Innovative Cancer Care in Uganda: An Automated Voice Call System
In Uganda, where many cancer patients often travel hundreds of kilometers for treatment, there’s a groundbreaking development aimed at bridging the gap in continuous patient monitoring. An automated voice call system, developed by the Uganda Cancer Institute (UCI), is transforming the way patients are supported post-treatment. This system calls patients after their treatments to check for side effects and alerts medical personnel if early interventions are needed.
Concept and Implementation
Recently, Johnblack Kabukye, a medical doctor and informatician at UCI, presented this innovative approach at the World Cancer Congress in Hong Kong. By embracing technology, UCI aims to circumvent the logistical hurdles patients face in rural areas, where returning to the hospital can be immensely challenging.
Initially, UCI set up call centers enabling patients to receive cancer-related information in seven different languages. The next step involved creating a fully automated system capable of reaching out to patients without human intervention. “When patients complete their treatment, they can experience various side effects like vomiting, pain, and nausea,” explained Kabukye. “Previously, we only found out about these issues when they returned three weeks later, or worse, when they didn’t come back at all.”
The process begins when nurses gather the patients’ phone numbers, preferred languages, and the times when they would like to receive calls. After treatment, the automated system initiates calls, asking patients a series of pre-recorded questions. “Patients respond by choosing one of four options,” Kabukye noted, emphasizing the simplicity and accessibility of the system – there’s no need for the patient to have a smartphone or even internet access.
Accessibility and Cost-Effectiveness
The system is based on Interactive Voice Response (IVR) technology, making it entirely free for patients, as the hospital incurs the expenses by initiating the calls. This aspect is crucial in a country like Uganda, where many cancer patients face significant economic hardships and rely on out-of-pocket payments for healthcare.
The pilot program initially supported around 100 patients with blood cancers, leading to approximately 700 automated calls per week. Remarkably, in 18 cases, patients were instructed to return to the hospital earlier than scheduled due to serious side effects reported through the automated system. Funded by a $50,000 grant from the International Cancer Foundation, this system also serves an educational purpose, raising awareness about cancer risks and treatments.
Future Expansion Plans
UCI currently operates the automated call system through six channels, with ambitions to scale up to 100 channels to accommodate more patients and incorporate additional languages. Scaling up, however, will require further funding for airtime and partnership opportunities with telecommunications companies. “We hope to prevent patients from being left without follow-up,” Kabukye asserted.
Given Uganda’s ongoing issues with power instability, Kabukye’s team is also exploring the use of solar power to maintain the system, enhancing its sustainability and environmental responsibility.
Real-Life Experiences and Impact
Getrude Nakigudde, a breast cancer survivor and advocate, emphasizes the significance of free solutions like the IVR system, particularly for patients in low-income settings. “It’s a game-changer because the patient doesn’t spend on anything,” she shared. Reflecting on her own experiences as a patient two decades ago, Nakigudde noted the tragic outcomes faced by many due to inadequate follow-up systems. “Most cancer patients are poor. Such innovations are made for us and benefit us,” she added.
The importance of government support in facilitating access to such innovative technologies is underscored by Nakigudde’s call for sustainable financing models to ensure these solutions reach more patients.
Broader Context: Rising Cancer Trends
The need for innovations like the automated voice call system is somewhat dire, especially considering global trends in cancer incidence. During the Congress, data highlighted that cancer cases are rising significantly, particularly in low-income countries. The World Health Organization and International Agency for Research on Cancer reported 20.6 million new cases and nearly 10 million deaths in 2024, with projections suggesting that incidence could reach nearly 35 million by 2050.
Daniel Kyabayinze, the director of public health at Uganda’s Ministry of Health, expressed optimism about the future of the automated system at UCI. “Cancer is on the rise in Uganda, and this project is timely,” he noted. Kyabayinze mentioned the potential for this technology to save costs for both patients and the government by reducing the need for additional staffing.
Conclusion: A Model for the Future
As the Uganda Cancer Institute continues to adapt the automated call system for other types of cancer, such as breast cancer, the possibilities for its application seem vast. “We can follow up on patients anytime and any day at no cost to them,” emphasized Kabukye, hinting at future expansions beyond Uganda to other African nations.
With healthcare systems facing unprecedented challenges, Uganda’s approach to cancer care represents an inspiring model, showcasing how technology can improve patient outcomes even in resource-limited settings.