Digital Health Foundations

Digital Health Foundations is the Level I starting point for everyone working in or alongside African health systems: clinicians, nurses, pharmacists, laboratory scientists, public-health and health-information staff, managers, and students. No prerequisites are required. In four to six hours (5 CEU), you build a shared language and a clear mental model of digital health and why Africa's demographic, epidemiological, and resource transitions make it a structural necessity rather than a luxury. You will learn how health information actually flows through records, registries, and routine systems like DHIS2 and OpenMRS, why fragmentation breaks it, and what interoperability and national platforms fix. You will also examine digital health literacy for the whole workforce, and the privacy and consent principles that protect patient trust. Grounded in real African systems and offline-first realities, this course gives you the vocabulary and confidence to work across disciplines and prepare for ADHA's advanced courses.

Course glossary

• Digital health — The field of knowledge and practice associated with the development and use of digital technologies to improve health (WHO); the umbrella term.
• eHealth — The cost-effective and secure use of information and communications technologies (ICT) in support of health.
• mHealth — Health practice supported by mobile devices; in Africa often delivered via SMS/USSD on basic feature phones.
• Telehealth — The delivery of health services and information at a distance.
• Telemedicine — Remote clinical services (diagnosis, treatment, consultation) delivered by health professionals.
• Health informatics — The science of how health data, information, and knowledge are collected, managed, and used.
• Health information system (HIS) — The people, processes, and technologies that collect, manage, and report health data.
• Universal health coverage (UHC) — All people receiving the quality health services they need without suffering financial hardship.
• Leapfrogging — Adopting newer technology directly without building legacy stages; requires foundational "rails."
• Pilotitis — The failure pattern of many small projects that show promise but die when grant funding ends.
• Donor cliff — The collapse of a grant-funded service when funding ends because no government or revenue source was designed to absorb it.
• Electronic medical record (EMR) — The digital chart of a patient within one organisation.
• Electronic health record (EHR) — The longitudinal, shareable record that follows a patient across organisations.
• Health management information system (HMIS) — Routine aggregation of facility data for management and planning (in Africa, usually DHIS2).
• DHIS2 — The open-source District Health Information Software, the de facto national HMIS backbone across much of Africa.
• OpenMRS — An open-source EMR platform developed for low-resource settings, widely deployed in African HIV and chronic-care programmes.
• Data-use gap — When data is collected and reported but not used to improve decisions.
• Registry — An authoritative single list (of patients, health workers, facilities, or terminology) that anchors a health information ecosystem.
• Master patient index / client registry — A registry giving each person a unique identity across systems, enabling longitudinal records.
• Interoperability — The ability of two or more systems to exchange information and to use the information exchanged.
• HL7 FHIR — The modern, web-based standard for exchanging healthcare data between systems.
• ICD / LOINC — Standard terminologies for diagnoses (ICD) and laboratory observations (LOINC) that enable shared meaning across systems.
• Digital health platform (DHP) / infostructure — A shared information infrastructure offering reusable components (identity, registries, exchange, terminology) on which applications run.
• Health information exchange (HIE) — The governed capability and interoperability layer for moving health data between systems while preserving its meaning.
• Fragmentation ("eHealth chaos") — Many parallel, non-interoperable systems; a product of financing and governance, not technology.
• Digital health literacy (eHealth literacy) — The ability to seek, find, understand, appraise, and apply electronic health information; for workers, operational fluency with care systems.
• Blended learning — Combining digital content with in-person or facilitated sessions; the African default for scalable training.
• Offline-first — Designing tools and content to function without continuous connectivity, syncing when available.
• Informed consent — A patient's genuine, revocable agreement to data processing after understanding what, why, who, and their choices.
• Data minimisation / purpose limitation — Collecting only the data needed and using it only for the stated purpose.
• Special-category (sensitive) data — Health data, singled out by data-protection laws for stronger protection.
• Cyber-hygiene — Everyday personal security habits that form the first line of patient-data protection.
• Data sovereignty — The principle that nations govern the health data generated within their borders and capture its value.
• Community health worker (CHW) — A frontline community-based cadre (e.g. Ethiopia's health extension workers, Rwanda's binômes, Kenya's community health promoters) delivering much of rural primary care.

Frequently asked questions

• Q: I'm a student / non-clinician — is this course relevant to me? A: Yes. Digital health is interdisciplinary by nature: data clerks, pharmacists, laboratory scientists, nurses, managers, ICT staff, and students all share the same ecosystem. This foundation builds the common language and mental model everyone needs before specialising, with no prerequisites.

• Q: Is digital health just about expensive hardware and the internet? A: No. The most influential African programmes — MomConnect's maternal messaging, CHW data tools, USSD information lines — run on basic phones and offline-first designs. Digital health is about using whatever technology fits the context to strengthen care, not about buying the newest device.

• Q: What's the difference between an EMR and an EHR, in one line? A: An EMR is a patient's chart inside one facility; an EHR is the record that follows the patient across facilities. EMR digitises a clinic; EHR digitises a health system.

• Q: Why do so many digital health projects fail? A: The classic pattern is "pilotitis" — projects that work on grant money, never plan how a government budget or insurer will absorb them, and collapse at the "donor cliff." Success requires government ownership, interoperability, and financing planned from the start, not just a good launch.

• Q: What does interoperability really mean for my daily work? A: It means a lab result, a referral, or a patient's history can move accurately between systems so you don't re-enter it (introducing errors) and you can see the full picture. Without it, data is trapped in silos, surveillance signals are slow, and care is fragmented.

• Q: Do I need to be a programmer or memorise the laws to handle patient data responsibly? A: No. You need to apply a few consistent principles — obtain genuine consent, collect and use only what's needed, keep data confidential, protect your logins, and report breaches — and practise good cyber-hygiene. The laws (Malabo, POPIA, and national acts) formalise these everyday habits.

• Q: Why is the gender digital divide raised in a foundations course? A: Because equity is a design outcome, not a default. Women make up most of Africa's frontline health workforce yet are about a third less likely to use mobile internet; if programmes ignore this, they exclude both workers and patients. Everyone designing or using digital services should keep inclusion in view.

• Q: How does this course connect to the rest of the ADHA curriculum? A: It is the Level I shared foundation. It introduces concepts — interoperability, platforms, the digital workforce, governance and trust — that later, more specialised courses (on implementation, technologies, governance, and entrepreneurship) develop in depth. Master the vocabulary and mental model here, and the advanced material becomes far easier.