A decade of designing and implementing electronic health records in Sub-Saharan Africa: a scoping review
Open accessAbstract
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.
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SiKurang's inherently offline operation addresses the persistent bottleneck of unreliable connectivity and weak digital infrastructure in low-resource environments.
“SiKurang's inherently offline operation addresses one of the persistent bottlenecks to digital health utilization in low-resource environments, namely unreliable connectivity and weak digital infrastructure problems well characterized across sub-Saharan Africa (Mugauri et al., 2025).”
From SiKurang: Development and Field Evaluation of an Offline-First mHealth System for Community-Based Stunting Risk Detection and Counselling in Low-Connectivity Primary Care Settings (2026) · cites this paper as Mugauri et al., 2025
Unreliable connectivity and weak digital infrastructure are well characterized across sub-Saharan Africa.
“unreliable connectivity and weak digital infrastructure problems well characterized across sub-Saharan Africa (Mugauri et al., 2025).”
From SiKurang: Development and Field Evaluation of an Offline-First mHealth System for Community-Based Stunting Risk Detection and Counselling in Low-Connectivity Primary Care Settings (2026) · cites this paper as Mugauri et al., 2025
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- Authors
- Mugauri, H. D., Chimsimbe, M., Shambira, G., Shamhu, S., Nyamasve, J., Munyanyi, M., Gongora, R., Zizhou, S., Gabida, M., & Makurumidze, R.
- Affiliations
- University of Zimbabwe (ZW)
- University of Zimbabwe
- Ministry of Health and Child Care
- United Nations Children's Fund (US)
- Corresponding author
- Mugauri, Hamufare Dumisani
- ORCID
- Venue
- Global Health Action
- Publisher
- Informa UK Limited
- Published
- 2025-04-29
- Volume
- 18
- Issue
- 1
- Pages
- 2492913-2492913
- ISSN
- 1654-9716 (ISSN-L)
- 1654-9880
- PMC
- PMC12042231
- OpenAlex
- W4409903992
- Cited by
- 32
- References
- 33
- Citations by year
- 2026: 21 · 2025: 11
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Health Action (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- UNICEF Zimbabwe (ZIM/PCA2022145/PD2024487)
- University of Zimbabwe
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Keywords
- electronic health records, EHR implementation, sub-Saharan Africa, health information systems, data management, patient care, data privacy, health professions education, user acceptance, health infrastructure
- MeSH terms
- Data Management, Delivery of Health Care, Humans, Africa South of the Sahara, Electronic Health Records
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