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Cited by 101Mobile Health and mHealth ApplicationsTelemedicine and Telehealth ImplementationICT in Developing Communities

Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya

Open access
Njoroge, Martin, Zurovac, Dejan, Ogara, Esther A. A., Chuma, Jane, Kirigia, Doris·2017·BMC Research Notes
DOI 10.1186/s13104-017-2416-0PMC PMC5301342
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Abstract

BACKGROUND: The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya. The projects were examined based on strategic area of implementation, health purpose and focus, geographic location, evaluation status and thematic area. RESULTS: A total of 114 citations comprising 69 eHealth projects fulfilled the inclusion criteria. The eHealth projects included 47 mHealth projects, 9 health information system projects, 8 eLearning projects and 5 telemedicine projects. In terms of projects geographical distribution, 24 were executed in Nairobi whilst 15 were designed to have a national coverage but only 3 were scaled up. In terms of health focus, 19 projects were mainly on primary care, 17 on HIV/AIDS and 11 on maternal and child health (MNCH). Only 8 projects were rigorously evaluated under randomized control trials. CONCLUSION: This review discovered that there is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDs. Based on our analysis, most of the projects were rarely evaluated. In addition, few projects are implemented in marginalised areas and least urbanized counties with more health care needs, notwithstanding the fact that adoption of information and communication technology should aim to improve health equity (i.e. improve access to health care particularly in remote parts of the country in order to reduce geographical inequities) and contribute to overall health systems strengthening.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review inventories 69 eHealth projects implemented in Kenya, finding that most were mHealth initiatives concentrated in urban counties and rarely rigorously evaluated. It concludes that eHealth activity is poorly aligned with marginalized areas and Ministry of Health priorities, limiting scale-up and equity impact.

Key findings

  • Of 69 eHealth projects, 47 (69%) were mHealth, 9 (13%) health information systems, 8 (11%) eLearning, and 5 (7%) telemedicine.
  • Geographic distribution was skewed: Nairobi had 24 mapped projects, while least urbanized counties such as Turkana, Wajir, and Garissa had 1, 1, and 2 projects respectively; Samburu, Marsabit, and Mandera had none. Of 14 marginalized counties, 10 had at least one project, with Kilifi highest at 5 and Kwale at 4.
  • Health focus was mainly primary care (19; 28%), HIV/AIDS (17; 25%), and maternal and child health (11; 16%).
  • Evaluation was limited: only 28 of 69 projects (41%) reported any evaluation, and only 8 (12%) were randomized controlled trials; 41 projects (59%) had no reported evaluation.

Methods

  • Systematic review of peer-reviewed and non-peer-reviewed sources, including PubMed, Embase, Web of Science, Econlit, SocIndex, Cochrane, Google Scholar, organizational websites, blogs, personal communication with implementers, and hand searches; no time period was specified.
  • The search identified 5,506 citations plus 40 hand-searched publications; after removing 354 duplicates and excluding records, 114 citations reporting 69 eHealth projects met inclusion criteria.
  • Projects were categorized by strategic area, thematic area, health focus, geographic location, and evaluation status; geo-coded maps were layered by urbanization and marginalisation using Commission on Revenue Allocation classifications.

Limitations

  • Stated by the paper: some projects may have lacked documentation or externally shared reports because they were profit-driven, aid-funded, or proprietary, and some projects may have been implemented after data collection concluded, so the inventory may not be exhaustive.
  • Evident from the text: reliance on non-peer-reviewed sources, organizational websites, blogs, and personal communication may introduce selection or reporting bias.
  • Evident from the text: because 41 of 69 projects (59%) had no reported evaluation, the review cannot assess effectiveness or cost-effectiveness for most included projects.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s13104-017-2416-0

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 46 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The majority (47; 69%) of eHealth projects in Kenya were delivered through mHealth.

    “Projects implemented in Kenya covered all eHealth strategic areas with majority (47; 69%) of them delivered through mHealth, less commonly focusing on health information systems (9; 13%), eLearning (8; 11%) and telemedicine (5; 7%) as shown in Table 2.”
    • Also stated in: § Results · plain
      “The eHealth projects included 47 mHealth projects, 9 health information system projects, 8 eLearning projects and 5 telemedicine projects.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Only three eHealth projects were scaled up to national level.

    “In terms of projects geographical distribution, 24 were executed in Nairobi whilst 15 were designed to have a national coverage but only 3 were scaled up.”
    • Also stated in: § Geographic location of the projects by urbanization and marginalisation · plain
      “However, only three projects were scaled up to national level [27–31].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [27] Maurer B. Mobile money: communication, consumption and change in the payments space. J Dev Stud. 2012;48(5):589–604. source

      Not checked in the free run.

    • cites [28] Sahay S, Sæbø J, Braa JR. Scaling of HIS in a global context: same, same, but different. Inf Organ. 2013;23(4):294–323. source

      Not checked in the free run.

    • cites [29] Suri T, Jack W, Stoker TM. Documenting the birth of a financial economy. Proc Natl Acad Sci. 2012;109(26):10257–62. source

      Not checked in the free run.

    • cites [30] Afyainfo. The AfyaInfo Project. 2014. http://www.afyainfo.org/index.php/features/the-afyainfo-project . Accessed 20 May 2014.

      Not checked in the free run.

    • cites [31] KEMSA. KEMSA E-mobile. 2015. http://kemsa.co.ke/index.php?option=com_content&view=article&id=66&Itemid=153 . Accessed 10 Mar 2015.

      Not checked in the free run.

  • Findingcitation

    The first eHealth project in Kenya was implemented in 2001.

    “Another noteworthy finding is that the first eHealth project was implemented in 2001 [40–43] in Kenya while most of the projects (n = 42) were initiated in 2010 and onwards.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [40] Vanderbilt University. The Moi Schools of Medicine & Public Health, Kenya. Eldoret. 2001. http://www.vecd.org/trainee-sites/the-moi-schools-of-medicine-public-health-kenya/ . Accessed 20 May 2014.

      Not checked in the free run.

    • cites [41] Diero L, Rotich JK, Bii J, Mamlin BW, Einterz RM, Kalamai IZ, et al. A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre. BMC Med Inform Decis Mak. 2006;6(1):21. source

      Not checked in the free run.

    • cites [42] Fazen LE, Chemwolo BT, Songok JJ, Ruhl LJ, Kipkoech C, Green JM, et al. AccessMRS: integrating OpenMRS with smart forms on android. Stud Health Technol Inform. 2012;192:866–70.

      Not checked in the free run.

    • cites [43] Rajput ZA, Mbugua S, Amadi D, Chepnǵeno V, Saleem JJ, Anokwa Y, et al. Evaluation of an android-based mHealth system for population surveillance in developing countries. J Am Med Inform Assoc. 2012;19(4):655–9. source

      Not checked in the free run.

  • Findingown data

    A total of eleven eHealth projects were executed in the least urbanized counties.

    “In total there were a total of eleven projects being executed in the least urbanized counties as demonstrated by Fig. 2.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The search identified 114 citations reporting 69 eHealth projects.

    “The search concluded with 114 citations reporting 69 eHealth projects (Fig. 1).”
    • Also stated in: § Results · plain
      “A total of 114 citations comprising 69 eHealth projects fulfilled the inclusion criteria.”
    Quote in the paperSubstantial claim
  • May combine two claims. 24
  • Classified as probably not a substantial claim. 18

  • May combine two claims.

    Findingown data

    Of the remaining 21 projects, 1 was a non-randomized intervention study, 7 were cross-sectional studies, 1 was a cohort study, 9 were feasibility and acceptability studies, and 3 were qualitative studies.

    “Of the remaining 21 projects, one was non-randomized intervention studies (1%), 7 cross-sectional studies (10%), and 1 cohort study (1%), 9 were feasibility and acceptability studies (13%) while 3 (4%) were qualitative studies (Table 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Health financing was a focus of four (5%) eHealth projects.

    “Health financing | 4 (5%)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Supply chain management was represented by four (5%) eHealth projects.

    “Supply chain management | 4 (5%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Provider training and education and financial transactions and incentives were each represented by six (9%) projects.

    “The other thematic areas involved provider training and education, and financial transactions and incentives. These thematic areas were represented by six (9%) projects in each of the respective domains.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Samburu, Marsabit and Mandera had no eHealth project being implemented.

    “However, the other least urbanised counties such as Samburu, Marsabit and Mandera had no eHealth project being implemented.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Three thematic areas applying sensors and point-of-care diagnostics, registries and vital events tracking, and electronic decision support were each represented by two innovations.

    “Finally, three thematic areas applying sensors and point-of-care diagnostics, registries and vital events tracking, and electronic decision support were each represented by two innovations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Drug supply was a focus of four (5%) eHealth projects.

    “Drug supply | 4 (5%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The total number of mapped projects excluding national projects was 148, greater than the 69 actual projects.

    “Additionally, most of the projects (n = 41) were implemented in multiple counties thus the total number of mapped projects excluding national projects (n = 148) were greater than the number of actual projects (n = 69).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Malaria was a focus of eight (11%) eHealth projects according to the text.

    “In terms of health focus, this study found that nineteen (28%) projects focused on primary care followed by HIV/AIDS (17; 25%), then maternal and child health (11; 16%) and malaria (8; 11%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    One of the nationally scaled eHealth projects relied on mobile money to provide health care and was not mapped.

    “One of these projects relied on the innovative use of mobile money [27, 29] to provide health care and therefore it was not mapped.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Maurer B. Mobile money: communication, consumption and change in the payments space. J Dev Stud. 2012;48(5):589–604. source

      Not checked in the free run.

    • cites [29] Suri T, Jack W, Stoker TM. Documenting the birth of a financial economy. Proc Natl Acad Sci. 2012;109(26):10257–62. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Most eHealth projects were designed to be implemented in specific geographical locations, with a few projects implemented nationally.

    “Most eHealth projects were designed to be implemented in specific geographical locations with a few projects implemented nationally.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Other health purposes accounted for seven (10%) eHealth projects.

    “Other purposesb | 7 (10%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Most of the eHealth projects were used to influence client education and behaviour change and to collect patient data.

    “Most of the eHealth projects were used to influence client education and behaviour change and to collect patient data.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    SMS communications were cost-effective and reliable.

    “These types of interventions have been proven to be effective as evidenced by the small sample of evaluated mHealth interventions [16, 20, 32, 33, 45], that showed that SMS communications had positive effect on patient behaviour and health outcomes and was also cost-effective and reliable [50].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Zurovac D, Larson BA, Sudoi RK, Snow RW. Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers’ adherence to malaria guidelines in Kenya. PLoS ONE. 2012;7(12):e52045. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    According to this study, mHealth and eHealth projects are on the rise.

    “According to this study, mHealth and eHealth projects are on the rise, which could be explained by the increasing growth of ICT sector in Kenya and the political willingness to advance investment in this important industry.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Of the 15 national projects, only two reported some form of evaluation; one was a cross-sectional survey and the other was a qualitative study.

    “Of the 15 national projects, only two reported some form of evaluation, one being a cross-sectional survey [27, 29] while the other was a qualitative study [51, 52].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [27] Maurer B. Mobile money: communication, consumption and change in the payments space. J Dev Stud. 2012;48(5):589–604. source

      Not checked in the free run.

    • cites [29] Suri T, Jack W, Stoker TM. Documenting the birth of a financial economy. Proc Natl Acad Sci. 2012;109(26):10257–62. source

      Not checked in the free run.

    • cites [51] IntraHealth International. Capacity Kenya. 2009. http://www.intrahealth.org/page/capacity-kenya . Accessed 19 May 2014.

      Not checked in the free run.

    • cites [52] IntraHealth International. Kenya. Nairobi. 2014. http://www.intrahealth.org/files/media/kenya/Country_Brief_Kenya_web%20ready.pdf .

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    As illustrated by this study, projects implemented were not aligned to the Ministry of Health health needs and priorities; instead majority of projects focused on specific diseases and population groups such as HIV/AIDS and maternal and child health at primary care.

    “As illustrated by this study, projects implemented were not aligned to the MoH health needs and priorities and instead majority of projects focused on specific diseases and population groups such as HIV/AIDS and maternal and child health at primary care.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Based on this analysis, majority of the eHealth initiatives under implementation are fragmented and not integrated with the national health information system, creating interoperability challenges.

    “For example, based on this analysis, majority of the eHealth initiatives under implementation are fragmented and not integrated with the national health information system creating interoperability challenges.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Majority of the eHealth initiatives implemented in Kenya are funded by development agencies and international non-governmental organisations, raising the issue of ownership by the Ministry of Health.

    “Another important finding in this study is that majority of the eHealth initiatives implemented in the country are funded by development agencies and international non-governmental organisations raising the issue of ownership by the Ministry of Health.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    SMS communications had a positive effect on patient behaviour and health outcomes.

    “These types of interventions have been proven to be effective as evidenced by the small sample of evaluated mHealth interventions [16, 20, 32, 33, 45], that showed that SMS communications had positive effect on patient behaviour and health outcomes and was also cost-effective and reliable [50].”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [16] Curran K, Mugo NR, Kurth A, Ngure K, Heffron R, Donnell D, et al. Daily short message service surveys to measure sexual behavior and pre-exposure prophylaxis use among kenyan men and women. AIDS and Behav. 2013;17(9):2977–85. source

      Not checked in the free run.

    • cites [20] Lester RT, Mills EJ, Kariri A, Ritvo P, Chung M, Jack W, et al. The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol. Trials. 2009;10(1):87. source

      Not checked in the free run.

    • cites [32] Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010;376(9755):1838–45. source

      Not checked in the free run.

    • cites [33] Pop-Eleches C, Thirumurthy H, Habyarimana J, Graff Zivin J, Goldstein M, De Walque D, et al. Mobile phone technologies improve adherence to antiretroviral treatment in resource-limited settings: a randomized controlled trial of text message reminders. Aids. 2011;25:825–34. source

      Not checked in the free run.

    • cites [45] Odeny TA, Bailey RC, Bukusi EA, Simoni JM, Tapia KA, Yuhas K, et al. Text messaging to improve attendance at post-operative clinic visits after adult male circumcision for HIV prevention: a randomized controlled trial. PLoS ONE. 2012;7(9):e43832. source

      Not checked in the free run.

    • cites [50] Zurovac D, Larson BA, Sudoi RK, Snow RW. Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers’ adherence to malaria guidelines in Kenya. PLoS ONE. 2012;7(12):e52045. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    There is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDS.

    “This review discovered that there is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDs.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Kenya National eHealth Strategy outlined five specific strategic areas of focus: telemedicine, health information systems, mHealth, eLearning, and health information for citizens.

    “The national eHealth strategy outlined five specific strategic areas of focus to aid eHealth project implementation in the country. These include telemedicine, health information systems (including electronic health records), mHealth (health through the use of mobile devices), eLearning (including distance education or learning) and health information for citizens (health information provision to”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Republic of Kenya. Kenya National e-Health Strategy 2011–2017. In: Ministry of Medical Services, Ministry of Public Health and Sanitation, editors. Nairobi. 2011.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Most private eHealth projects were not prepared to disclose information deemed delicate.

    “However, due to the sensitive nature of this information, most private projects were not prepared to disclose the information deemed as delicate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Conflicting opinions during screening were resolved through discussion amongst the authors.

    “Conflicting opinions were resolved through discussion amongst the authors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The strategic area referring to health information for citizens was not analysed separately but included in other project implementation areas due to overlap.

    “Due to overlap with other areas, the strategic area referring to health information for citizens was not analysed separately but included in other project implementation areas.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    One of the major eHealth public health objectives is to improve access to health services through strengthening the health system by ensuring hard-to-reach communities receive effective and quality health care.

    “One of the major eHealth public health objectives is to improve access to health services through strengthening health system [3, 55] by ensuring hard-to-reach communities receive effective and quality health care.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3] Kirigia JM, Seddoh A, Gatwiri D, Muthuri LH, Seddoh J. E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region. BMC Public Health. 2005;5:137. doi: 10.1186/1471-2458-5-137 . source

      Not checked in the free run.

    • cites [55] Alvarez RC. The promise of e-Health—a Canadian perspective. eHealth Int. 2002;1(1):4. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    In a few instances, the ICT sector has experienced successful public private partnerships, for example M-Pesa, showing that scaling up of eHealth projects can be executed in Kenya with proper planning and sufficient funding.

    “In a few instances, the ICT sector has experienced successful public private partnerships for example business mobile products such as M-Pesa [58] shows that the scaling up of eHealth projects can be executed in Kenya with proper planning and sufficient funding.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Jack W, Suri T, Townsend RM. Monetary theory and electronic money: reflections on the Kenyan experience. FRB Richmond Econ Q. 2010;96(1):83–122.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The researchers combined different methods to ensure all projects were documented and inventoried.

    “Even though it was a challenge gathering information relating to innovations being implemented in the country, the researchers combined different methods to ensure all projects were documented and inventoried.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    Some projects may have lacked documentation or externally shared reports, probably due to the profit-driven or aid-funded nature of the eHealth projects, while some projects were proprietary business ventures.

    “First, some projects may have lacked documentation or externally shared reports, probably due to the profit driven or aid funded nature of the eHealth projects whilst some projects were proprietary in nature and thus business ventures.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The rise in mHealth and eHealth projects could be explained by increasing growth of the ICT sector in Kenya and political willingness to advance investment in this industry.

    “According to this study, mHealth and eHealth projects are on the rise, which could be explained by the increasing growth of ICT sector in Kenya and the political willingness to advance investment in this important industry.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    ICT treats geographically displaced resources as if they were centralized, thus promoting economies of scale.

    “As noted by Kirigia et al., ICT treats geographically displaced resources as if they were centralized thus promoting economies of scale [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Kirigia JM, Seddoh A, Gatwiri D, Muthuri LH, Seddoh J. E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region. BMC Public Health. 2005;5:137. doi: 10.1186/1471-2458-5-137 . source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    This review concludes that there is a myriad of eHealth projects being implemented in urban centres rather than marginalised areas where geographical inequalities and inequities in access to health care exist in Kenya.

    “This review concludes that there is a myriad of eHealth projects being implemented in urban centres rather than marginalised areas where geographical inequalities and inequities in access to health care exist in Kenya.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    If eHealth projects are implemented and evaluated effectively, they would contribute to improving access to and quality of health care, hence strengthening the overall health system to achieve good health outcomes.

    “Generally, if eHealth projects are implemented and evaluated effectively they would contribute to improving access to and quality of health care hence strengthening the overall health system in an effort to achieve good health outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Information from some of these types of innovations could not be shared with the authors and there might be projects implemented after data collection concluded, implying this study may not be an exhaustive inventory of all eHealth innovations implemented in Kenya.

    “Therefore, information from some of these types of innovations could not be shared with the authors and there might be projects that have since been implemented once the data collection had been concluded implying that this study may not be an exhaustive inventory of all eHealth innovations implemented in Kenya.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Due to lack of government stewardship and leadership, eHealth initiatives are not aligned to Ministry of Health priorities, hence project location is often determined by implementers.

    “Due to lack of government stewardship and leadership, eHealth initiatives are not aligned to the Ministry of Health priorities hence projects location is often determined by implementers.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The benefits arising from eHealth adoption are often not passed on to patients or beneficiaries.

    “The implication being that the benefits arising from eHealth adoption are often not passed on to patients or beneficiaries.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Marginalised areas have limited access to health care services yet bear the highest burden of disease.

    “The marginalised areas have limited access to health care services yet they bear the highest burden of disease [54].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [54] Vision K. 2030 (2007). A globally competitive and prosperous Kenya: https://www.opendatagoke/download/jih3-amby/application/pdf .

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The use of text-message reminders is an inexpensive and effective way to improve health workers' adherence to malaria treatment guidelines.

    “This analysis showed that the use of text-message reminders is inexpensive and effective way to improve health workers adherence to malaria treatment guidelines.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Zurovac D, Larson BA, Sudoi RK, Snow RW. Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers’ adherence to malaria guidelines in Kenya. PLoS ONE. 2012;7(12):e52045. source

      Not checked in the free run.

38 of 38

  • The paper relies on this without support.

    There is a dearth of evidence of eHealth initiatives being implemented in Kenya, specifically a lack of a registry of all projects under implementation and documentation of their characteristics.

    “However, there is dearth of evidence of initiatives being implemented in the country. Specifically, there is lack of a registry of all projects under implementation and documentation of their specific characteristics including contributions to strengthening the Kenyan health system.”

  • The paper relies on this without support.

    A large number of eHealth projects in Kenya were not reported in peer reviewed literature.

    “This however was not sufficient as there were large number of eHealth projects in Kenya that were not reported in peer reviewed literature.”

  • The paper relies on this without support.

    The cost of setting up mobile health systems is considerably low compared to other ICT systems.

    “The cost of setting up mobile health systems is considerably low compared to other ICT systems.”

  • The paper relies on this without support.

    Mobile Health driven initiatives provide easy accessibility to interventions effectively at any setting.

    “Mobile Health driven initiatives provide easy accessibility to interventions effectively at any setting.”

  • The paper relies on this without support.

    In the developing and building up phase, eHealth initiatives are majorly driven by the need to improve access and quality of health care.

    “In this phase, the eHealth initiatives are majorly driven by the need to improve access and quality of health care.”

  • The paper relies on this without support.

    The major pressing health priorities in marginalised regions are maternal and child health challenges and communicable diseases such as malaria, tuberculosis, and HIV/AIDS.

    “The major pressing health priorities in these regions are maternal and child health challenges and communicable diseases such malaria, tuberculosis, and HIV/AIDS.”

  • The paper relies on this without support.

    Health systems are interconnected.

    “Since health systems are interconnected, it is necessary that eHealth projects be able to integrate to the overall health system.”

  • The paper relies on this without support.

    Development agencies focus on their countries' development assistance strategic direction while international non-governmental organisations focus on the most popular diseases in an effort to attract funding.

    “This is because development agencies focuses on their countries’ development assistance strategic direction while international non-governmental organisations would focus on the most popular diseases in an effort to attract funding.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Incorrect number of projects remaining after randomized trials

    Minor

    Of the 28 evaluated projects, 8 underwent randomized controlled trials, leaving 20 rather than 21.

    Reported 21 · recomputed 20

  • Primary-care percentage differs from the project count

    Minor

    The stated 19 primary-care projects represent about 27.5% of 69 projects, which rounds to 28%, not 27%.

    Reported 27 · recomputed 27.536232

  • Malaria project count differs between table and text

    Minor

    Table 2 lists 7 malaria projects, but the health-focus section reports 8.

  • eLearning share is understated

    Minor

    The 8 eLearning projects represent about 12% of 69 projects, not 11%.

    Reported 11 · recomputed 11.594203

  • Four-project categories are reported as 5%

    Minor

    Four of 69 projects is about 5.8%, which rounds to 6%, not 5%. Table 2 also reports 5% for the four-project health financing and drug supply categories.

    Reported 5 · recomputed 5.797101

  • Cross-sectional study count differs between table and text

    Minor

    Table 2 lists 6 cross-sectional studies, but the evaluation section reports 7.

6 of 6

Cites

Flagged first, then by citations

1 of the 40 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Talbot D. Kenya’s mobile prescription: local programmers and homegrown business models are helping to realize the vast promise of using phones to improve health care and save lives. Technol Rev (Camb, Mass). 2012;115:52.
  2. Kenya National Bureau of Statistics. Economic survey 2014. Nairobi: Kenya National Bureau of Statistics; 2014.
  3. Hoibak S, Schilperoord M. Android phones for mosquito net surveys. Forced Migr Rev. 2011;1(38):32.
  4. Constitution K. Government Printer. Kenya: Nairobi; 2010.

Cited by

Sorted by citations

Related

Authors
Njoroge, M., Zurovac, D., Ogara, E. A. A., Chuma, J., & Kirigia, D.
Affiliations
  • Kenya Medical Research Institute (KE)
  • Boston University (US)
  • Ministry of Health (KE)
Corresponding author
Njoroge, Martin
ORCID
Venue
BMC Research Notes
Publisher
Springer Science and Business Media LLC
Published
2017-02-10
Volume
10
Issue
1
Pages
90-90
ISSN
1756-0500 (ISSN-L)
DOI
10.1186/s13104-017-2416-0
PMC
PMC5301342
OpenAlex
W2586626150
Semantic Scholar
1be9f4e520c591a227e4dfc1fd5972cc4bcb6db7
Cited by
100
References
40
Citations by year
2026: 4 · 2025: 9 · 2024: 9 · 2023: 17 · 2022: 10 · 2021: 16 · 2020: 14 · 2019: 10 · 2018: 5 · 2017: 6
FWCI
1.68
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Research Notes (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • International Development Research Centre (CA) (grant number 106229-011)
  • Wellcome Trust (GB) (092654)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
e-health, mobile health, Kenya, health information systems, telemedicine, online learning, HIV/AIDS, maternal and child health, primary care, health equity, health system strengthening, project evaluation
MeSH terms
Acquired Immunodeficiency Syndrome, Community Health Services, Developing Countries, Humans, Kenya, Primary Health Care, Public Health, Randomized Controlled Trials as Topic, Telemedicine, Healthcare Disparities, Health Information Systems

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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