title: Assessing the Coverage of E-Health Services in Sub-Saharan Africa. A Systematic Review and Analysis.
abstract: BACKGROUND
  E-Health has attracted growing interests globally. The relative lack of facilities, skills, funds and information on existing e-Health initiatives has affected progress on e-Health in Africa.
  
  
  OBJECTIVE
  To review publicly available literature on e-Health in sub-Saharan Africa (sSA) towards providing information on existing and ongoing e-Health initiatives in the region.
  
  
  METHODS
  Searches of relevant literature were conducted on Medline, EMBASE and Global Health, with search dates set from 1990 to 2016. We included studies on e-Health initiatives (prototypes, designs, or completed projects) targeting population groups in sSA.
  
  
  RESULTS
  Our search returned 2322 hits, with 26 studies retained. Included studies were conducted in 14 countries across the four sub-regions in sSA (Central, East, South and West) and spreading over a 12-year period, 2002-2014. Six types of e-Health interventions were reported, with 17 studies (65 %) based on telemedicine, followed by mHealth with 5 studies (19 %). Other e-Health types include expert system, electronic medical records, e-mails, and online health module. Specific medical specialties covered include dermatology (19 %), pathology (12 %) and radiology (8 %). Successes were 'widely reported' (representing 50 % overall acceptance or positive feedbacks in a study) in 10 studies (38 %). The prominent challenges reported were technical problems, poor internet and connectivity, participants' selection biases, contextual issues, and lack of funds.
  
  
  CONCLUSIONS
  E-Health is evolving in sSA, but with poorly published evidence. While we call for more quality research in the region, it is also important that population-wide policies and on-going e-Health initiatives are contextually feasible, acceptable, and sustainable.
authors.affiliation: Dr. Davies Adeloye, Demography and Social Statistics, and the e-Health Research Cluster, Covenant University, Ota, Nigeria, E-mail: Davies.Adeloye@covenantuniversity.edu.ng.
authors.forename: Davies
authors.initials: D
authors.lastname: Adeloye
authors.forename: Taiwo
authors.initials: T
authors.lastname: Adigun
authors.forename: Sanjay
authors.initials: S
authors.lastname: Misra
authors.forename: Nicholas
authors.initials: N
authors.lastname: Omoregbe
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D034742:Electronic Mail / Q000706:statistics & numerical data*; D014943:Global Health / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D000072638:Patient Portals / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000706:statistics & numerical data*; D014600:Utilization Review
keywords: E-health; africa; mhealth; sub-saharan; telemedicine