, Vantage recognised the tremendous potential of the business and supported it with R250m ($17m) of capex funding to accelerate its rollout. Today, just four years later, Vumatel has become the largest provider of fibre to the home in the country. Over the life of Vantage’s investment, the number of homes passed has grown forty-fold and the number of subscribers fifty-fold as the company has laid thousands of kilometres of cable. Vumatel has also played a major role in upgrading the infrastructure of South African schools by providing free uncapped fibre services to public and private schools that its networks bypass.
In 2018, Vumatel was recognised with a prestigious award from the South African Venture Capital Association for the best medium-sized South African growth champion.
Last year, CIVH majority owned by Remgro acquired full ownership of Vumatel after initially securing a 34.9% stake in 2018. Vantage’s investors were beneficiaries of this transaction from both ends as Vantage had in a separate transaction provided New GX, a black owned and controlled investor, with mezzanine funding to part-finance their fibre-related assets including local manufacturing capacity.
Vantage exited the New GX transaction in 2018 and last week, Vantage’s mezzanine facility was refinanced by Vumatel after it secured substantial funding from a consortium of South African banks.
To date, Vantage has now successfully exited twelve investments across its three generations of mezzanine debt funds generating cumulative proceeds of R4.2bn ($360m) and x-money of 2.3x (1.8x in dollars).
Luc Albinski, co-Managing Partner at Vantage Capital, pointed out that “Vumatel is one of our many success stories, where we have supported businesses with mezzanine debt to achieve their growth ambitions. In this investment, we saw the opportunity to partner with an exceptional management team in a fast-growing sector and we are proud of the role Vantage played in unlocking the exceptional growth that Vumatel has since delivered.”
Warren van der Merwe, co-Managing Partner at Vantage Capital, added: “The Vumatel investment is an excellent case study of how mezzanine debt can unlock growth opportunities where banks remain risk-averse. In this way, Vantage plays an important role in supporting mid-size corporates before they are sufficiently established to fully fund their operations and growth ambitions with bank debt.”
Hugo van den Heever, Associate Partner at Vantage Capital, added “we have focused a lot of attention on the technology infrastructure sector with its high growth potential. In line with our pan-African mandate, we have looked at opportunities across the continent including markets such as Nigeria, the East African Community and Egypt. We hope to be able to announce further investments in this sector shortly.”
Nigeria’s five-year naira futures slid past 550 to the dollar on Thursday after the central bank weakened the currency on the derviatives market across maturities, traders said.
The bank weakened the currency on average by 73 naira across tenors, traders said, with the one-year maturity revised by 27 naira. The 5-year naira future weakened to 569 per dollar, traders said, from 413 naira in the previous session.
Airports in Nigeria will remain closed for an additional four weeks as part of the measures to control the spread of the novel coronavirus, the government said on Wednesday.
The extension is the second since March 23 when the Nigerian government suspended all of its commercial flights.
Boss Mustapha, secretary to the government of the federation, said the federal government decided to extend the flight ban after due consultation.
“We have assessed the situation in the aviation industry and have come to the conclusion that given the facts available to us and based on the advice of experts, the ban on all flights will be extended for an additional four weeks,” Mustapha said.
The Nigeria Center for Disease Control announced on Wednesday that the country has recorded 3,145 case of COVID-19 with 103 deaths.
To control the spread of coronavirus, the Kenyan Ministry of Health COVID-19 Taskforce implemented initial prevention and mitigation measures. These included encouraging the public to wash their hands, wear face masks and stay home.
But not everyone will be able to adhere to these because they rely on a daily wage and cannot afford to stay home. Many of these people live in Nairobi’s low income settlements which are overcrowded and where sanitation and social distancing measures are near impossible to maintain. COVID-19 would spread rapidly under these conditions.
To make sure this doesn’t happen, health authorities need timely data to design policies and interventions that are easily understood and relevant to the lives of urban slum inhabitants.
Along with our colleagues at the Population Council (an organisation dedicated to carrying out research on critical health and development issues), we worked with the government’s taskforce committees to do just that. We used rapid phone-based surveys to collect information on knowledge, attitudes, practices and needs among 2,000 households in five Nairobi urban slums. The survey will be conducted every 2 to 3 weeks over the coming months as the pandemic unfolds in Kenya.
Some of our key findings so far are that prevention methods are being adopted by most, but people are starting to struggle: many are missing meals, have lost work and say that the cost of living is going up.
It’s vital to have this information as it will help to inform prevention, control and mitigation measures during epidemics. A recent example is from the Ebola response, where surveys identified the prevalence of misconceptions about Ebola transmission and prevention, the need to prevent stigmatisation of Ebola survivors, and to foster safer case management and burial practices.
What people are saying
One of our key findings so far was that most people are adopting prevention practices, including social distancing, hand washing and wearing face masks. For instance participants reported that – compared to before COVID-19 – they: saw less of family (56%), saw less of their friends (87%), avoided public transportation (76%) and stayed at home more (85%).
But staying at home is proving more difficult. In the day before the survey, 79% had left the house; 37% left once, 24% left twice, 39% left three times or more. Of those that left home, 34% travelled outside of the slum where they live, suggesting significant travel around Nairobi.
When it came to wearing face masks, 89% said they had worn one in the last week, 73% said they always wore the face mask when outside of the home. Of those who did not always wear a face mask, the reasons were mainly that they were uncomfortable (57%) and unaffordable (19%).
Hand-washing was also a widely adopted practice: 95% said most public spaces have hand-washing stations, 76% said they washed their hands more than seven times a day, and 88% said they always used soap. Only 5% of participants say they wash their hands between 1 and 3 times per day. Barriers to regular handwashing were a lack of access to water at home (25%) and that they couldn’t cannot afford (32%) extra soap or water.
Hand sanitisers were used far less: 40% of participants said they don’t use them because they’re too expensive (83%) or not available in shops (24%).
The pandemic is clearing having a negative impact on people’s health and economic and social status.
Most people who responded to our survey (68%) said they had had skipped a meal or eaten less in the past two weeks because they did not have enough money to buy food. Only 7% had received any type of assistance – such as cash, vouchers, food and soap – and only half said the assistance given was enough to cover their households’ most important needs.
Participants expressed their single biggest unmet need was food (74%) followed by cash (17%). This may be related to 77% of participants reporting increased food prices and 87% noting household expenditures increased, as well as more than 4 out of 5 participants reporting complete or partial loss of income or employment.
Women may be disproportionately affected with increased time spent on chores (67% vs 51% of men) and more women reported a complete loss of income or employment compared to men.
When it came to how well-informed people are of the illness, we found a big majority knew that fevers (83%) were a symptom. But less knew about difficulty breathing (48%) and coughs (52%).
We also found that young people were less likely to think they were at high risk of becoming infected compared to older people. We identified two other persistent myths: 27% thought that coronavirus was a punishment from god and 13% thought it could not spread in hot places.
Based on our findings, we recommend that the Kenyan government continue its public education campaigns, with a focus on:
Clarifying that everyone can be infected with COVID-19 and pass on the virus to others, even if they themselves are not at high risk from severe illness.
Recognise that people are starting to be flooded with information on COVID-19 from all sources. This suggests that messaging can be refocused toward accurate prevention measures and accessing social protection.
Given the high rates of people forgoing food, and experiencing a complete or partial loss of income, assistance must be provided so as to avoid a secondary humanitarian crisis. It is particularly important that assistance gets into the hands of women to help them cope with these challenges.
Current assistance efforts are reaching less than 10% of the participants and should be ramped up in a coordinated way.
Kenya is facing a double burden of communicable and non-communicable diseases. Clustering of infections (such as HIV or TB) and noncommunicable diseases such as diabetes or hypertension is now common. This is putting pressure on the overstretched healthcare system.
In spite of this, many individuals with noncommunicable diseases remain undiagnosed for a number of reasons. These include unfamiliarity with symptoms, lack of testing equipment, and costs associated with the tests.
Recent statistics show that just over half a million adults were living with diabetes in Kenya in 2019. About 40% were unaware of their condition. Deaths from cancer are estimated at 7% while cardiovascular diseases account for 13%.
Overall, almost half of hospital admissions and about 55% of deaths in Kenya are associated with noncommunicable diseases.
This leaves countries like Kenya in a particularly vulnerable position when it comes to the severity of COVID-19. Globally, evidence shows people with underlying medical conditions such as cardiovascular disease, hypertension, diabetes or cancers are at a higher risk of COVID-19.
Is the health system in Kenya prepared?
Even before the COVID-19 pandemic reached Kenya, access to chronic care, especially for noncommunicable diseases, was challenging. This is worse for patients with more than one chronic disease.
Kenya’s health system is fragmented and largely designed to manage individual diseases rather than managing patients with multiple diseases. This is partly due to health system challenges such as staff shortages, inadequate or dysfunctional medical equipment, drug stock-outs and unskilled providers.
Unlike HIV, tuberculosis and malaria, access to care for most noncommunicable diseases such as diabetes is a major problem especially among the poor. Findings from our study at Mbagathi district hospital in Nairobi revealed some of these challenges.
A 52-year-old female patient said:
My HIV/AIDS care is provided free of charge but other diseases such as diabetes I pay for.
Another 58-year-old male patient said:
Every time I use KSh.1500 (US$15); consultation fee is KSh.300 ($3); I buy drugs for three months and that costs KSh.300 ($3).
During the COVID-19 pandemic, access to care may be even more difficult due to overwhelmed health systems, lockdown and curfews as well as fear of infections. Currently, preparations are being made to prevent or manage COVID-19 cases. But little is said about protocols to manage patients with chronic conditions.
It’s important to strengthen the healthcare system in Kenya to offer integrated care that addresses not only the COVID-19 pandemic but also chronic illnesses.
Management of COVID-19 should take account of other conditions. The current funding such as the $50 million provided by the World Bank should provide horizontal treatment and care. It should address all conditions rather than only prioritising COVID-19 cases.
Integrating care means that individuals could get access to testing and medical care for COVID-19 as well as other conditions such as diabetes or hypertension.
The Kenyan government must also provide healthcare workers with adequate personal protective equipment and address staff shortages by hiring more unemployed doctors and nurses.
And healthcare providers with chronic conditions must be relieved from being at the frontline in managing COVID-19 cases. If this is not possible, providers must be well protected to avoid being infected.
Collaborating with communities and local administrations will help in reporting and tracking cases or deaths, and citizens who defy government laws. Community health workers can sensitise community members and individuals at risk of COVID-19 on preventive measures.
Finally, the police force in Kenya should be made aware that, even during the COVID-19 pandemic, patients with chronic diseases need constant engagement with hospitals. Lockdowns or curfew measures should be sensitive to these populations.
Econet Wireless hiked data prices by up to 225 percent overnight Tuesday – sparking anger from hard-up Zimbabweans.
The increase in data costs could not have come at a worse time for Econet customers who are in the middle of a coronavirus-induced lockdown that has forced many to conduct business online, including universities and private schools.
There was no explanation for the sharp price increase, but in a letter to its suppliers on April 20, Econet said it was experiencing "difficult trading conditions" occasioned by a "harsh economic environment and the compounded effects of the Covid-19 pandemic."
"As Econet, we operate in a regulated industry where our tariffs are significantly trailing the upward movement in our operational costs, threatening the viability of our business," wrote Econet chief supply chain officer, Sharon Marufu, in the memo.
"We, therefore, need to take drastic measures now to safeguard the business and ensure we remain viable so that we are able to continue offering our services to our customers and to retain our suppliers."
Ironically, Econet was asking its suppliers to slash their prices by 20 percent. The suppliers targeted in the memo included companies providing fuel, trucks, shop space for Econet's retail outlets, and land for base stations.
Zimbabweans reacted with anger to the latest increase on social media, and the hashtag #EconetMustFall was trending on Tuesday morning.
"Everyone is depending on data for work and school and you just chock-slam us with a Z$1,300. Nonsense. Adjust down," one Econet customer wrote on Twitter, quoting the new price of the monthly ‘Private Wifi' which went up from Z$400 for 25GB.
"Lack of serious competition enables Econet to do as they please. The barriers to entry in the telecommunications industry means that we are doomed for a long, long while as consumers and we can't do anything about it," added Paul Nyabando on Twitter.
The popular Private Wifi bundle also sees 50GB go up to Z$2,000 – more than a third of a doctor's salary.
Econet customers also complained that the price increase was effected before midnight, between 10 and 11PM – denying many a chance to buy data at the old prices.
Last month, the Zimbabwe government agreed with bakers, millers and other businesses to cut the prices of basic goods, including bread and sugar, to levels before the country entered a coronavirus lockdown on March 30 amid soaring inflation.
Annual inflation has hit 676.39 percent, one of the highest rates in the world, as a currency that was re-introduced last year weakens amid acute shortages of foreign currency, food and hospitals short of medicines.
Vice President Kembo Mohadi said price increases seen since March 30 were "speculative and unjustified."
Mobile phone companies are regulated by the Postal and Telecommunications Regulatory Authority (POTRAZ), which must approve any price increase.
South Africa on Wednesday confirmed that Madagascar had requested assistance with scientific research on Artemisia – the herb used in the production of COVID-Organics.
Addressing the issue, Health Minister Zweli Mkhize said South Africa had agreed that its scientists will only assist with analysis of the herb.
“We received a call from the government of Madagascar, who asked for help with scientific research. Our scientists would be able to assist with this research. We will only get involved in a scientific analysis of the herb. We are not at that point yet,” Mkhize tweeted.
The now controversial herb has been donated by the Malagasy government to a number of African countries amongst them: Equatorial Guinea, Republic of Congo and Guinea-Bissau – the latter received a consignment meant for the ECOWAS region.
The African Union, AU, have confirmed that they are in talks with Madagascar over COVID-Organics, the island nation’s purported herbal cure for COVID-19.
A May 4 statement by the AU said it was in contact with Antananarivo “through its embassy in Addis Ababa, with a view to obtain technical data regarding the safety and efficiency of a herbal remedy, recently announced by Madagascar for the reported prevention and treatment of COVID19.”
AU and Malagasy diplomats have held meetings in Addis Ababa with the view to getting necessary information regarding the remedy.
“Once furnished with the details, the Union, through the Africa Centres for Disease Control and Prevention (Africa CDC), will review the scientific data gathered so far on the safety and efficacy of the COVID-19 Organics.
“This review will be based on global technical and ethical norms to garner the necessary scientific evidence regarding the performance of the tonic,” an AU statement further disclosed.
Meanwhile, the World Health Organization, WHO; have reiterated its caution against people putting their faith in herbal remedies that have not been scientifically tested.
In a statement, WHO said despite supporting all efforts – including traditional medicines – in search for treatments, it was important that any purported treatments be thoroughly tested.
In his last address, President Rajoelina said Madagascar was building a factory to scale up production. He also said the cure was to undergo clinical trials and that aside the drinks, injection options were being pursued. Over half-dozen African countries have expressed interest in it.
Credit: VILLAGE REPORTER