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


CONCLUSIONS
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.
Department of Public Health Research, KEMRI-Wellcome Trust Research Programme, PO BOX 43640-00100, Nairobi, Kenya. wnjoroge@kemri-wellcome.org.
Martin
M
Njoroge
Department of Public Health Research, KEMRI-Wellcome Trust Research Programme, PO BOX 43640-00100, Nairobi, Kenya.|Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, CCVTM, Oxford, OX3 7LJ, UK.|Center for Global Health and Development, Boston University School of Public Health, 85 East Concord Street, Boston, MA, 02118, USA.
Dejan
D
Zurovac
Ministry of Health, Division of eHealth, Nairobi, Kenya.
Esther A A
EA
Ogara
Department of Public Health Research, KEMRI-Wellcome Trust Research Programme, PO BOX 43640-00100, Nairobi, Kenya.
Jane
J
Chuma
Department of Public Health Research, KEMRI-Wellcome Trust Research Programme, PO BOX 43640-00100, Nairobi, Kenya.
Doris
D
Kirigia
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000517:prevention & control; D003153:Community Health Services / Q000379:methods*; D003906:Developing Countries; D063005:Health Information Systems / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D011634:Public Health / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine / Q000458:organization & administration / Q000706:statistics & numerical data*
Evaluation; Health equity; Health information systems; Kenya; Telemedicine; eHealth; mHealth