Conceptualization and practices in digital health: voices from Africa

Abstract

This paper presents voices from Africa on digital health in Africa. These voices were gleaned during interviews and an online, focus group session in May 2020, during which 30 experts across Africa, among others from the South, were asked about their experiences and observations on the conceptualisation of, and practices in, digital health in their respective communities and countries. Extensive input was provided, both orally and textually. The quotes gathered and presented in this paper indicate that there is a distinct need for the respectful co-development of digital health interventions in Africa. In addition, the quotes show how a one-size-fits-all solution approach does not exist, it is not a solution to Africa. Further, the community-focus, fit, and fragmentation of existing activities digital health interventions is questioned. The narratives provide a rich resource indicating capable and local agency and the need to address power-differences in international health development.
 Keywords: Digital health; Africa; ethnography.

Enablers and barriers to the acceptability of mHealth for maternal healthcare in rural Edo, Nigeria

“…They ensured women's safe transportation to healthcare facilities as part of Text4Life and planned for contingencies with transportation. Confirming our findings is an analysis of digital health practices across African countries that showed that failure to engage communities in digital health innovations inadvertently leads to the outright rejection of innovations [ 27 ]. Similarly, Arnaert et al [ 28 ] indicated that the engagement of community health workers in Burkina Faso in a mHealth program to support antenatal care enhanced spousal acceptance of the intervention and hence its continuity.…”

A roadmap for the digital management of long-lasting insecticide-treated mosquito nets (LLINs) distribution campaigns in the Democratic Republic of Congo (DRC)

“…In recent times, the widespread application of information and communications technology (ICT) in the health sector has significantly improved the health care delivery system, such as promoting health care and improving the quality of health interventions [ 13 , 14 ]. Their application in the management of mass LLIN distribution campaigns in the DRC has been a decisive contribution, in particular in the context of COVID-19 where the necessary physical distancing imposes the limitations on training and validation workshops and household registration practices.…”

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases

“…There is a growing debate that digital health technologies could assist Africa in realizing the SDG 3 targets and leaving no one behind [12][13][14][15] . The growing need for home-grown creativity and international partnerships for co-development of digital health technologies in Africa is promising, which also coincides with the World Health Organization's (WHO) global strategy on digital health that encourages cross-country collaboration and knowledge transfer in the area 16 .…”

“…Important studies and policy insights inform the extent to which digital health interventions have been implemented in Africa and the barriers for the success or lack thereof [17][18][19][20][21][22][23] . Full adoption and implementation of digital health technologies in Africa require more training, access to better devices and infrastructure, and more investigations on emerging technologies including artificial intelligence, wearable devices, and big data to provide robust evidence of their potential in Africa 12,15 . However, literature is lacking that characterizes the cross-national dynamics of the macro-level digital health ecosystem in Africa and strategically maps countries of high priority for meaningful and sustainable effects of digital health technologies on the health and well-being of citizens.…”