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Table 7 Summary of SSA health-related elements of framework

From: The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective

SSA related aspectsMotivation/ description
Regulations and standardsCompliance to specific regulations and standards mandatory in health industry.
Regulatory authoritiesFor example, in SA’s public health sector, the NDoH is a key stakeholder in the ecosystem. Platform owners would need to consider such authorities if they want access to government and public hospitals.
Building trustTrust may need to be built with users where technology is still unfamiliar. Within local authorities there might also be a sense of scepticism due to several similar initiatives that failed.
EHRs and EMRsThe platform might need access or enable use of existing EHRs or EMRs. These can be non-existent or hard to access in these contexts.
Data silosThere are currently no clear interoperability standards for this context and subsequently there are several silos of data that would require specialised effort to access.
Integration and interoperabilityIntegration and interoperability with systems in this context may be particularly difficult as they are often outdated and undefined.
Security and privacyIn SA, the Protection of Personal Information (PoPI) Act is a fundamental part of its citizens. Effort should be taken into keeping data, such as HIV statuses, secure and private whilst complying with the Act.
Health and technology educationThe end users, particularly in rural areas, may not be digitally literate. These end-users are often uneducated on health-related issues. This affects adoption and sustained use.
SustainabilityFinancial sustainability, as well as adoption and sustained use by the end users are particularly challenging in developing environments.
Available devicesSome end users may only have access to very simple and old mobile devices, therefore resulting in limitations and constraints in the design process.
AdoptionAs technology may not be familiar for all, adoption might be slow and require support and active change management.
Data availability and costIn rural areas the end users may have limited connectivity and may not be able to afford mobile data. This has an effect on back-ups, sending and storing of data. Often end-users work with pay-as-you-go data and will reject the app if is it costs anything at all.
Data trafficHeavy data traffic may prevent apps from working sufficiently, therefore implicating the design.