The development of telemedicine programs in Sub-Saharan Africa: Progress and associated challenges

Abstract

Monitoring the progress of telemedicine use in Sub-Saharan Africa (SSA) countries has received a considerable attention from many health organizations and governmental agencies. This study reviewed the current progress and challenges in relation to the development of telemedicine programs in SSA. The results from reviewing 66 empirical studies revealed an unbalanced progress across SSA countries. Further, technological, organisational, legal and regulatory, individual, financial, and cultural aspects were identified as the major barriers to the success of telemedicine development in SSA. This study reported the current trends in telemedicine application, as well as highlighting critical barriers for consideration by healthcare decision makers. The outcomes from this study offer a number of recommendations to support wider implementation and sustainable usage of telemedicine in SSA.

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

“…Accurate BP measurement is critical to the diagnosis and management of hypertension in patients with CKD. Various landmark hypertension clinical trials and guidelines reports have detailed various standardized BP measurement techniques/methods for both office and out-of-office BP to define target BP goals [17][18][19][20][21] . Newer out-of-office techniques continue to incorporate digital health technologies (e.g., telemonitoring) into BP measurement via education, monitoring and support, timely feedback, and remote access to health professionals [22][23][24] .…”

“…Later in 1905, Nikolai Korotkov described his auscultatory measurement method making SBP and diastolic BP (DBP) readings feasible [26] . Although it has since become standardized to report BP using systolic and diastolic values, however, due to variations in measurement techniques [27] , professional societies and guideline committees [20,21,28] have repeatedly recommended specific approaches to improve the accuracy of BP measurement [Table 1]. Such recommendations have been made in light of findings from landmark clinical trials [19,[29][30][31] [Figure 1] and in response to transitions from the use of manual aneroid devices (which easily lose calibration) to automated devices capable of measuring BP both in and out of the office [27] .…”

“…Such recommendations have been made in light of findings from landmark clinical trials [19,[29][30][31] [Figure 1] and in response to transitions from the use of manual aneroid devices (which easily lose calibration) to automated devices capable of measuring BP both in and out of the office [27] . Although BP guideline committees may provide different BP targets based on available evidence, they have been mostly consistent in methods/ techniques of BP measurement [20,21,28] . Based on the clinical setting, BP measuring techniques can be broadly categorized into office and out-of-office BP measurements:…”

Evaluation of Current and Former Teleradiology Systems in Africa: A Review

“…Before the late 1990s, telemedicine and teleradiology developments in Africa were generally small and scattered pilot-type projects [8]. However, in 1998, the first major development in teleradiology occurred in South Africa at the Department of Health (DOH) [9].…”

“…Since the inception of the National Telemedicine System in South Africa, several other African countries have attempted to institute similar initiatives, including but not limited to Mauritania; Mozambique; Mali; Botswana, and Ethiopia [8]. Despite the broad range of expansion, the robustness of the development in each country remains unclear.…”