A decade of designing and implementing electronic health records in Sub-Saharan Africa: a scoping review
Hamufare Dumisani Mugauri, Memory Chimsimbe, Gerald Shambira, Shepherd Shamu, Juliet Nyamasve, Manes Munyanyi, Robert Gongora, Simukai Zizhou, Meggie Gabida, Richard Makurumidze
Abstract
Electronic Health Records (EHR) systems offer extensive opportunities to enhance healthcare delivery in sub-Saharan African (SSA) countries by improving data management and patient care and reducing errors. Nonetheless, EHR systems face a myriad of challenges, ranging from infrastructure and resources to policy, data management, and implementers' capacitation. This review provides a comprehensive 10-year overview of EHR implementation in the SSA region. A systematic search of PubMed, Web of Science and HINARI databases identified 30 relevant studies published from 2014 to 2024. Inclusion criteria focused on studies discussing the implementation, benefits, and challenges of EHR systems in SSA countries. Data extraction and thematic analysis facilitated the synthesis of findings. The review identified themes organized into four categories: EHR-enabled data management reduced errors, enhanced accuracy, and improved accessibility of patient records. Improved patient care correlated with better data management, facilitating timely and informed decision-making. Challenges such as limited infrastructure (power and connectivity), financial constraints, data privacy concerns, and the need for extensive training were prevalent. User acceptance also emerged as a critical barrier, with healthcare providers often resistant to adopting innovative technologies due to perceived complexity and the time required for training. EHR systems can significantly enhance healthcare delivery in sub-Saharan Africa. To fully realize these benefits, it is crucial to address challenges through targeted strategies and investments. By investing in reliable infrastructure, securing financial support, enhancing data security, developing comprehensive training programmes, and engaging stakeholders, sub-Saharan Africa can improve data management, patient care, and overall healthcare outcomes.