The potential of digital health technologies in African context, Ethiopia

ABSTRACT The World Health Organization (WHO) recently put forth a Global Strategy on Digital Health 2020 - 2025 with several countries having already achieved key milestones. We aimed to understand whether and how digital health technologies (DHTs) are absorbed in Africa, tracking Ethiopia as a key node. We conducted a systematic review, searching PubMed-MEDLINE, ScienceDirect, African Journals Online, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to 02 February 2021 for studies of any design that investigated the potential of DHTs in clinical or public health practices in Ethiopia. This review was designed to inform our ongoing DHT-enabled randomized controlled trial (RCT) ( ClinicalTrials.gov ID: NCT04216420 ). We found 23,897 potentially-relevant citations, among which 47 studies met the inclusion criteria, comprising a total of 594,999 patients, healthy individuals, and healthcare professionals. The studies involved seven DHTs: mHealth (25 studies, 573,623 participants); electronic health records (13 studies, 4,534 participants); telemedicine (3 studies, 445 participants); cloud-based application (2 studies, 2,382 participants); genomics data (1 study, 47 participants); information communication technology (2 studies, 551 participants), and artificial intelligence (1 study, 13,417 participants). The studies targeted six health conditions: maternal and child health (15), infectious diseases (11), non-communicable diseases (3), dermatitis (1), surgery (3), and general health conditions (14). The outcomes of interest were feasibility, usability, willingness or readiness, effectiveness, quality improvement, and knowledge or attitude towards DHTs. Four studies involved RCTs. The analysis showed that although DHTs are a relatively recent phenomenon in Ethiopia, their potential harnessing clinical and public health practices are highly visible. Their adoption and implementation in full capacity requires more training, access to better devices such as smartphones, and infrastructure. DHTs hold much promise tackling major clinical and public health backlogs and strengthening the healthcare ecosystem in Africa. More RCTs are needed on emerging DHTs including artificial intelligence, big data, cloud, genomics data, cybersecurity, telemedicine, and wearable devices to provide robust evidence of their potential use in such settings and to materialize the WHO’s Global Digital Health Strategy.