Key Takeaways:
- The narrative has moved from hype to infrastructure and outcomes.
- Digital health isn’t just apps; it’s an ecosystem of tech, policy, capital, and people.
- Progress is uneven, but real; telemedicine and data systems have taken root.
- Fragmentation and siloed systems are the Achilles’ heel.
- The digital divide is a health equity issue.
- Clinician adoption remains stubbornly low.
- Funding models are misaligned with sustainable scale.
- Policy leadership matters, but it is inconsistent.
- Local capacity isn’t keeping pace with need.
- Future success hinges on standardisation and shared infrastructure.
When discussing digital health in Africa, we often centre our conversations on individual startups such as the next promising telemedicine platform, the next innovative diagnostics app, or the breakthrough e-pharmacy that claims to revolutionise access.
When we solely focus on isolated ventures, we miss the bigger picture.
What matters now is the ecosystem, which is the interconnected web of technologies, policies, infrastructure, human capacity, and capital that determines whether digital health solutions can scale and sustain impact across the continent.
We are no longer seeing hype; there has been a shift. The shift from hype to infrastructure and outcomes represents a critical maturation point for African digital health.
Between 2015 and 2020, the sector experienced a huge wave of enthusiasm, with investors pouring money into ventures promising to leapfrog traditional healthcare delivery.
Today, the conversation has evolved. Stakeholders are asking tougher questions: they want to know whether these platforms can achieve financial sustainability on their own, without relying solely on donor funds.
Do they integrate with existing health systems?
Are they improving health outcomes at scale, or merely digitising inefficiency?
This article maps Africa’s digital health ecosystem as it stands today. It examines the key components that make it function, the tangible progress already achieved in Africa, the persistent gaps that constrain growth, and what the sector needs to move from potential to performance.
Understanding this landscape is essential for anyone working in, planning to invest in, or currently designing policy around digital health in Africa.
“What matters now is the ecosystem, which is the interconnected web of technologies, policies, infrastructure, human capacity, and capital that determines whether digital health solutions can scale and sustain impact across the continent.”
Key Components Of Africa’s Digital Health Ecosystem
Africa’s digital health ecosystem is made up of several interdependent layers, each critical to the sector’s overall functionality.
Service delivery platforms form the most visible layer. These include telemedicine platforms like Rocket Health in Uganda and mPharma’s network across multiple African countries, e-pharmacy services such as LifeStores in Nigeria, and diagnostic technologies ranging from point-of-care devices to AI-powered radiology interpretation tools.
According to a 2023 report by the African Union Development Agency, over 600 registered digital health startups now operate across the continent, up from fewer than 200 in 2016.
Health information systems and electronic health records (EHRs) represent the data backbone.
Solutions like OpenMRS and DHIS2 (District Health Information Software 2) have been deployed in numerous African countries.
DHIS2 alone is used in more than 40 African nations for health data management, according to the Health Information Systems Programme at the University of Oslo.
However, these systems often exist in silos, with limited interoperability between platforms or across national borders.
Infrastructure layers include connectivity, devices, cloud services, and payment systems.
Mobile penetration across sub-Saharan Africa reached approximately 46% as of 2024, according to GSMA Intelligence, with 4G coverage extending to roughly 70% of the population.
Even with this, we still face significant gaps: rural connectivity lags far behind urban regions, device affordability remains a significant barrier for lower-income populations, and reliable electricity supply, which is essential for charging devices and powering health facilities, is inconsistent in many of these regions.
The human layer comprises clinicians, community health workers, patients, and the broader workforce that enables digital health.
Kenya’s Community Health Strategy, for instance, leverages over 60,000 community health volunteers who increasingly use digital tools for patient tracking and data collection.
However, clinician adoption rates vary widely. This has often been hindered by inadequate training, poor user interface design, and resistance to changing established workflows, even though they are less efficient and more expensive.
Progress We Can Clearly Point To
The COVID-19 pandemic clearly accelerated telehealth adoption across Africa, in ways that would have taken years otherwise.
Nigeria saw platforms like LifeBank and Helium Health rapidly scale their services during the pandemic lockdown.
In South Africa, government-backed platforms, such as the National Health Insurance pilot projects, incorporated telemedicine components to maintain care continuity.
A 2022 World Health Organisation report noted that telehealth consultations in several African countries increased by 300-500% between 2019 and 2021.
Government-led digital health strategies have matured significantly. For example, Rwanda’s national digital health architecture, launched in phases since 2016, now includes integrated EHR systems used across all public health facilities.
Also, Kenya’s Digital Health Act of 2023 established a comprehensive legal framework for data protection, interoperability standards, and the regulation of digital health services.
Ghana’s Health Information System Strategic Plan (HISSP) 2022–2025 focuses on optimising health service data and strengthening the national health information architecture to support evidence-based decision-making.
The quality and experience of local founders have improved remarkably. Unlike the first generation of digital health ventures led primarily by technologists with limited healthcare experience, current founders often combine clinical training with technical expertise.
Dr Funmi Adewara of Mobihealth (Nigeria) exemplifies this hybrid leadership model—bringing both medical expertise and business acumen.
Similarly, platforms like Zoie Health (South Africa) were founded by individuals with deep clinical knowledge combined with market understanding. And the list goes on.
Public-private collaboration has strengthened. The Smart Africa Alliance, comprising over 40 African countries, has developed frameworks for cross-border interoperability in digital health.
In Ghana, the National Health Insurance Authority partnered with private tech firms to develop an Android version of the ClaimsIT app. This application’s claims processing systems have reduced payment cycles from months to weeks.
Kenya’s Beyond Zero campaign collaborated with mobile network operators to provide maternal health information via SMS to over 2 million women.
“However, clinician adoption rates vary widely. This has often been hindered by inadequate training, poor user interface design, and resistance to changing established workflows, even though they are less efficient and more expensive.”
Persistent Gaps And Friction Points
Despite the progress, fragmentation and interoperability remain the ecosystem’s most significant challenges.
Most digital health platforms operate as standalone systems with proprietary data formats.
A patient receiving care from multiple providers often has health information scattered across incompatible systems.
The Africa CDC’s Digital Health and Interoperability Technical Working Group, established in 2021, has made recommendations for continental standards, but implementation has remained a huge challenge.
Infrastructure inequality across regions has created a two-tiered ecosystem. While urban centres in countries like South Africa, Kenya, and Nigeria enjoy relatively robust connectivity and digital infrastructure, rural areas where healthcare needs are often most acute lag significantly.
According to the International Telecommunication Union’s 2024 data, internet penetration in rural sub-Saharan Africa stands at just 23%, compared to 57% in urban areas. This digital divide directly translates to health access disparities.
The low clinician adoption in some markets stems from multiple factors. Many healthcare workers view digital tools as additional administrative burdens rather than practice enhancers.
In a 2023 study published in the Journal of Medical Internet Research, researchers found that only 34% of clinicians in five West African countries regularly used digital health tools provided by their employers, citing poor integration with existing workflows, inadequate training, and concerns about data privacy.
Sustainability challenges beyond donor funding threaten long-term viability. Many digital health initiatives launched with grant funding from organisations such as the Bill & Melinda Gates Foundation, USAID, and various UN agencies struggle when transitional funding ends.
While there is no single fixed percentage across the continent, data on digital health “pilotitis” in Africa suggest that the vast majority of donor-funded projects cease operations once initial funding cycles end.
In Kenya, government data has indicated that 63% of health projects fail shortly after implementation due to a lack of sustainability strategies.
Country And Regional Snapshots
East Africa demonstrates policy-led innovation with strong government involvement.
In Rwanda, the Ministry of Health has systematically implemented digital health infrastructure, including the national EHR system and drone-based medical delivery in partnership with Zipline.
Kenya’s robust startup ecosystem has produced ventures like Ilara Health (diagnostics) and Zuri Health (telemedicine), supported by relatively progressive regulatory frameworks.
West Africa features more private-sector-driven platforms seeking to scale through market-based approaches.
Nigeria, with Africa’s largest population, hosts the continent’s highest concentration of digital health startups.
mPharma’s expansion across West Africa demonstrates the potential for regional integration, though regulatory harmonisation remains limited.
The ECOWAS region has discussed digital health integration frameworks, but sadly, implementation lags behind policy declarations.
Southern Africa benefits from stronger telecommunications and financial infrastructure, but faces slower regulatory agility.
South Africa’s sophisticated healthcare system has been slower to embrace digital transformation than that of countries with less-developed traditional infrastructure.
This is a classic “leapfrog” paradox, but recent initiatives, such as the National Department of Health’s mHealth strategy, are gaining increasing momentum.
Francophone markets present unique dynamics shaped by language and different policy traditions inherited from French colonial influence.
Digital health platforms must navigate French-language interfaces and regulatory frameworks often modelled on European systems.
Countries like Senegal and Côte d’Ivoire are developing digital health strategies, but the francophone ecosystem remains less developed than its anglophone counterparts, partly due to smaller venture capital flows and fewer regional integration mechanisms.
What The Ecosystem Still Needs
Standardisation and shared infrastructure top the priority list. Rather than each platform building proprietary solutions, the ecosystem needs common standards for data exchange, patient identification, and service integration.
The African Union’s Smart Africa initiative has proposed continental digital health standards, but adoption requires political will and technical capacity at the national level.
Stronger operator-founders and implementation partners are essential for translating digital solutions into real-world health system improvements.
The ecosystem needs more leaders who understand both technology and the operational complexities of healthcare delivery in resource-constrained settings.
This includes implementation partners who manage change management, training, and sustained user support, often work that is uneasy and receives insufficient attention and funding.
Better alignment between policy, funding, and execution remains elusive. This needs more attention. Government digital health strategies often lack adequate budgets for implementation.
We understand that donor funding frequently supports short-term pilots rather than sustainable systems. On the other hand, venture capital seeks rapid returns that may conflict with the patient relationship-building required for healthcare impact.
Aligning these different stakeholder incentives requires new funding models and governance structures.
The ecosystem also needs improved data governance frameworks that balance innovation with patient privacy.
While Kenya and Rwanda have enacted comprehensive data protection laws, many African countries lack clear legal frameworks for managing health data. This regulatory uncertainty deters both investors and users.
Finally, local capacity for health informatics must expand significantly.
African universities are beginning to offer specialised programs in health informatics and digital health, but the workforce gap remains substantial.
According to the WHO’s Global Strategy on Digital Health, Africa needs tens of thousands of additional health informatics professionals to adequately support the ecosystem’s growth.
“Sustainability challenges beyond donor funding threaten long-term viability. Many digital health initiatives launched with grant funding from organisations such as the Bill & Melinda Gates Foundation, USAID, and various UN agencies struggle when transitional funding ends.”
Conclusion
Africa’s digital health ecosystem has evolved from a collection of experimental pilots to a more structured landscape with demonstrable achievements, clearer challenges, and increasingly sophisticated stakeholders.
The next phase of development will be characterised by depth rather than novelty. This stage will focus on interoperability over proliferation, sustainability over experimentation, and measurable health outcomes over technological impressiveness.
The ecosystem’s maturation requires moving beyond the startup-centric narrative to address systemic questions: How do we build infrastructure that serves the entire health system, not just early adopters?
How do we ensure digital health reduces rather than exacerbates existing inequalities?
How do we create business models that align financial sustainability with public health goals?
These questions will frame our subsequent explorations of this ecosystem.
The next articles in this series will examine funding dynamics and investment patterns shaping African digital health, the specific challenges and strategies for scaling digital health solutions across diverse African markets, and the regulatory landscape and policy frameworks that enable or constrain ecosystem growth.
Understanding where we are now with an honest assessment of both progress and persistent gaps will provide the foundation for navigating where we need to go.
The opportunity for digital health to transform healthcare access and quality across Africa remains substantial, but realising that potential demands ecosystem thinking, not just the usual entrepreneurial enthusiasm we have always seen.
