PubHSol (Public Health Solutions)

The specific problems that we are addressing include lack of access to digital technologies in remote and rural areas, lack of access to SRHR services and lack of knowledge of SRHR among the youth. 

Digital innovation in health is transforming many aspects of patient care and health service delivery. (Davenport & Kalakota, 2019) It can play a crucial role in achieving the sustainable development goals.(Owoyemi et al., 2020) However, many low and middle-income (LMIC) countries, particularly South Africa, need more resources to ensure a more meaningful application of this digital technology.(Owoyemi et al., 2020) Rural and remote areas are often forgotten when new technologies are developed, technologies that could benefit these populations immensely. There is a dire need to optimise the opportunities offered by digital innovation, especially in rural areas, to deliver critical public health services and improve access to sexual and SRHR services for youth and adolescents.

Sexual and reproductive health and rights (SRHR) needs of youth and adolescents are often underserved and underestimated in Africa. (Ninsiima et al., 2021) Access to these essential services can prevent significant morbidity and mortality amongst this vulnerable population. (Ooms et al., 2020) However, there are approximately 2 billion people globally who do not have access to SRHR services. (Ooms et al., 2020) In South Africa, there is a heavy reliance on local clinics to offer SRHR services such as HIV medication, testing and prevention, contraception, treatment of sexually transmitted infections (STIs), abortion and antenatal services. (Baker et al., 2023) These services are particularly important in South Africa, a country with the largest HIV epidemic in the world with over 7.8 million people living with HIV. Furthermore, young women and men rely on contraceptive services to prevent unplanned pregnancies, where estimated pregnancy rates among young women and adolescent girls (15-24 years) remain between 16%-22% in South Africa. (Baker et al., 2023) Despite the demonstrated need and urgency for these services, access remains a desperate challenge due to affordability, convenience, stigma, facility operating hours, lack of knowledge and staff attitudes. (Ninsiima et al., 2021) 

Megalo Melon, an organisation started by four enthusiastic public health professionals, has devised an innovative solution to the problem described above by leveraging telemedicine to improve access to SRHR gender-specific health solutions in remote areas. This solution comes in the form of an Artificial Intelligence (AI) supported telemedicine booth named PubHSol, derived from the important task of providing Public Health Solutions. 

PubHSol is a portable, soundproof booth fitted with internet and an electrical technological device such as a tablet. The telebooth dimensions will be the size of a typical phone booth and be fitted with a chair. The energy used to power the internet source and the electrical device will be supplied through solar panels. The booth will be situated in the most central areas of the rural community to allow for ease of access. Healthcare users, in this case, the young people accessing SRHR services, can enter the booth and consult remotely either with one of the multidisciplinary healthcare providers available or with the AI chatbot, Pubby. 

The PubHSol concept takes into consideration that language is often a barrier to efficient communication, therefore it will be programmed to assist in the 12 official languages of South Africa, initially paying focus to the main languages spoken at the target population sites described below.

The PubHSol telemedicine booth considers confidentiality because once the healthcare user enters the booth, they can seek healthcare assistance, enquire about any of their concerns and report any issues such as abuse without fear of judgement, rejection, or punishment, thus empowering the youth. The PubHSol telemedicine booth is also a tool for health promotion and education. Any question may be asked to the chatbot or healthcare professional, this will enhance learning and capacitate communities with SRHR related knowledge that they did not have access to prior. 

Additionally, the unique AI feature established in the PubHSol telemedicine booth will facilitate the collection of data without identifiers for statistical use, informing gaps in knowledge, as well as aiding in targeted interventions.

The remote availability of multidisciplinary healthcare providers allows for access to holistic services such as medical, allied, pharmaceutical as well and mental health. Where urgent care is needed the healthcare services user will be directed to their nearest facility or mobile assistance may be deployed for the healthcare user. This facility also aids in the provision of home-based care, a strategy that was introduced to reduce pressure in public health facilities and improve patient comfort through being treated at home.

The innovative PubHSol telemedicine booth adopts and supports Africa’s Digital transformation strategy 2020-2030 as well as South Africa’s “better health for all enabled by digital health” strategy 2019 -2024. We at Megalo Melon believe that digitization of health is a great opportunity to transform and strengthen the health systems and ensure collaboration, inclusivity, and sustainability.

Our target population is young people from the age 9 to 18, which will include both males and females since the purpose of the PubHSol telemedicine booth is to be inclusive across all genders, race, and ethnicities. Adolescents and young adults will be the target market to address the limited access to sexual reproductive health services and information often faced by this group in remote settings of South Africa. By providing convenient and confidential access through the telemedicine booth, these young people will be empowered to make more informed decisions regarding their sexual health.

Men in the community will also be included in this telemedicine booth by engaging them in sexual reproductive health discussions and services. They will have access to information on Sexually Transmitted Infections (STI) preventative measures, family planning and responsible sexual behaviour to benefit them and their partners.

The booth will also offer educational resources which include brochures, videos, and interactive tools to promote awareness and spread accurate information on sexual reproductive health. This will result in improved knowledge and behavioural changes within the target population.

By offering confidential access to sexual reproductive health services, the telemedicine booth can help individuals overcome barriers associated with stigma, privacy concerns and judgement which is often coupled with seeking these services in healthcare settings. Regarding services that will not be readily available in the telemedicine booth, Megalo Melon aims to collaborate with other service providers to bring these services to the people using proper referral systems.

Possible pilot sites include provinces across the country with vast rural areas. These provinces include Mpumalanga, Northern Cape, North West and the Eastern Cape. Remote areas of Mpumalanga Province, located in South Africa, have significant challenges regarding lack of infrastructure and limited access to sexual reproductive health services. These issues disproportionately affect the population residing in these areas, highlighting the urgency for interventions and improvements to ensure equitable healthcare access. 

Mpumalanga province is made up of a population of 5.1 million during the year 2022 which is 8% of South Africa’s population. According to data from the South African National Department of Health and various research studies, remote communities in Mpumalanga face inadequate infrastructure, including limited healthcare facilities, roads, and transportation options. These deficiencies hinder accessibility to essential sexual reproductive health services, such as family planning, antenatal care, maternal and child health, and sexually transmitted infection (STI) testing and treatment. 

Moreover, the lack of infrastructure often results in lengthy travel distances that individuals must undertake to reach healthcare facilities. This can pose significant challenges, particularly for pregnant women seeking antenatal care or delivery services. In addition, limited transportation options exacerbate the difficulties faced by community members, particularly those without personal vehicles.

There are also disparities in sexual reproductive health outcomes in remote areas of Mpumalanga. Reports indicate higher rates of unintended pregnancies, teenage pregnancies, maternal mortality, and unsafe abortions compared to urban areas. Limited access to contraception, comprehensive sex education, and reproductive healthcare contribute to these statistics.

Lerato has worked as a medical doctor in the public and private sectors from community clinics to tertiary level hospitals. This exposure to different service levels and sectors of the healthcare system has inspired Lerato’s holistic approach to healthcare. Her time in working in the mental health wards has made her a strong advocate for social inclusion. 

Lerato believes that access to quality healthcare is important for all, and having worked with telemedicine she is convinced that digital innovation can be leveraged to improve access to healthcare.  Her involvement in PubHSol is one such attempt to be a part of an innovative team that will change the face of rural healthcare. 

Inge is a medical doctor with a passion for public health and health systems. Completing her studies in the Gauteng Province, provided Inge with an appreciation for health systems strengthening (HSS) and the importance of good leadership and governance, access to healthcare and health information systems. She advocates for HSS and policy, universal health coverage, and sustainable development goals with a particular focus on Health, gender and climate change.

She is passionate about gender equity in global health leadership, and gender equity across the health system. Health systems planning cannot be done if data is not disaggregated to capture the needs of women’s health in the country and globally. Therefore, she advocates and works towards achieving these goals. As part of PubHSol’s team at Megalo Melon, she will bring these interests to the table. 

Siphesihle is a medical doctor and public health professional from a rural village in the Eastern Cape. Her experiences have shaped her perspectives on the challenges faced by young people who grew up in rural areas regarding access to quality sexual and reproductive health and rights services.

 Furthermore she advocates for addressing the social determinants of health, promoting gender equity, and improving the mental health and well-being of individuals. Addressing disparities in these social factors through advocacy, intersectoral collaboration and policy development is essential for ensuring that all young individuals, have equal opportunities to make informed decisions and access sexual and reproductive health services.

Her passion for mental health underscores the importance of providing holistic support and integrating mental health services into sexual and reproductive healthcare. Mental well-being is intricately linked to healthy relationships and positive sexual experiences, making it a crucial component of comprehensive youth-focused sexual health programs.

Zethu is a pharmacist from a rural township in Mpumalanga. Growing up in a rural area provided her with firsthand experience on the lack of access to health services for young people from poor communities. Apart from her fulltime job, she is an advocate for health promotion, disease prevention, addressing the social determinants of health and improving health outcomes. Furthermore, her training in Theology enhanced her ability to engage stakeholders outside the health sector.  Her areas of interest are pharmaceuticals, access to healthcare, health education, knowledge exchange and generation, resource distribution, climate change, gender equality, GBV and social injustice(crime)

The solution is holistic, groundbreaking, and unique. It meets the needs of the South African population as it is contextual, adaptive, and embraces the cultural and linguistic differences of South Africans. The solution will have a positive impact by empowering young people with knowledge. Through its futuristic design and being AI driven it is reliable, dynamic, and it will enhance and ensure health for all by also supporting research advancements through data collection and/or analysis. The PubHSol telemedicine booth is portable, powered by a reusable energy source, it is accessible and embraces the advanced goals of digital transformation set by the African Union and the South African health department locally. Overall wellbeing towards SRHR can be achieved and is no longer a distant dream.

Our one-year goals for PubHSol include the development phase of the product which can be seen below:

1. Develop the telemedicine booth (PubHSol) product.
2. Develop the AI software that will drive PubHSol.
3. Design and construction of booth
4. Engage in Stakeholder engagements and form strategic partnerships towards a sustainable product.
5. Identify the most suitable pilot site and engage with relevant stakeholders regarding the pilot phase planning.

Following the development phase, the five-year goal is more extensive and hopes to span across the development to the implementation phase (See below):

1. Ongoing PubHSol development
2. Ongoing AI software development
3. Improvements on booth structure
4. Pilot the product by the start of 3rd year for the duration of 12 months
5. Ongoing collaboration with partnerships and sustaining product feasibility
6. Evaluate the pilot of the product, make necessary changes, and plan for implementation.
7. Stakeholder engagement to expand implementation of the product into all provinces in the country.
8. By year 4/5 we aim to implement it across the country

Megalo Melon acknowledges that this product will require additional funding and strengthen public-private partnerships to ensure success. Community engagement will be ongoing to address the health needs of young people and once the pilot has been conducted, data will be used for knowledge exchange and enhanced disaggregated gender-specific data will be used to engage in policy and advocacy work towards SRHR.

Despite the development and modernisation in the country over the last few years, a large proportion of our population still does not have the ability to access healthcare due to health infrastructure or health information. The healthcare users are not always tech-savvy and have difficulty accessing other digital platforms. The AI feature of PubHSol assists those who aren’t technologically skilled, and users are able to speak in the language that they are most comfortable with that way everyone can use it. This product hopes to bridge that gap by enhancing access to address key health issues among young people regarding SRHR to improve overall health and wellbeing, decrease teenage pregnancy rates, and improve school completion rates.

1. Activity: Develop and pilot the product after which it will be implemented across the country. 
2. Input: The AI-driven PubHSol will be strategically placed to improve access to healthcare services for young people regarding SRHR.
3. Output: Utilization of PubHSol by youth regarding SRHR as well as health and wellness.
4. Impact: An increase in access to SRHR healthcare services, a more knowledgeable society empowered with knowledge and access, a decline in teenage pregnancies and illegal abortions, and an increase in school completion rates.

Megalo Melon has four permanent staff members and additional part-time staff members for PubHSol.

Full-time: Megalo Melon has four permanent staff members.

Part-time: There are three part-time staff members.

Contractors: Part-time project-based consultants will be onboarded as the product progresses and needs are identified.

PubHSol was conceptualized in August 2023 

The team consists of four innovators from different backgrounds, three of which are from previously disadvantaged backgrounds. We also come from different provinces. We speak different languages, among the four of us we speak at 6 languages. 

Our team commits to being inclusive, diverse, and accepting.

Our business is a service providing business. 

The company offers consulting, health promotion and advocacy, training, and development as well as health technology services.

• Target populations: Both population-based and community-based populations that require public health solutions for health and wellbeing.
• Products and services: Consultancy and advocacy, training and development, community-based interventions, Health Technology, and digital innovation
• How do we provide value: Contextualized and holistic consulting and advocacy work across all areas of health. Training and development focus on the younger generation and young professionals in career pathing, mentorship, and knowledge training in various areas regarding health. Health promotion efforts that are community-based interventions through engagements ensure appropriate and sustainable efforts. Innovate digital health technology with a holistic and comprehensive approach to addressing pressing healthcare needs.
• Gap/needs being addressed: Themes include SRHR, SDGs, SDOH, Climate Change, Mental Health, Health information and literacy, health education and promotion and gender equity.
• Revenue generation plan: Product development and sales will be a source of revenue generation. Additional donor funding/ grant applications and sponsorships will be applied to ensure the sustainability and feasibility of products to fund digital innovation. Furthermore, fees for service will be collected when training is given, consultancy work is done, or health promotion efforts are delivered.

The company is a hybrid company to ensure the for-profit branch drives the non-governmental branch ensuring long-term sustainability. Additionally, the financial sustainability plan can be seen below:

• Consulting: Consulting fees will be collected for public health-related work done in various areas of health.
• Health promotion and advocacy: fees for service will be collected for campaigns, products and advocacy work done in health.
• Health Technology: Products will be developed by the team or on request to address various health needs.
• Fundraising: Additional fundraising will be done to fund various projects that will be done by the team or in collaboration with other stakeholders to ensure sustainability and feasibility. 
• Training and education: Skill and knowledge training will be done for youth and young professionals to ensure career pathing, job readiness and access to mentors/mentees through a mentorship program.
• Social investment projects: We will partner with relevant stakeholders on social investment projects to enhance and improve the health and well-being of communities.
• Strategic partnerships: Through the strategic partnerships, projects will remain onboarded, ongoing and a continuous workload will be ensured, creating visibility and sustainability for the company.

Advertising fees: These fees will be collected from partners who would like to advertise across our social media platforms and boast their online presence.