Assessing the landscape of digital health implementation for data services: The Perspective of Digital Health Experts in Cameroon

Frankline Sanyuy Nsai^1,2*Palle John Ngunde¹Anna Longdoh Njunda¹Tendongfor Nicholas¹Cho Sabastine Anye³Juliet Nabyonga-Orem^2,4Omer Njajou⁵

• ¹Faculty of Health Sciences, University of Buea, Buea, Cameroon
• ²World Health Organization (Namibia), Windhoek, Namibia
• ³Africa Centres for Disease Control and Prevention, Addis Ababa, Addis Ababa, Ethiopia
• ⁴NorthWest University, Potchefstroom, South Africa
• ⁵University of Minnesota Health Sciences, University of Minnesota Medical Center, Minneapolis, Minnesota, United States

Digital health technologies offer promising avenues to address challenges in healthcare systems, particularly in regions like Sub-Saharan Africa, including Cameroon. These technologies can improve access to care, enhance quality, and optimize healthcare delivery and monitoring through better data management and interoperability. This study aimed to assess the landscape of digital health implementation for data services in Cameroon, focusing on governance, interoperability, and the adoption of digital platforms. We used a mixed methods approach, administering questionnaires (n=60) and conducting in-depth interviews (n=6) with digital health experts. The sample was purposively selected to include individuals with experience in digital health projects. Data were analyzed to assess the extent of digital health adoption, including challenges related to interoperability with the District Health Information System 2 (DHIS2). The study revealed significant gaps in governance and policy support for digital health in Cameroon, with 85% of respondents unaware of any existing guidelines. This gap in governance highlights the need for comprehensive policies to guide digital health initiatives. Moreover, 86.7% felt there was inadequate policy support for digital health implementation, particularly among those with higher academic qualifications (f = 16.033, p = 0.001) and those working at the central level (90.9%). This lack of policy support underscores the necessity for stronger governance and specific policies to support digital health implementation. While 63.3% of organizations had used digital platforms, only 63.3% of respondents received formal training, and 80% were aware of DHIS2. However, 45% reported challenges in interoperability between their systems and DHIS2, which was significantly more common among males (χ² = 4.411, p = 0.036) and those with a Master's degree (f = 12.057, p = 0.003). These interoperability issues indicate a need for technical solutions and training to ensure seamless data exchange between different health information systems. Cameroon faces critical challenges in digital health implementation, particularly in governance, policy support, and system interoperability. Addressing these issues requires a concerted effort to develop comprehensive digital health policies, enhance training, and ensure interoperability of health information systems. These measures are essential for leveraging digital health technologies to improve healthcare delivery and outcomes in Cameroon.