A scoping review has just been published, in which “a situation of eHealth in e-Chaos” in sub-Saharan Africa is documented. The review1 , available from ICTworks (https://www.ictworks.org/wp-content/uploads/2023/02/ehealth-chaos-digita...) notes that there are “too many eHealth interventions across Africa”: the authors found “738 distinct digital health interventions at different levels of functioning in the SSA region over the past 10 years”. These tend to be concentrated in a few countries (e.g., Kenya, Uganda, Ethiopia, Malawi) with an unprecedented level of duplication within and between countries:
One in five do not have a link to any health service outcomes.
Only half of the digital health interventions can be classified as “established”.
Two of every three are only focused on solutions in one building block, limiting integration.
Most (92%) require health worker engagement for them to work.
The largest proportion (84%) are focused on mining data, as opposed to improving provision of services.
A bias toward service delivery (81.7%) compared to the other five health systems strengthening building blocks
A preference for targeting health care providers (91.8%) to the detriment of the other three target users
A big challenge in scale-up of the interventions with only 53% reported as established.
84% of eHealth is focused on “data mining” of some sort, instead of improving service provision.
8% of the digital health solutions are aligned to 20% of designated system categories.
The review highlights the need to re-strategize ideation, development, and the scale-up of digital health in the Region.
1 The use of Digital Health Interventions for Health Systems Strengthening in sub-Saharan Africa over the last 10 years by Humphrey C Karamagi, Derrick Muneene,Benson Droti, Violet Jepchumba, Joseph C Okeibunor, Juliet Nabyonga, James Avoka Asamani, Moussa Traore, Hillary Kipruto
Chris Zielinski
Centre for Global Health, University of Winchester, UK and
Vice President, World Association of Medical Editors (WAME)
HIFA profile: Chris Zielinski: As a Visiting Fellow and Lecturer at the Centre for Global Health, University of Winchester, Chris leads the Partnerships in Health Information (Phi) programme, which supports knowledge development and brokers healthcare information exchanges of all kinds. He is the elected Vice President (and President-in-Waiting) of the World Association of Medical Editors. Chris has held senior positions in publishing and knowledge management with WHO in Brazzaville, Geneva, Cairo and New Delhi, with FAO in Rome, ILO in Geneva, and UNIDO in Vienna. He served on WHO's Ethical Review Committee, and was an originator of the African Health Observatory. He also spent three years in London as Chief Executive of the Authors Licensing and Collecting Society. Chris has been a director of the UK Copyright Licensing Agency, Educational Recording Agency, and International Association of Audiovisual Writers and Directors. He has served on the boards of several NGOs and ethics groupings (information and computer ethics and bioethics). chris AT chriszielinski.com. His publications are at https://www.researchgate.net/profile/Chris-Zielinski and https://winchester.academia.edu/ChrisZielinski/ and his blogs are http://ziggytheblue.wordrpress.com and https://www.tumblr.com/blog/ziggytheblue
