National eHealth strategy frameworks in Africa: a comprehensive assessment using the WHO-ITU eHealth strategy toolkit...

Many African nations have developed national eHealth strategies to harness the benefits of digital health solutions. Our study assessed the current state of national eHealth strategies in Africa. A systematic search identified publicly available national eHealth strategy documents published from 2000 to 2023 in Africa. The documents were independently reviewed and scored using the eHealth National Strategy Rating Tool, developed using the WHO-ITU national eHealth strategy toolkit and the Findability, Accessibility, Interoperability and Reusability Guidelines. The eHealth National Strategy Rating Tool covered five domains: (i) eHealth national vision and strategy, (ii) implementation plan, (iii) monitoring and evaluation component, (iv) Findability, Accessibility, Interoperability and Reusability mention and (v) recency of policy development. The study followed a rigorous five-step methodological approach proposed by Arksey & O'Malley (2005). This study found the national eHealth strategies for 34 African countries, with only 16 updated to cover the year 2023 or beyond. Significant variability in the quality and comprehensiveness of national eHealth strategies was observed. Nine countries had 'strong', 17 had 'moderate', and eight had 'weak' eHealth strategies. Critical gaps were identified in the implementation plan, monitoring and evaluation, and the alignment of policies with the Findability, Accessibility, Interoperability and Reusability data principles. Addressing the gaps identified in the development and implementation of national eHealth strategies across Africa by aligning national strategies with global best practices will be crucial for African nations to harness the transformative potential of digital technologies and ensure equitable access to quality healthcare for their populations.