Digital Health Solutions and State of Interoperability: Landscape Analysis of Sierra Leone

Emeka Chukwu; Lalit Garg; Edward Foday; Abdul Konomanyi; Royston Wright; Francis Smart

doi:10.2196/29930

Digital Health Solutions and State of Interoperability: Landscape Analysis of Sierra Leone

JMIR Form Res. 2022 Jun 10;6(6):e29930. doi: 10.2196/29930.

Authors

Emeka Chukwu¹, Lalit Garg¹, Edward Foday², Abdul Konomanyi³, Royston Wright⁴, Francis Smart²

Affiliations

¹ Department of Computer Information Systems, Faculty of Information and Communication Technology, University of Malta, Msida, Malta.
² Directorate of Planning, Policy, and Information, Ministry of Health and Sanitation, Freetown, Sierra Leone.
³ Directorate of eGovernment, Ministry of Information and Communication, Freetown, Sierra Leone.
⁴ Monitoring and Evaluation Unit, Health and Nutrition, UNICEF, Freetown, Sierra Leone.

PMID: 35687406
PMCID: PMC9233249
DOI: 10.2196/29930

Abstract

Background: The government and partners have invested heavily in the health information system (HIS) for service delivery, surveillance, reporting, and monitoring. Sierra Leone's government launched its first digital health strategy in 2018. In 2019, a broader national innovation and digital strategy was launched. The health pillar direction will use big data and artificial intelligence (AI) to improve health care in general and maternal and child health in particular. Understanding the number, distribution, and interoperability of digital health solutions is crucial for successful implementation strategies.

Objective: This paper presents the state of digital health solutions in Sierra Leone and how these solutions currently interoperate. This study further presents opportunities for big data and AI applications.

Methods: All the district health management teams, all digital health implementing organizations, and a stratified sample of 72 (out of 1284) health facilities were purposefully selected from all health districts and surveyed.

Results: The National Health Management Information System's (NHMIS's) aggregate reporting solution populated by health facility forms HF1 to HF9 was, by far, the most used tool. A health facility-based weekly aggregate electronic integrated disease surveillance and response solution was also widely used. Half of the health facilities had more than 2 digital health solutions in use. The different digital health software solutions do not share data among one another, though aggregate reporting data were sent as necessary. None of the respondents use any of the health care registries for patient, provider, health facility, or terminology identification.

Conclusions: Many digital health solutions are currently used at health facilities in Sierra Leone. The government can leverage current investment in HIS from surveillance and reporting for using big data and AI for care. The vision of using big data for health care is achievable if stakeholders prioritize individualized and longitudinal patient data exchange using agreed use cases from national strategies. This study has shown evidence of distribution, types, and scale of digital health solutions in health facilities and opportunities for leveraging big data to fill critical gaps necessary to achieve the national digital health vision.

Keywords: HIE; Health information and communication technologies; Sierra Leone; big data; digital health; eHealth; interoperability; mHealth; mobile health.

©Emeka Chukwu, Lalit Garg, Edward Foday, Abdul Konomanyi, Royston Wright, Francis Smart. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.06.2022.