Adoption, barriers and opportunities of interoperability and eHealth standards in Africa: a scoping review.

Objectives: Interoperability, the seamless exchange and use of data across digital health systems, is essential for integrated, efficient healthcare delivery. However, evidence on its adoption in Africa remains limited and fragmented. This scoping review aimed to map existing evidence, identify key barriers and highlight emerging opportunities for strengthening interoperability across all levels on the continent.

Methods: We conducted the review in line with the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. Searches were carried out across PubMed/MEDLINE, IEEE Xplore, African Index Medicus and Google Scholar, focusing on English-language publications from January 2010 to March 2025. Eligible sources included peer-reviewed articles, conference papers and relevant policy documents.

Results: Sixteen studies met the inclusion criteria. The findings revealed wide disparities in the adoption of interoperability standards, with countries such as Uganda, South Africa and Kenya showing greater momentum due to national digital strategies and health information exchange initiatives. Common challenges included limited technical capacity, fragmented infrastructure and inadequate regulatory support. However, there were encouraging developments around the use of open-source platforms like OpenHIE, regional policy alignment through the African Union Digital Health Strategy and growing public-private partnerships.

Discussion: Progress remains uneven, shaped by each country's digital maturity, workforce capabilities and policy landscape. Capacity-building and better alignment with global standards could bridge current gaps.

Conclusion: To build resilient digital health systems, African countries must strengthen governance, invest in infrastructure and develop technical expertise. Future work should assess how interoperability influences clinical care and explore regional readiness for cross-border data exchange.