The World Health Organisation, in their 2016 report
on Global Diffusion of eHealth, states that Universal
Health Coverage (UHC) cannot be achieved without
the support of eHealth.
Existing literature and narratives on eHealth appear
to be originating from awestern epistemology.
Zimbabwean research shows that the meaning of
eHealth depends from one’s location and worldview.
Figure 1: No UHC without eHealth (WHO, 2016)
eHealth in Zimbabwe: Universal Health Coverage
and a case of local techno-social development
Trymore Chawurura1, Ronald Manhibi2, Janneke van Dijk2, Gertjan van Stam2,
1 Ministry of Health and Child Care, Masvingo Provincial Hospital, Zimbabwe
Abstract Code Number: 650
Key words: eHealth, Africa, transdisciplinarity
Our research shows that eHealth:
1. is not subservient to current forms of health care,
but an integral part of such acare
2. does not replace ‘older systems’, but gives
scalability and ability to additional forms of care
3. challenges the spatiality (the reach) and scalarity
(the hierarchy) of local practices and established
4. opens up both exciting opportunities and real
threats to the central features of contemporary
health management in Africa
In Zimbabwe, as many other African countries,
eHealth is still to go beyond the stage of sensitisation,
testing, amending, and small-scale implementations,
into ubiquitous availability and operation.
Figure 2: Various digital health platforms in Zimbabwe
Various ways in which eHealth can be instrumental:
•as abackbone of health systems with tools for the
prevention and management of disease with the
aim of epidemiological control
•in the measurement and evaluation of health
service delivery as an instrumental part of the
statistical and administrative enterprise
•as anetwork of tools, platforms, and applications,
through attention by technology inclined entities
•in facilitating the public and private health sectors
to report on health outcomes and, for instance,
providing health messages and the facilitation of
eHealth is context sensitive.Issues are, among others:
•paradigmatic and cultural (ubuntu/unhu versus
•technical (latency, congestion and variety of
•dependencies (on people, processes, systems, and
•epistemic (socialities, indigenous knowledge, and
cognitive justice of African experience)
eHealth developments in Africa and abroad are
contrapuntal:they are interdependent yet
independent in flow and delineation.
We propose to deconstruct and reconstruct eHealth
rationales to ensure eHealth aligns with African
people, processes, systems and local cultures, taking
into account local ways of meaning-making and the
value of established, embedded, local processes.
We advocate the development of African eHealth
models that are rooted in community engagement,
workforce development, and thought leadership that
strengthen local capacity development and
•Bishi, J., Shamu, A., van Dijk, J., van Stam, G.: Community
Engagement for eHealth in Masvingo, Zimbabwe.In:Proceedings of
1st International Multi Disciplinary Conference, 23-25 August 2017,
Lusaka, Zambia (2017)
•Chawurura, T., Manhibi, R., van Dijk, J., van Stam, G.: eHealth in
Zimbabwe, acase of techno-social development. In:IFIP WG 9.4
Conference, 1-3 May 2019,Dar es Salaam, Tanzania (2019).
•Fulgencio, H., Ong’ayo, A., van Reisen, M., van Dijk, J., van Stam, G.:
mMoney Remittances: Contributing to the Quality of Rural Health
Care.In:Proceedings of Africomm 2016, 6-7 Dec 2016,
Ouagadougou, Burkina Faso (2016).
•Hobbins, M., Kavenga, M., Manhibi, R., van Dijk, J., van Stam, G.:
eHealth: Connecting communities for health, selected cases in
Zimbabwe.Medicus Mundi Bulletin, 148 (2018).
•Johnson, D., van Stam, G.: The Shortcomings of Globalised Internet
Tech nology in Southern Africa. In:Proceedings of Africomm 2016, 6-7
Dec 2016,Ouagadougou, Burkina Faso (2016).
•MoHCC:The National Health Strategy for Zimbabwe, 2016-2020.
Equity and Quality in Health: Leaving No One Behind.Ministry of
Health and Child Care, Harare (2016).
•van Stam, G.: Toward s an Africanised Expression of ICT.In:Lecture
Notes of the Institute for Computer Sciences, Social-Informatics and
Tele co mm unication s Engineering, Vol.119 LNICST. Springer: Berlin,
•van Stam, G.: African Engineering Agency and the Informatisation of
the World. The case of Big Data and Information and Communication
Tech nologi es.In:EAI International Conference for Research,
Innovation and Development for Africa, 20-21 June 2017, Victoria
Falls, Zimbabwe, (2017).
•World Health Organisation:WHA58.28 eHealth. EHealth Resolutions
to the 58th Meeting of the World Health Assembly, (4), 121–123
•World Health Organization:Global diffusion of eHealth: making
universal health coverage achievable.In: Report of the third global
survey on eHealth. World Health Organization:Geneva (2016).
cost-effective and secure use
support of health and health-related
health literature, and
knowledge and research .
Harvesting from long time and rich experiences –
living research, in situ –both in rural and urban areas,
we regard eHealth as amulti-faceted, dynamic and
integrative episteme conducive for UHC in Africa.
We compiled atransdisciplinary eHealth narrative
from health professionals, participants at Technical
Working Groups at Zimbabwe’s Ministry of Health and
Child Care, and Information and Communication
Technology experts in Zimbabwe.
National Health Strategy (
investments in health
are necessary for the
and other service delivery
platforms to function
]new innovative programmes such as
are implemented to enhance and not
what has been working so far