Social and Legal aspects of Dr.One

A solution like Dr.One could really help for our remote areas.
High ranking GHS official

The impact of Dr.One in Ghana

The impact on health indicators of adding Dr.One to the mix of “last mile” delivery vehicles is difficult to predict. In addition to having timely availability of medication, aspects such as sufficiently trained staff, healthcare seeking behavior and hygiene are also crucial. The actual impact of Dr.One can only be estimated by measuring the effects of Dr.One operations for a certain period of time The following questions relating to the impact of Dr.One have been addressed during the Proof of Concept:

  • Is implementation of Dr.One services in line with the Ghana national strategy?

    This question can be answered positively. The Dr.One concept focuses on the lowest level of health care and therewith strengthens the Primary Care Concept, which is a common strategy in many African countries. Moreover, the “Health Sector Medium Term Development Plan 2014-2017” states that expanded community based health services are seen as the strategy for achieving universal access to health.

  • Is Dr.One a solution for high-priority problems in remote/hard to reach areas?

    This question can also be answered positively. Based on information retrieved by the Ghana Living Standards Survey from chiefs, elders and opinion leaders from rural communities in rural areas, approximately 63% of the communities in the Upper East Region mention the lack of adequate facilities and the distance to health facilities as their major problems for health care delivery.
    Approximately 68% of the communities mention that the community can only be reached part of the year by public transport. Dr.One services operate independent of road infrastructure and can deliver (emergency) medication and commodities when there are no other options. The focus of Dr.One is on facilitating care at the community level, at the local health facility that is staffed by a Community Health Worker or a nurse. The local health facility is where a pregnant woman with complications will most likely turn to in case of an emergency. When the roads are impassable and an ambulance is not available, Dr.One might be the only option to send required emergency medication to a local health facility.

  • How many lives can be saved/improved when Dr.One services are added to the transportation mix?

    This question is difficult to answer due to lack of detailed data. For each use case scenario the lives that might be saved has been determined by using historical data. Although the factor transportation was of importance to these cases, it is not possible to guarantee that the cases would have ended differently when Dr.One services would have been available. However, currently a substantial percentage of medication that is most often transported by motorbikes reaches the patients too late or not at all.

The health indicators of the Upper East region are better than those in several other regions. It is plausible that implementing a Dr.One in a more challenged region will result in a higher impact.

Acceptance of Dr.One

From the lowest till the highest level of personnel at the various Dr.One stakeholders, the Dr.One concept generated a positive response. All persons in Ghana that were interviewed on Dr.One, and especially in the Upper East Region, display an open and welcoming attitude for the innovative idea of the Dr.One concept. Several persons indicate that they are used to simply give new things a try, and if something doesn’t work, the idea is then to adapt it until it does work, or to try an alternative that might work.
Literature studies on the acceptance of drone technology in the western world, and on the acceptance of new technologies in Africa also provides valuable insights for the acceptance of Dr.One. As learned from input at the higher management in health care and at the political levels, it is very important to find broad support; at the political level, within the Ministry of Health, at the regional and at the community level. Transparent and reliable communications on the use of Dr.One will be very important.
Building customer awareness and informing the public on the positive aspects of Dr.One are all part of the acceptance strategy, when Dr.One is to be introduced within the Ghana Health Services.

In order for the Dr.One concept to become successful, the system has to be accepted by its users and by the context that it will be used in. In order to assess the acceptance of the concept as a whole and the operations with small Unmanned Aircraft Systems specifically, several interviews on the acceptance of Dr.One were held in Ghana.

Applicable Rules and Regulations

The most relevant rules and regulations for Dr.One operations in Ghana lie primarily within the fields of health care, aviation and national security.
With respect to health care rules and regulations, the Ghana Health Services (GHS) Code of Code of Ethics applies.
With respect to aviation, the Ghana Civil Aviation Authority (GCAA) has provided Dr.One with a set of rules that has to be adhered to.
For reasons of national security the regional and local authorities, the regional and local police and the immigration services need to be asked for permission.

Visit of the Dr.One Team at the Ghana CAA