Are we there yet? Unbundling the potential adoption and integration of telemedicine to improve virtual healthcare services in African health systems

Since the outbreak of COVID-19, the attention has now shifted towards universal vaccination to gracefully lift

strict COVID-19 restrictions previously imposed to contain the spread of the disease. Sub-Saharan Africa is

experiencing an exponential increase of infections and deaths coupled with vaccines shortages, personal protective equipment, weak health systems and COVID-19 emerging variants. Some developed countries integrated

telemedicine to reduce the impacts of the shortage of healthcare professionals and potentially reduce the risk of

exposure, ensuring easy delivery of quality health services while limiting regular physical contact and direct

hospitalization. However, the adoption of telemedicine and telehealth is still nascent in many sub-Saharan Africa

countries. Therefore, this study reflects on progress made towards the use of telemedicine, virtual health care

services, challenges encountered, and proffers ways to address them. We conducted a systematic literature review

to synthesise literature on telemedicine in sub-Saharan Africa. The study revealed that telemedicine provides

unprecedented benefits such as improving efficiency, effective utilization of healthcare resources, forward triaging, prevention of medical personnel infection, aiding medical students' clinical observation and participation,

and assurance of social support for patients. However, the absence of policy on virtual care and political will, cost

of sustenance of virtual health care services, inadequate funding, technological and infrastructural barriers, patient and healthcare personnel bias on virtual care and cultural barriers are identified as limiting factors to the

adoption of virtual health care in many African health systems. To alleviate some of these barriers, we recommend

the development of robust policies and frameworks for virtual health care, the inclusion of virtual care in the

medical school curriculum, supporting virtual care research and development, increasing health funding,

and removing the monopolisation of telecom.