In the 21st century we are witnessing a digital revolution. Big Tech and other digital companies quickly gained momentum, overwhelming us with innovations like: AI, VR and AR, Machine Learning, 5G, Quantum Computing, Blockchain (and other obscure terms). It seems like a very tecky “silicon valley clique” has embarked on a SpaceX Starship, rushing at supersonic speeds towards a utopian future. In the meantime, 41% of our planet population, if given a laptop, would, probably, use it as a nutcracker. The problem of digital division becomes a real challenge. It is not just a matter of personal habits and preferences of the older generation anymore, but a way of systemic exclusion from digital services of whole groups/societies. Social issues are complex subjects. Thus, I suggest we start tackling it with the health department. For this purpose, I am happy to introduce Deborah Maufi, who is a health project manager with work experience in Africa and Europe.
Dear Deborah, one of your professional objectives is expanding digital health equity. It’s quite an intricate term, so let’s break it into small pieces. What is health equity and how is it combined with digitalization?
Health equity is about ensuring that each person has the opportunity to reach his full health potential, regardless of his race, gender or socio-economic background. These factors influence the kind of care that one needs. When we bring digitalization into equation, we intend to make healthcare more effective and efficient. That’s why it is important to make sure that this digital complement actually helps and enhances access to healthcare, but does not create a barrier.
So, equality means giving everyone the same thing, whereas equity is about giving people what they need. Though, we’re used to think that people need the same things regardless of their background and not depending on it. Could you elaborate more on this idea?
For instance, there are some diseases that affect more the black than the white population and, in many areas, black people are a minority. The problem is that the healthcare system is tailored around the health indicators of the majority. Take the Body Mass Index (BMI), which is used to assess a person’s overall health. The “norm” ranges from 18.5 to 24.9, but it does not consider a person’s gender or ethnicity. A large 2003 study has shown that higher BMIs are more optimal for Black people, while lower BMIs are more common for Asians. Consequently, using a universal index for assessing the health of people of different races might lead to inequities.
Another example would be developing countries. If we are to bring them a complex and expensive tool, we are not going to help them, but rather create an additional barrier accessing a certain health service. Maybe they can’t afford maintaining the tool or even don’t know how to use it. It is essential to make sure that innovative digital solutions are suited for them. That’s why I am advocating for digital health literacy, trying to bridge that gap between solutions and an effective use of those solutions.
How do you exactly tackle these problems?
I founded a platform, Realize Health Equity (RHE), to promote health equity through education, partnerships and community engagement. I am also the Ambassador of HIMSS, a global health equity network, where I collaborate with members from diverse communities, to share insights, best practices and resources through virtual and in-person education events. This also includes speaking at conferences, publishing articles, collaborating with innovators and trying to find optimal solutions that will actually be adopted by the end user. An important part of this is working on implementation strategies, which is about diversifying the healthcare workforce and also making it inclusive.
I am very curious to know what made you pursue the mission of promoting health equity in the first place…
(Chuckling)…You know, I’m from Tanzania and when I grew up, I realized there’s quite a big gap between the rich and the poor. Only the rich had access to healthcare benefits and insurance. But when I moved to the Netherlands, I was surprised to notice that it was not a privilege, but a healthcare system that included everyone. That was the point when I understood that healthcare is a human right and thought that it would be a good idea to bring the problem of health inequity to light. It’s going to be a long journey, but we have to start somewhere. If we want to see change tomorrow, we have to start today.
on picture: Geta Rasciuc - founder & CEO of Babymoon CARE & Deborah Maufi MD / MBA, Chief Medical Officer at Babymoon CARE during October 2020 Babymoon Catwalk
You are also a health project manager and a chief medical officer at Babymoon Care. How do you help this particular business?
My role at Babymoon is to develop and implement health care strategies for baby wearing. Ordinary baby-carriers are just a means of transport, but we believe that they are much more than that. Think about premature babies that are kept in incubators. Babymoon’s solutions allow an infant to achieve healthier outcomes psychically, emotionally and socially through the skin-to-skin contact with a parent, which is also a more cost-effective tool that can replace incubators (in less severe cases). This also benefits developing countries, which can’t afford incubators, but can easily adopt baby-carriers. There is so much evidence about it. The idea originated in Colombia and has been there for years, but only now the World Health Organization actually recommends it as a cost-effective solution for premature babies.
It is wonderful how a bit of research does not lead to a greater digitalization, but encourages the return to our natural state
Indeed. We moved to a digital world and forgot that the simple things are the best. Now we are seeking new partnerships in new cultural contexts to implement this solution.
What other business can benefit from your expertise?
Hospitals, Healthcare Facilities, Digital Transformation Agencies, policy makers, Community-Based Organizations (CBOs), but also innovators.
Moldova is also a developing country, so I was wondering what systematic ways of treating the problem of digital health inequity you would suggest? How to involve the state?
I think the key is meaningful advocacy to relevant stakeholders. We need to find win-win situations for both parties: the community and the policy makers themselves. I tailor my message differently for every stakeholder, finding solutions that will benefit them and the community at the same time. This makes it easier for them do adopt the solutions that I am proposing. Let’s take the example of a developer of a self-management health app. What the developer needs to understand is that there are many factors that will influence the experience of the end-user. My work is to research the cultural/religious/health/economic differences and adjust the value propositions to different target-groups. This leads to a shorter customer adoption process, a better service for the end-user and also benefits the health system in general, reducing the burden on hospitals and increasing the socioeconomic status of the users. For these purposes, I am using the HIMSS platform, which has the right audience, with over 100.000 members from all levels.
Could you also share with us your most significant achievements in the field of health equity?
I recently got nominated for HIMSS Future50 Community, in the category of digital health leaders who make significant contributions to digital health globally. The goal of this community is to drive digital transformation on a global level.
My warm congratulations, Deborah! And, last but not least, I would like to ask for an advice. What should we prepare for and how can anyone contribute personally to achieving digital health equity?
Everyone should definitely prepare for the digital transformation, because it’s already happening. This starts from encouraging young people from different cultures to discover the field of science, medicine and tech, hereby making the workforce more diverse and inclusive. I’ll put it into simple words and state that „diversity is being invited to the party but inclusion is being asked to dance”.
It starts from you showing your grandmother how to use a self-care app at home and healthcare workers learning digital skills, to innovators creating user-friendly apps and the state making policies that increase digital literacy, including digital skills into the curriculum. Everyone has a role to play. That’s as simple as that.
interview by Mihaela Dima via pavelzingan.md