Digital Skills in Medical Training Strengthening Health System Resilience Through Health Workforce in Central Africa

Musa Nji, Dr. Asahngwa Constantine and Dr. Ronald Gobina

Executive Summary

Digital health technologies including electronic health records, telemedicine, mobile health applications, artificial intelligence enabled tools, and surveillance systems are increasingly being adopted across Central Africa to improve service delivery, disease surveillance, and health system management. Countries such as Cameroon, Gabon and Chad, have implemented platforms such as DHIS2 and digital surveillance systems, particularly during public health emergencies. However, the impact of these investments remains constrained by inadequate digital competencies among health workers. Current policies largely emphasize infrastructure and technology deployment, with limited attention to workforce training, interoperability, and digital competency development. Consequently, digital tools remain underutilized across many health systems. Evidence from Finland, Germany, Singapore, China, and Namibia demonstrates that integrating digital health into formal medical and health-professional education improves workforce preparedness and strengthens health system resilience. Central Africa therefore needs context-specific curriculum reform, competency frameworks, and regional collaboration to build a digitally capable health workforce.

Key Messages

• Central African countries are expanding digital health systems, but limited digital competencies among health workers continue to constrain effective utilization and health system impact.
• Digital health competencies including telemedicine, health informatics, electronic prescribing, AI-assisted diagnostics, and data interpretation should be integrated into pre-service and in-service health-professional training.
• Regional and national digital competency frameworks, linked to accreditation and workforce planning, are essential for sustainable and scalable digital health transformation in Central Africa.

Context

Digital health encompasses a wide range of tools, including electronic health records, telemedicine, mobile health (mHealth) applications, digital diagnostics, artificial intelligence–enabled clinical decision support systems, and health information platforms such as District Health Information Software 2 (DHIS2). Globally, digital health has emerged as a central pillar of health system strengthening, with the WHO emphasizing its role in meeting up with health priorities such as universal health coverage and the sustainable development goals.

Across Africa, health systems are increasingly adopting digital platforms to improve service delivery, disease surveillance, clinical decision-making, and health system management. According to  the Cotonou Declaration on Digital Transformation (November 2025), digital health in Central African countries such as Cameroon, Chad, Democratic Republic of the Congo, Central African Republic, Republic of the Congo, and Gabon now extends beyond national reporting systems to include electronic medical records, mobile health platforms, and digital surveillance tools deployed across different levels of care.

However, technology adoption alone does not translate into improved health system performance. The effectiveness of digital health investments depends heavily on the capacity of health workers to use these tools efficiently. Regional studies highlight persistent gaps in digital training, resulting in underutilization of systems, and limited impact on service delivery. Core competencies such as tele-consultations, electronic prescribing, health informatics, AI-assisted diagnostics, and routine data interpretation are inconsistently integrated into training programs. This creates a health system workforce mismatch, where the rapid expansion of digital platforms is not matched by equivalent investments in human capacity, ultimately constraining health system performance and progress toward Universal Health Coverage.

Regulatory frameworks and state of digital technology use in Central Africa

Unlike ECOWAS, which has adopted a regional digital health strategic plan 2026–2030, Central Africa relies almost entirely on national‑level digital‑health strategies without a formal regional harmonization framework although implementation remains uneven across countries. In Cameroon, DHIS2 serves as the official national health information system, supporting routine data collection, reporting, and real-time monitoring of health services. Its implementation is anchored within broader policy frameworks, the national Digital Health Strategic Plan (2020–2024), which outline priorities for digital infrastructure, governance, and data use. However, regulatory provisions for interoperability, data protection, and workforce digital competencies remain underdeveloped, limiting system optimization.

In the Democratic Republic of the Congo, digital health deployment has been strongly shaped by national health development plans and emergency preparedness frameworks, particularly during Ebola outbreaks. Digital surveillance tools such as SORMAS have been deployed for case tracking and reporting within the context of International Health Regulations (IHR) compliance and national epidemic response policies. Despite these advances, a shortage of skilled human resources in ICT and health informatics, and issues of interoperability between different systems still exist. Thus, regulatory frameworks and national e-health strategies are still being developed, hindering coordinated and sustainable implementation.

In Gabon, digital health development is supported by national ICT policies and e-health initiatives that promote telemedicine and electronic medical records. These efforts are framed within broader digital transformation strategies such as the use of electronic medical records (EMRs), yet regulatory enforcement and workforce readiness remain key challenges.

Similarly, in Chad and Republic of the Congo, digital health initiatives are embedded within national health policies and supported by international partners, particularly in strengthening surveillance systems. However, regulatory frameworks for integrating digital tools into routine care delivery and professional training remain limited. Thus, the absence of a comprehensive standalone digital health policy and limited regulatory guidance on data governance, interoperability, and digital training constrain large-scale and coordinated implementation.

While most Central African countries have made progress in establishing policy frameworks to support digital health adoption, these frameworks remain disproportionately focused on infrastructure and system deployment rather than workforce capacity building. This imbalance contributes to a fragmented digital ecosystem and reinforces the gap between available technology and effective utilization in practice.

Importance of Digital Technologies in Health

Digital technologies are critical enablers of health system strengthening, particularly in low- and middle-income settings. Electronic health records improve continuity and coordination of care by ensuring that patient information is accessible across different levels of the health system, while telemedicine expands access to services in underserved and remote areas, helping to address workforce shortages and geographic barriers.

Health information systems such as DHIS2 enhance the availability, timeliness, and accuracy of data, enabling evidence-based planning, resource allocation, and performance monitoring. At the same time, mobile health applications support community-level service delivery and improve patient follow-up, while digital surveillance platforms strengthen outbreak detection and response capabilities.

Beyond service delivery, digital technologies play a central role in public health governance by improving transparency, accountability, and coordination across health systems. Their importance was clearly demonstrated during Ebola and COVID-19 responses, where real-time data systems enabled faster detection and response to public health threats.

However, these benefits are contingent on the ability of health workers to effectively use digital tools. Without adequate competencies, investments in digital infrastructure do not translate into improved outcomes, reinforcing the importance of aligning technological adoption with workforce development.

Strategies adopted by other countries

Central African governments should prioritize digital competence as a core clinical and public-health skill and build it into formal health-professional education and training programs rather than treating it as an ad hoc workshop issue. The strongest lesson from the international evidence is that curriculum integration works best when it is linked to wider health-system digitalization, professional standards, and practical exposure to real tools. In Finland, for example, the University of Oulu introduced a compulsory digital health course for fifth-year medical students, while the national MEDigi initiative sought to strengthen digital competence themes across medical education. The study also suggests that national system digitalization and curricular reform can reinforce each other over time.

Germany offers one of the clearest evaluated curriculum models. A comparative study of an undergraduate digital health module found that participation improved students’ knowledge and supported the conclusion that digital competencies should be firmly implemented in medical education. Related German work has also documented that multiple medical faculties have begun integrating digital-health competencies into undergraduate training, moving the field from isolated innovation toward broader curricular normalization.

Singapore is useful as a governance model for national standard-setting. A qualitative study on digital competencies for Singapore’s national medical school curriculum examined the formal curricula of all three medical schools and identified the competencies needed for graduates to work in a digital health system. The value of this approach is not yet a trial-style educational outcome, but rather the creation of a national framework that aligns training objectives across institutions with the needs of an increasingly digital healthcare environment.

China provides another useful example, especially for nursing and allied-health education. An evaluated online Digital Health and Informatics Course for undergraduate nursing students was designed to improve knowledge and comprehension of digital-health and informatics topics, self-assessed nursing informatics competencies, and student satisfaction.

Within Africa, published evidence of full curricular integration with measured learner outcomes is still relatively limited, but there are important policy and implementation precedents. Namibia’s National eHealth Strategy 2021–2025 goes beyond general digital ambition and explicitly calls for collaboration with higher education institutions to develop appropriate training programs, create modularized eHealth training curricula for health workers and ICT workers, develop a Health Informatics curriculum, integrate ICT skills into clinical staff training, and pursue professional accreditation for health informatics personnel.

Conclusion

For Central Africa, digital health investments need to be matched by equivalent investments in human competency development This requires curriculum reform, faculty development, infrastructure support, and alignment between education systems and health system needs. Without such alignment, the region risks perpetuating a cycle in which digital technologies are available but underutilized, limiting their potential to improve health outcomes and system performance.

Recommendation

While global experiences in digital health education offer useful lessons, their direct application to Central Africa requires careful adaptation. High-income countries have integrated digital health into medical training within well-resourced systems, whereas Central African countries face constraints including limited infrastructure, workforce shortages, and fragmented training systems. The priority, therefore, is not replication but adaptation embedding digital competencies into education systems in ways that reflect local capacity and health system context specific needs. Thus,

1. Ministries of Health and Higher Education should prioritize the development of standardized digital competency frameworks for medicine, nursing, pharmacy, and allied health training. These frameworks should define core competencies in areas such as telemedicine, electronic health records, data management, and digital surveillance to better align workforce skills with evolving health system needs.
2. Training institutions and accreditation bodies should embed digital health competencies into pre-service and in-service education rather than relying on short-term workshops. Priority should be given to practical training using existing digital platforms such as DHIS2, electronic medical records, and telemedicine tools to ensure graduates are prepared for increasingly digital health systems.
3. Governments and professional councils should expand blended and online learning models to address faculty and infrastructure constraints while linking digital competencies to professional accreditation and career progression. This will support sustainable workforce development and improve long-term utilization of digital health technologies across the region.
4. Regionally, Central African countries should leverage existing regional platforms, particularly the WHO AFRO–ITU francophone initiative, to develop harmonized and scalable training approaches instead of fragmented national efforts.