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Broomhead SC, Mars M, Scott RE, et al. EHealth Investment Appraisal in Africa: A Scoping Review. Inquiry. 2021;58:469580211059999doi: 10.1177/00469580211059999.
Broomhead, S. C., Mars, M., Scott, R. E., & Jones, T. (2021). EHealth Investment Appraisal in Africa: A Scoping Review. Inquiry : a journal of medical care organization, provision and financing, 58469580211059999. https://doi.org/10.1177/00469580211059999
Broomhead, Sean C, et al. "EHealth Investment Appraisal in Africa: A Scoping Review." Inquiry : a journal of medical care organization, provision and financing vol. 58 (2021): 469580211059999. doi: https://doi.org/10.1177/00469580211059999
Broomhead SC, Mars M, Scott RE, Jones T. EHealth Investment Appraisal in Africa: A Scoping Review. Inquiry. 2021 Jan-Dec;58:469580211059999. doi: 10.1177/00469580211059999. PMID: 34905975; PMCID: PMC8679012.
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Inquiry. 2021 Jan-Dec;58:469580211059999. doi: 10.1177/00469580211059999.

EHealth Investment Appraisal in Africa: A Scoping Review.

Inquiry : a journal of medical care organization, provision and financing

Sean C Broomhead, Maurice Mars, Richard E Scott, Tom Jones

Affiliations

  1. Department of TeleHealth, College of Health Sciences, 72753University of KwaZulu-Natal, Durban, South Africa.
  2. 72753Health Information Systems Program South Africa, Pretoria, South Africa.
  3. 72753African Centre for EHealth Excellence, Cape Town, South Africa.
  4. College of Nursing and Health Sciences, 72753Flinders University, Adelaide, South Australia.
  5. Department of Community Health Sciences, Cumming School of Medicine, 72753University of Calgary, Calgary, Canada.

PMID: 34905975 PMCID: PMC8679012 DOI: 10.1177/00469580211059999

Abstract

eHealth is an opportunity cost, competing for limited available funds with other health priorities such as clinics, vaccinations, medicines and even salaries. As such, it should be appraised for probable impact prior to allocation of funds. This is especially pertinent as recognition grows for the role of eHealth in attaining Universal Health Coverage. Despite optimism about eHealth's potential role, in Africa there remain insufficient data and skills for adequate economic appraisals to select optimal investments from numerous competing initiatives. The aim of this review is to identify eHealth investment appraisal approaches and tools that have been used in African countries, describe their characteristics and make recommendations regarding African eHealth investment appraisal in the face of limited data and expertise. Methods: Literature on eHealth investment appraisals conducted in African countries and published between January 1, 2010 and June 30, 2020 was reviewed. Selected papers' investment appraisal characteristics were assessed using the Joanna Briggs Institute checklist for economic evaluations and a newly developed Five-Case Model for Digital Health (FCM-DH) checklist for investment appraisal. 5 papers met inclusion criteria. Their assessments revealed important appraisal gaps. In particular, none of the papers addressed risk exposure, affordability, adjustment for optimism bias, clear delivery milestones, practical plans for implementation, change management or procurement, and only 1 paper described plans for building partnerships. Discussion: Using this insight, an extended 5-Case Model is proposed as the foundation of an African eHealth investment appraisal framework. This, combined with building local eHealth appraisal capabilities, may promote optimal eHealth investment decisions, strengthen implementations and improve the number and quality of related publications.

Keywords: Africa; appraisal; assessment; developing countries; digital health; eHealth; economics; impact; investment

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