Unending reign of frivolity and 2018 budget fears

Minister of Budget and National Planning, Udo Udoma

The word “frivolous” implies something that has no serious purpose or value, and in the context of the national budget, it becomes anything that has no developmental effect, especially in this period of high borrowing aimed at delivering the economy from the shackles of inactivity.

Yearly, the menace and scam has been perpetrated with inexplicable terms, repetitions, and mind boggling sums cutting across from the agencies to the Presidency. Sometimes, some of the expenditure proposals cannot be supported by any high level national plan or policy.

These frivolities ignore the pressing problems and challenges, while providing for the fancy, whims and caprices of the budget crafters. The inappropriate provisions also are not suitable or proper, given the present circumstances. They are short of policy goals declared by the government.

Unclear provisions are deliberately crafted by Ministries, Departments and Agencies (MDAs), to deceive the uninitiated and sail through given the volume of the document, as many who would have shown interest are discouraged ab initio by numerous pages made of the national plan.

Already, about N219.4billion has been identified as resources to be saved and reprogrammed by the National Assembly, if only the lawmakers will do the needful for the common good.

The Lead Director, Centre for Social Justice (CSJ), Eze Onyekpere, while speaking with The Guardian, said the strategy is made to confuse, and most times, the provisions do not have any fixed meaning, without clear activities, services, goods, construction and deliverables that any reasonable person can understand.

“In the age of ‘Buy Made in Nigeria’, most MDAs are insistent on buying foreign products and brands, and even have the temerity to put the foreign brands in the budget when there are equally good locally made alternatives. This is more pronounced in the quest for foreign SUVs,” he said.

For the BudgIT, a civic organisation that applies technology to intersect citizen engagement with institutional improvement, to facilitate societal change, the 2018 plan is masked with several opaque administrative items as capital projects just to shore up the percentage of capital component.

In the 2018 budget proposal, there are huge provisions for cleaning and fumigation and subscription to professional bodies, which are obviously bogus, while the yearly ritual of buying computers and computer software remained large in almost all the government agencies.

Specifically, from the Office of the National Security Adviser, over N1.14billion was proposed for cleaning and fumigation services. This sounds outrages for a mention, and in the usual budget process, it will go through without further inquisition to know how many “estates” are involved in this sanitation and “chemical bath”.

Similarly, the Directorate of State Security Service came up with a N2.2billion proposal tagged, “Social Media Mining Suite.” These proposals need further explanation and interrogation to determine the appropriateness and purpose of this vote.

These raise more posers: Should the government be buying computers and software every year? What happened to previously acquired computers and software? At the State House, Presidential Villa, there are large requests for yearly maintenance, repairs, and rehabilitation far in excess of the reasonable needs of the Villa. This tradition is followed by a number of MDAs.

The State House, Lagos Liaison Office, put in a request tagged Maintenance of Office Building/Residential Quarters for N31million and another, “Rehabilitation/Repairs of Office Buildings for N145.8million. What is the difference between the two provisions by the agency?

It is regrettable that a budget head like Service Wide Vote still remains in the national fiscal plan years after the Oronsaye Committee instituted by the same Federal Government declared it illegal and wasteful. Since then, its appropriations have not been below N300billion yearly, and there has not been any physical evidence of its accomplishments, even under the current administration.

Out of this provision for 2018, an item tagged, National Planning Commission (Infrastructure Master Plan) will get N1.2billion. This is despite the fact that there is a full ministry with the same name. What part of the Infrastructure Master Plan is to be implemented with this vote? This is a regular vote every year and lawmakers should call NPC to give an account of what they did with the vote in the last two years.

Onyekpere noted that “The huge vote of N51.75billion for social development goals (SDGs) calls for vigilance and proper oversight on the part of the legislature after approval. For over 13 years, this type of vote had been approved without Nigerians getting value and improvement in their lives for the large sums of money.

“Some MDAs simply played on words like ‘empowerment’, ‘capacity building’ and ‘human capital development’ to request for large sums of money. But the word empowerment is devoid of specificity. It is hanging and must be contextualised. Also, capacity building ought to be done within the context of developing specific competencies. Again, there are many requests for research and development, which are hanging and not specifically tied to any deliverables,” he added.

Office of the Secretary to the Government of the Federation repeated the fumigation conundrum for N106.8million, and added “Subscription to Professional Bodies”, N208million; and “Computer Software Acquisition” for N170million. How large is this office? How many persons are deployed in this office that pays annual dues and at what rate? What happened to previously acquired software, which is procured yearly?

The Programme Officer, Environment, CSJ, Martins Eke, observed that the proposals of the Federal Ministry of Agriculture and Rural Development are suffused with large sums of money without specifics and details, and if not properly clarified, Nigerians will be in the dark as to what these sums of money are voted for.

“ Promotion and development of rice value chain for instance, states nothing about the activities, goods and services to be delivered with billions of Naira. This means that citizens cannot be reasonably expected to monitor projects they do not know about. This is not a good way to craft a budget. Transparency, which leads to accountability, is imperative to make these proposals reasonable.

“Nigeria is still planning to build a nuclear power plant, when we lack the capacity to manage it. This is coming at a time major world powers are decommissioning their nuclear power plants. It makes no sense, and it is suicidal to continue this quest,” he argued.

The Communications Lead at BudgIT, Abiola Afolabi, said about 42.9 per cent of Capital Projects in the 2018 proposed budget only looked like it, but has no direct impact on citizens.

Corroborating a recent analysis by BudgIT, he told The Guardian that approximately N744.48billion of the N2.65trillion capital allocation will go into administrative items, which include the procurement of cars, retrofitting of government offices, trainings, consultancies, purchase of furniture, and computers and so on.

Given that the funds marked for capital expenditure will be largely borrowed (as highlighted in the proposed 2018 budget), it is disheartening to discover that most line items therein show a great disconnect from the developmental goals of government, as stated in its Economic Recovery and Growth Plan (ERGP).

The deficit in the plan is estimated at N2.005trillion – 23 per cent of the overall expenditure, and 30 per cent of the retained revenue and to be financed mainly by borrowing of about N1.699trillion from external and domestic sources. This will further add to our already high debt profile and increase provisions for debt repayment and servicing in subsequent years. The balance of N306billion is to be financed from proceeds of the privatisation of some non-oil assets by the Bureau of Public Enterprises.

“In a pre-election year, we would have expected that capital projects will be solely devoted to projects with direct developmental impact on the larger population. We have seen several items included in the capital budget that should ordinarily have been excluded given the tight fiscal condition and meagre economic growth. Most of the administrative capital items as shown in our research analysis will benefit less than one per cent of its populace – politicians and civil servants.

“Our scope of developmental capital projects as urgently needed should include the acquisition, upgrading, construction and maintaining of physical assets such as hospital, schools, roads, railways, power plants, street lights, and boreholes among others. In contrast, administrative capital items are projects that cannot be easily accessed by the general public and have very little or no developmental impact on the population.

“We also notice the fragmentation of capital items, as 94.7 per cent of the 9,331 line capital items in the 2018 proposed budget have monetary values below N500million each, but accompanied with vague descriptions that will prove difficult to monitor or track in physical and auditing terms,” he said.

Presently, civil society groups are raising alarm on the above subject matter, as further breakdown of the fiscal plan showed that only 26 per cent of capital allocations to the ministries are trackable, and/or can be directly linked to the written, medium-term aspirations of the government as highlighted in the Economic Recovery and Growth Plan. They include Health, Education, Agriculture, Transportation, Niger Delta, Water Resources, Science, Works, Power and Housing.

There is also the concern that the Medium Term Expenditure Framework 2018-2020 (MTEF), has not been approved and as such, could not have been the basis for the preparation of the 2018 budget as required by Section 18 of the Fiscal Responsibility Act (FRA). The available MTEF is still a proposal that is subject to legislative alteration before approval.

Section 18 of the FRA states: “Notwithstanding anything to the contrary contained in this Act or any other law, the Medium-Term Expenditure Framework shall – (1) be the basis for the preparation of the estimates of revenue and expenditure required to be prepared and laid before the National Assembly under section 81 (1) of the Constitution. (2) The sectoral and compositional distribution of the estimates of expenditure referred to in subsection (1) of this section shall be consistent with the medium-term developmental priorities set out in the Medium-Term Expenditure Framework”.

Across the board, a significant amount of capital allocated in the 2018 budget falls under certain generically-named items, which have no detailed description, and do not communicate the number of beneficiaries of such items.

Over the years, it is common to find the following entries in the budget of every government MDAs: welfare packages, sporting activities, drugs and medical supplies, medical expenses, software acquisition, monitoring and evaluation, budget preparation, access to credit, food and agricultural policies, and international training.

Afolabi noted that “This system of budgeting with ‘one-liners’ without details, gives room for financial indiscretion, and the potential abuse of funds. It is antithetical to what the government continually professes to stand for.

“Most crucial is that the Federal Government is yet to come out plainly on the amounts spent on capital items in the 2016 and 2017 financial years. While the Ministry of Finance repeatedly claims a sum totalling N1.2 trillion has been released, the Budget Implementation Reports released by the Budget office of the Federation show otherwise.

“Overall, we believe that the 2018 budget proposal will need proper interrogation from all stakeholders and also important for the National Assembly and Executive to significantly reduce the administrative component of the budget, and direct funds towards improving education, health, and other critical infrastructure.”

Therefore, it is still not late for the lawmakers to dig deep for the details of these controversial issues, correct the anomalies, and conclude early, especially with regards to the touted new fiscal calendar. It is a matter of priority, acclaimed patriotism, transparency and accountability and good of the economy.

Nigeria: Between Obasanjo and Buhari - the Dangers, the Fear

 OPINION

By Jide Ajani

For two men whose ideas of Nigerian unity are poles apart, one vigorously into farming, and the other a herdsman with a ranch, Nigerians should watch it. Is Olusegun Obasanjo a strategic thinker or a hype-man? Is President Muhammadu Buhari a strong and effective person or an insensitive and ineffectual nepotic leader? These two issues stick to the core of recent developments in Nigeria regarding the President Buhari governance processes, outputs and outcomes, as well as last week's scathing special press statement issued in typical character, by former President Obasanjo. However, between the hype-man and the alleged ineffectual leader, Nigerians need to know the workings of the mind of both men of power. Interestingly, both have age and authority on their sides and, therefore, a frontal, no-holds-barred revelation of the workings of the innermost recesses of these individuals cannot be openly engaged. Yet, this report will show that whereas Obasanjo spoke truth to power, his high degree of complicity in the serial mismanagement of Nigeria's governance process for decades remains legendary. The report will also attempt to show that President Buhari runs the risk of being recorded on the wrong side of history if he doesn't take urgent, concrete and unique steps to correct the plethora of manifest insensitive errors of omission and commission of his administration. Considering the personalities of both men, this latest tiff should encourage well-meaning Nigerians to intervene.

TWO MEN, TWO IDIOSYNCRASIES, ONE VISION

Obasanjo: In 1979, just after one of the executive meetings of the Unity Party of Nigeria, UPN, some concerned members of the then military junta, led by General Olusegun Obasanjo, employed back channels to reach the UPN leadership regarding the choice that had just been made by Chief Obafemi Awolowo. The latter had just picked Sir Philip Umeadi, of Igbo extraction, as his choice for running mate. Other reports had it that an attempt to pick an elder statesman from the North was deemed a waste of time as, according to a source who played a major role in the events of that era, "the North was not prepared to vote for Awolowo". Awo, as the UPN leader and presidential candidate for that year's general elections was fondly called, did not back down on the junta's request to drop Umeadi from the ticket. He contested the election with Umeadi; and lost. The circumstances which surrounded the outcome of the litigation against his co-contestant, Alhaji Usman Aliyu Shehu Shagari, at the Supreme Court, till date, is alleged, in some quarters, to have enjoyed a tacit support of Obasanjo's military government. Gleefully, Obasanjo handed over to Shagari that morning of October 1, 1979 at Tafawa Balewa Square, Race Course, Lagos. The Yoruba nation never forgot, nor forgave Obasanjo's perceived theft of the presidency. But here was a man who believed in the workability of a united Nigeria and, therefore, could not come to terms with a political party fielding a Yoruba and Igbo as presidential and vice presidential candidates, barely nine years after the civil war.

Buhari: In December, 2014, Buhari gave a speech after his election as the presidential candidate of the All Progressives Congress, APC. His words: "My nomination is not because I am better than any of the other contestants. I see it as a tribute and mark of confidence to carry the torch as we all join hands to rescue our dear country Nigeria, from those who have led us into the current state of insecurity, poverty, sectarian divide and hopelessness among our people. What I say today is for all Nigerians: Christian and Muslim, southern and northern, rich and poor, young and old, man and woman. We are all citizens of Nigeria. There is no dividing line among us that I care to honour. Either we advance as one or fail altogether."

One writer had observed Buhari's speech thus: "Consider the order of his words: Christian before Muslim, southern before northern and rich before poor.

"Buhari, who had been faulted as a Muslim extremist, chose to put Christians before his fellow Muslims. Said to be a northern irredentist, he chose to put his southern brethren before his northern compatriots and the former head of state, who has been hailed as a champion of the poor masses and a foe of the rich, in his speech, put the rich before his beloved poor supporters".

In concluding, Buhari had said, "My choice and my colleagues' choice and wish are that we progress together. Preserving the nation's future is a sacred obligation to all of us in this party. Leaders should be wholly committed to fulfilling this obligation otherwise they have no business being leaders. Sadly, the current administration does not believe in this obligation. By their actions they are leading us to calamity".

And in his inaugural speech on May 29, 2015, the new President declared that he was "for everybody and for nobody".

Whereas Obasanjo enjoys the confidence and support of the international community as a statesman and continues to be engaged on the global stage, the former President has an understanding of Nigeria's unity from the prism which some have continued to describe as an unfortunate standpoint of first being seen as pro-Nigeria, before his Yoruba origin.

Conversely, President Buhari places the primacy of his roots, the Fulani, on the same, if not higher, pedestal than other Nigerians.

Like the late Yoruba sage once noted, you cannot claim to be Nigerian without first acknowledging that you are either a Yoruba man or an Igbo or Hausa. Therefore, Buhari cannot be faulted for showing preference to his people to the extent that he does not cross the boundaries of equity and fairness. But many can see that he has crossed many lines.

In the wake of the letter written by Obasanjo last week, a national newspaper had, in its editorial, observed the following, "This government seems to be alarmingly slow. Buhari set himself up for failure from the outset, ring-fencing his presidency with appointees, mostly from his part of the country, relatives and acolytes. Without regard for the ethnic and sectarian diversity of the country, he loaded the security apparatus preponderantly with northerners and filled vacancies in departments and agencies with northerners. Of some top 20 security positions, at least 17 are held by northerners. Never in the history of this country has a leader demonstrated such clannishness and insensitivity. A sharp cleavage is tearing the country apart."

This was exactly the point Obasanjo clearly referred to in his letter.

Continuing, the editorial made the distinction that "refraining from plunder is not the only test of integrity: fairness and equity, fulfilment of promises and zero tolerance for errant aides and associates also matter. Buhari fails the integrity test by his benevolent treatment of Fulani terrorists, who are on the rampage nationwide; his continued retention of appointees who smuggled in a wanted pension thief, and who, at various times, have hobbled the anti-corruption war. This indicates that things have changed in worrying ways. Buhari's record of failed electoral promises such as one to break up the Nigerian National Petroleum Corporation, whose indiscretions have saddled us with yet another round of petrol scarcity, beggars belief."

BLIND FAITH IN KEEPING NIGERIA ONE

Both men, rather queerly, have this abiding faith in the indissolubility of the Nigerian nation. They have supporters who believe in same.

However, the point of divergence is the near-myopic, Mephistophelean insistence that the structure of the Nigerian state, as it is presently put up, does not really need restructuring. This suggests an unthinking thesis for, contemporary Nigeria continues to wobble on account of the jagged structure which, for years, has been identified as a major source of underdevelopment.

When former President Goodluck Jonathan began driving down the road of ethnicity, Obasanjo was quick to charge at him, insisting such was dangerous for Nigeria's unity. He has done the same with Buhari in his latest letter. Yet, the same Obasanjo as a PDP member, lampooned his party chairman, Audu Ogbeh, who, by the way, is the Minister of Agriculture, in today's APC administration, when the latter attempted to prick Obasanjo's conscience about the shambling polity that Obasanjo's governance process was producing at that time.

There are unverified claims in some quarters that some of the appointments by this administration that have caused so much angst in the land, because of the lopsided nature, were done by some other people inside Aso Rock Presidential Villa. If true, that, in itself, is an indictment of President Buhari and his governance processes - although his January 1, 2018 speech to the nation pointed at processes as being Nigeria's problem and not the structure. But his own process too, considering the discounts, may not be tidy enough.

Whereas Obasanjo works very hard - and even tries to make profit of it - to promote and uplift others outside his Yoruba stock, even carrying it to a near-ridiculous extent of denunciation, President Buhari makes no bones about his heritage and its promotion. That is why there is a preponderance of people not just from the North, but from his Katsina State and particularly Daura, in his government.

They (Buhari and Obasanjo) both claim to be (and indeed they are) patriots, but their patriotism derives from different sources. While Obasanjo, most times, seeks justification from and mostly kow-tows to the North to prove his patriotism, PMB looks inward, especially to his Fulani heritage, and corals other Nigerians to justify why the nation must remain one. Unfortunately for Obasanjo, some of his Yoruba people perceive him as an outcast, and some of his children don't see eye to eye with him. Buhari's Fulani people see him as a liberator - and, indeed, he is, no matter what anybody says.

THE DANGER, THE FEARS

With a following that is at once fanatical about President Buhari; and an Obasanjo's voice that is strong in the international community, both men typify the proverbial two elephants set to do battle.

Buhari, in the estimation of the young, uneducated (and even some educated) northerners, is a messiah that is misunderstood but for whom they are ready to do anything - just anything. Therefore, the prospects of a Buhari seeking a second term and losing at the ballot, come with the dangerous possibility of another violent uprising as was the case in 2011, because his people believe that he can never lose a free and fair election in the North. Since 2003, 2007, 2011, he has always garnered more votes than his opponents, while not doing well at all in the South. Yet, Obasanjo, known for his swashbuckling push whenever he makes such pronouncements as was made last week, never holds back. In fact, to have put himself in the middle of the Coalition for Nigeria, CN, suggests an agenda that has already been rehearsed and well-thought out.

Obasanjo, who once said any Nigerian that is "well born and well-bred and well brought up, will respect two things, among others: age and authority - and I have them both"- has never been known to be a man who shies away from being heard.

Unfortunately, this time, Obasanjo must bear the burden of the reality that his words will not access the consciousness of those driving the process that has rendered the Buhari administration discombobulate and shambolic. What this means is that Obasanjo, also referred to derisively as the EBORA-OWU (the spirit from Owu), will not back-off. He will dig-in and either say more, or galvanise public opinion.

Take, for instance, the issue of access. Did Obasanjo attempt to use official or backdoor channels to reach the President and ventilate some of the issues he publicly talked about? If he did, was he turned down or pooh-poohed? If not, why did he opt to go public? Well, some believe that it is vintage Obasanjo. Remember, there are strong feelings in some quarters that Obasanjo supported Buhari in order to spite Jonathan and get him out of Aso Rock, not necessarily because of his interest in Nigeria; because had Jonathan danced to Obasanjo's tunes all the way, he wouldn't have abandoned him.

Buhari, on the other hand, in 2015, sought Aso Rock, because he was convinced to seek the office by some others, and, as a complementary endeavor, there was a need to rebalance the equation - after cumulative 14 years that the North had been out of power. Has he rebalanced the equation? Work-in-progress!

Sometimes, it is as if Obasanjo works so hard to get people to power, watch them flounder, abandon them and wait for their mistakes. It is also as if he does it so that he would still be seen as the best ever to have ruled. The editorial earlier quoted also noted that whereas President Buhari is "the chief host when Nigerians record accomplishments and the chief mourner when they are in distress, the Fulani herdsmen killings have brought impunity to a spectacular climax". It added, "But Buhari did not visit when 73 persons were slaughtered in Benue State, over 100 in Numan, Adamawa State, and 19 persons butchered in Rivers State on New Year's Day. Everywhere else, leaders share in the triumphs and grief of their people. Buhari only donned military fatigues to inaugurate an army battalion to combat cattle rustlers in Zamfara State, as if cattle are more precious than human lives".

This type of world view - even if it is mere perception - is dangerous in a polity of clashing interests.

Did Obasanjo need to speak out? Yes.

Has Buhari become this bad? Yes and no!

Because the political firmament is near-bare for now and even the birds flying about do not in any way present a veritable option, sans nepotism and insensitivity of this administration, things can still be put right should the famed owners of Nigeria decide to fully engage President Buhari and help him come to terms with the realities of a multi-ethnic, multi-religious, multi-interest Nigeria, and move Nigeria towards the progress and development which he promised and for which he amassed so much goodwill.

Nigeria

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Meet the 'backpack midwife' bringing healthcare for all

By Monty MunfordTechnology of Business reporter

• 23 January 2018

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Image copyrightMONTY MUNFORD

Image captionMidwife Margaret Wairimu Maina carries a backpack crammed with useful health monitoring tech

Call the midwife in Nairobi, Kenya, and you may receive a visit from someone like Margaret Wairimu Maina.

She sets off on foot looking something like an astronaut, carrying a backpack stuffed full of hi-tech gadgets designed to monitor a baby's health.

The pack includes a wind-up foetal doppler used for measuring the baby's heartbeat, a portable ultrasound screen, a life-light with matching solar panel, in-ear thermometers, and a range of other medical instruments related to pregnancy.

The gear has become crucial for her voluntary job as a community health worker.

Although the backpack weighs just 5kg (11lb) it's still a heavy load as she does her rounds twice a week, says Margaret. She is responsible for more than 120 households in the local area and manages to see up to 20 a day when she visits between noon and 4pm.

"I have two sons, aged five and 11," she says. "Both of my pregnancies were very OK with no complications because I started my ante-natal care visits after only two months, and I had a skilled attendant around for delivery."

Many other women in the country are not so lucky.

In Kenya, unlike other African countries such as Ethiopia, primary health care is not paid for by the government or local authority.

Margaret works out of the Kiambu Community Life Centre north of Nairobi, where voluntary health workers are the first point of contact for those seeking medical help.

Image copyrightPHILIPS

Image captionMany women in Kenya don't have any access to medical care

"In large parts of Africa, people like Margaret are unpaid volunteers who often lack formal training or even basic equipment to help them with their tasks," says Jasper Westerink, chief executive of Philips Africa, the firm that developed the backpack.

"For years, we have had strong focus on mother and child care in Africa."

Working with local government, Philips is developing a number of community life centres to support community health workers and midwives equipped with these hi-tech backpacks.

"Our ambition is to introduce this model throughout Africa to drastically improve access to primary care," says Mr Westerink.

Meanwhile, on the other side of Nairobi lies Kibera. It is the biggest slum in Africa and though officially home to 500,000 people, some estimate it might actually hold two million inhabitants.

Kibera is an open sewer with little or no sanitation - a random matrix of undulating roads and paths that ambulances cannot access.

In fact, the only thing close to an ambulance is an improvised wheelbarrow with a yellow siren attached to its handles. Patients are placed in the cart and the lucky ones are wheeled to the community health clinic.

But in the remote region of Mandera, on Kenya's north-eastern border between Somalia and Ethiopia, pregnant women don't even have the option of a wheelbarrow ambulance.

It takes two days to reach the area by road from Nairobi and the infant mortality rate here is one of the highest in the world with almost 4,000 maternal deaths per 100,000 births.

Image copyrightAFP

Image captionIn the remote parts of north-east Kenya often the only way to travel is by camel

Public transport is so expensive here that travelling by camel is the only option for pregnant women. It's not surprising that by the time they finally reach a doctor, they are not only in great danger of losing their unborn child, they are at great risk themselves.

A new clinic was established in the region last year through a partnership between the United Nations Population Fund (UNFPA), Mandera county's local government and Philips.

"Maternal and newborn health outcomes in Kenya's remote six counties contribute nearly 50% to all maternal deaths in Kenya and we want to stop that with centres such as these," says Dr Ademola Olajide of UNFPA.

The remoteness of these regions means that portable health monitoring technologies with mobile connectivity are proving invaluable to local volunteers, who can now access knowledge and advice from experts far away.

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For example, in Ghana, the Ghana Health Service and Novartis Foundation are co-operating to develop a nationwide "telemedicine" programme by 2019.

Community health workers can access specialists - doctors, nurses and midwives - through a 24-hour teleconsultation centre. It began as a pilot in a remote part of the Ashanti region in 2011, covering 30 communities of around 35,000 people.

Now Novartis says there are enough teleconsultation centres to serve the entire country.

In another example, Uganda's MamaOpe has developed a Smart Vest application for the diagnosis and continuous monitoring of pneumonia in young children. The disease can often be misdiagnosed as malaria.

Image copyrightNANA KOFI ACQUAH/NOVARTIS FOUNDATION

Image captionHealth workers in Ghana can access expert advice over the phone when helping patients

In a matter of minutes, the data collected is sent to doctors who can make a diagnosis quickly and cheaply.

And smartphones are being used a diagnostic tools in their own right, testing for hearing loss, for example.

• The 'invisible epidemic' afflicting millions globally

Plugged in to services such as IBM's supercomputer Watson, with its ability to absorb vast swathes of clinical and social data and come up with likely prognoses, they are giving local community health workers access to knowledge they would never previously have had.

But while such technology may be impressive, it would of little use without the heroic efforts of volunteer health workers such as Margaret Wairimu Maina.

Her work isn't always easy, she admits.

"Sometimes I find it very difficult emotionally to go into the community and interact with people who are very underprivileged, with little or no resources," she says.

"But that is what I must do, and it makes me feel happy to be useful and known in the community."

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Related Topics

• Kenya
• Mobile phones
• Pregnancy
• Ghana

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