Legal and Public Health Governance for Sustainable Integration of Mobile Health (mHealth) Technologies in East Africa
DOI:
https://doi.org/10.12928/biste.v8i1.14943Keywords:
Legal, Public Health, mHealth, Technologies, East AfricaAbstract
Mobile health (mHealth), which comprises mobile health applications, telemedicine, SMS-based treatments, and wearable health monitors, has the power to change healthcare delivery, but at the same-time, it is going through a rapid developmental phase that regulators cannot keep up with. This is considered a necessity in balancing the Integration of mHealth technology innovation through enhanced laws within East Africa. It is in view of this that this examines the legal and public health framework in integrating mHealth technology in enhancing the healthcare system within East Africa. The study adopts a doctrinal and systematic analytical method of study directed by the PRISMA framework, allowing thorough legal analysis while at the same time guaranteeing a transparent, stringent, and comprehensive review of related literature. The study found that fragmentation of laws, lack of centralized public health and data governance, unequal access to mHealth services, and constraints on innovation, weakens the integration and regulation of mHealth. Hence, the study recommends and concludes that for effective integration of mHealth in enhancing the public health care system, the research insists on a unified legal system that states unambiguously which data protection benchmarks apply, what the liability conditions are, what the integration of different systems and regulations requirements is, and how to coordinate among different countries' regulators. Besides that, it suggests measures for strengthening the capacity of the targeted groups, such as: medical professionals, trainees, users’ digital literacy campaigns, and local mHealth technology developers’ institutions’ support.
References
K. Ndlovu, M. Mars, and R. E. Scott, “Development of a conceptual framework for linking mHealth applications to eRecord systems in Botswana,” BMC Health Services Research, vol. 21, no. 1, p. 1103, 2021, https://doi.org/10.1186/s12913-021-07134-4.
L. Wallis, P. Blessing, M. Dalwai, and S. D. Shin, “Integrating mHealth at point of care in low- and middle-income settings: The system perspective,” Global Health Action, vol. 10, no. sup3, p. 1327686, 2017, https://doi.org/10.1080/16549716.2017.1327686.
K. Harding et al., “A mobile health model supporting Ethiopia’s eHealth strategy,” Digital Medicine, vol. 4, no. 2, pp. 54–65, 2018, https://doi.org/10.4103/digm.digm1018.
K. M. Emmanuel, “Impact of technology on global health initiatives,” Sciences (NIJRMS), vol. 6, no. 2, pp. 66–73, 2025, https://doi.org/10.59298/NIJRMS/2025/6.2.6673.
K. Ndlovu, R. E. Scott, and M. Mars, “Interoperability opportunities and challenges in linking mHealth applications and eRecord systems: Botswana as an exemplar,” BMC Medical Informatics and Decision Making, vol. 21, no. 1, p. 246, 2021, https://doi.org/10.1186/s12911-021-01606-7.
S. Africa, Top Up Your Healthcare Access. Financializations of Development: Global Games and Local Experiments. 2023. https://books.google.co.id/books?hl=id&lr=&id=EjexEAAAQBAJ.
N. S. Mohta, E. Prewitt, L. Gordon, and T. H. Lee, “The Macro Trends Driving Care Delivery,” NEJM Catalyst Innovations in Care Delivery, vol. 5, no. 5, 2024, https://doi.org/10.1056/CAT.24.0159.
K. G. Mugalula, “Regulation of artificial intelligence in Uganda’s healthcare: exploring an appropriate regulatory approach and framework to deliver universal health coverage,” International Journal for Equity in Health, vol. 24, no. 1, p. 158, 2025, https://doi.org/10.1186/s12939-025-02513-3.
B. Clough, Challenging the frames of healthcare law. Embracing Vulnerability: The Challenges and Implications for Law. 2020. https://books.google.co.id/books?hl=id&lr=&id=y-_QDwAAQBAJ.
M. Njoroge, D. Zurovac, E. A. A. Ogara, J. Chuma, and D. Kirigia, “Assessing the feasibility of eHealth and mHealth: A systematic review and analysis of initiatives implemented in Kenya,” BMC Research Notes, vol. 10, no. 1, p. 90, 2017, https://doi.org/10.1186/s13104-017-2416-0.
W. K. Kansiime et al., “Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: A cross-sectional study,” BMC Primary Care, vol. 25, no. 1, p. 173, 2024, https://doi.org/10.1186/s12875-024-02430-4.
S. Mburu and O. Kamau, “Framework for development and implementation of digital health policies to accelerate the attainment of sustainable development goals: Case of Kenya eHealth Policy (2016–2030),” Journal of Health Informatics in Africa, vol. 5, no. 2, 2018, https://doi.org/10.12856/JHIA-2018-v5-i2-210.
K. Perehudoff, “Universal access to essential medicines as part of the right to health: a cross-national comparison of national laws, medicines policies, and health system indicators,” Global Health Action, vol. 13, no. 1, p. 1699342, 2020, https://doi.org/10.1080/16549716.2019.1699342.
E. C. Fuse Brown, A. S. Kesselheim, D. Malina, G. Pittman, and S. Morrissey, “Fundamentals of Health Law—a new perspective series,” New England Journal of Medicine, vol. 387, no. 4, pp. 372-373, 2022, https://doi.org/10.1056/NEJMe2207887.
S. Till et al., “Digital health technologies for maternal and child health in Africa and other low- and middle-income countries: Cross-disciplinary scoping review with stakeholder consultation,” Journal of Medical Internet Research, vol. 25, p. e42161, 2023, https://doi.org/10.2196/42161.
V. M. Kiberu, M. Mars, and R. E. Scott, “Barriers and opportunities to implementation of sustainable e-health programmes in Uganda: A literature review,” African Journal of Primary Health Care and Family Medicine, vol. 9, no. 1, pp. 1–10, 2017, https://doi.org/10.4102/phcfm.v9i1.1277.
P. A. Aidonojie, J. Nwazi, and U. Eruteya, “The legality, prospect, and challenges of adopting automated personal income tax by states in Nigeria: A facile study of Edo State,” Cogito, vol. 14, no. 2, 2022, https://www.ceeol.com/search/article-detail?id=1060583.
World Health Organization. Universal health coverage partnership annual report 2022: More than 10 years of experiences to orient health systems towards primary health care. World Health Organization. 2024. https://books.google.co.id/books?hl=id&lr=&id=d_cXEQAAQBAJ.
I. Iyamu, A. X. T. Xu, O. Gómez-Ramírez, A. Ablona, H. J. Chang, G. Mckee, and M. Gilbert, “Defining digital public health and the role of digitization, digitalization, and digital transformation: Scoping review,” JMIR Public Health and Surveillance, vol. 7, no. 11, p. e30399, 2021, https://doi.org/10.2196/30399.
A. Endalamaw et al., “A scoping review of digital health technologies in multimorbidity management: mechanisms, outcomes, challenges, and strategies,” BMC Health Services Research, vol. 25, p. 382, 2025, https://doi.org/10.1186/s12913-025-12548-5.
P. A. Aidonojie, O. O. Anne, and O. O. Oladele, “An empirical study of the relevance and legal challenges of an e-contract of agreement in Nigeria,” Cogito, vol. 12, no. 3, 2020, https://www.ceeol.com/search/article-detail?id=1034422.
A. A. Victor, L. J. Frank, L. E. Makubalo, A. A. Kalu, and B. Impouma, “Digital health in the African region should be integral to the health system’s strengthening,” Mayo Clinic Proceedings: Digital Health, vol. 1, no. 3, pp. 425–434, 2023, https://doi.org/10.1016/j.mcpdig.2023.06.003.
L. O. Gostin and B. M. Meier, Global Health Law and Policy: Ensuring Justice for a Healthier World. Oxford University Press. 2023. https://books.google.co.id/books?hl=id&lr=&id=JDXYEAAAQBAJ.
H. W. Kohl III, T. D. Murray, and D. Salvo, Foundations of physical activity and public health. Human Kinetics. 2025. https://books.google.co.id/books?hl=id&lr=&id=HQ9PEQAAQBAJ.
K. Ndlovu, M. Mars, and R. E. Scott, “Interoperability frameworks linking mHealth applications to electronic record systems,” BMC Health Services Research, vol. 21, no. 1, p. 459, 2021, https://doi.org/10.1186/s12913-021-06473-6.
J. McCool, R. Dobson, R. Whittaker, and C. Paton, “Mobile health (mHealth) in low- and middle-income countries,” Annual Review of Public Health, vol. 43, no. 1, pp. 525–539, 2022, https://doi.org/10.1146/annurev-publhealth-052620-093850.
E. Rusdiana, P. A. Aidonojie, M. Jufri, H. Ismaila, and N. Ibrahim, “Augment legal efforts through artificial intelligence in curtailing economic fraud in Nigeria: Issues and challenges,” Indonesian Journal of Criminal Law Studies, vol. 10, no. 1, pp. 115–148, 2025, https://doi.org/10.15294/ijcls.v10i1.22147.
P. A. Aidonojie, N. Okuonghae, A. Najjuma, O. O. Ikpotokin, and E. Obieshi, “Legal and socio-economic challenges of e-commerce in Uganda: Balancing growth and regulation,” Trunojoyo Law Review, vol. 7, no. 1, pp. 1–32, 2025, https://doi.org/10.21107/tlr.v7i1.27704.
G. E. Iyawa, S. Hamunyela, A. Peters, S. Akinsola, I. Shaanika, B. Akinmoyeje, and S. Mutelo, “Digital transformation and global health in Africa,” in Handbook of Global Health, pp. 137–167, 2021, https://doi.org/2021.10.1007/978-3-030-45009-0_6.
A. A. Abdi, W. Guyo, and M. Moronge, “Moderating effect of mobile technology on the relationship between health systems governance and service delivery in national referral hospitals in Kenya,” European Journal of Medical and Health Research, vol. 2, no. 1, pp. 18–27, 2024, https://doi.org/10.59324/ejmhr.2024.2(1).03.
P. A. Aidonojie, E. C. Aidonojie, O. Eregbuonye, S. W. Abacha, and M. Okpoko, “Prospect, legal, and health risks in adopting the metaverse in medical practice: A case study of Nigeria,” Jurnal Hukum dan Peradilan, vol. 13, no. 3, pp. 483–522, 2024, https://doi.org/10.25216/jhp.13.3.2024.483-522.
P. A. Aidonojie, O. O. Ikubanni, N. Okuonghae, and A. I. Oyedeji, “The challenges and relevance of technology in administration of justice and human security in Nigeria: Amidst the COVID-19 pandemic,” Cogito, vol. 13, no. 3, pp. 149–171, 2021, https://www.ceeol.com/search/article-detail?id=1034989.
P. A. Aidonojie, O. O. Ikubanni, and N. Okuonghae, “The prospects, challenges, and legal issues of digital banking in Nigeria,” Cogito, vol. 14, no. 3, 2022, https://www.ceeol.com/search/article-detail?id=1193350.
T. Manyazewal, Y. Woldeamanuel, H. M. Blumberg, A. Fekadu, and V. C. Marconi, “The potential use of digital health technologies in the African context: A systematic review of evidence from Ethiopia,” NPJ Digital Medicine, vol. 4, no. 1, p. 125, 2021, https://doi.org/10.1038/s41746-021-00487-4.
K. Appiah, I. Sam-Epelle, and E. L. C. Osabutey, “Technology and health services marketing in Africa,” in Health Service Marketing Management in Africa, pp. 243–254, 2019, https://doi.org/10.4324/9780429400858.
P. A. Aidonojie, A. Owoche, Y. A. Aleshinloye, K. I. Maifada, and B. Resty, “The prospect, legal, and medical issues in integrating AI in medical practice in Uganda,” KIULJ, vol. 6, no. 2, pp. 189–203, 2024, https://doi.org/10.59568/KIULJ-2024-6-2-10.
A. A. Yusuf, M. Charles, M. Samuel, A. Bello, and L. Ronald, “The development and growth of AI in Uganda: How is Uganda faring from a legal perspective?,” KIULJ, vol. 6, no. 2, pp. 204–223, 2024, https://doi.org/10.59568/KIULJ-2024-6-2-11.
H. I. Adebowale, A. Mohamed, C. O. Agwu, H. Shehu, C. Magnus, D. J. John, and Y. H. N. Osman, “Intellectual property law and artificial intelligence in Uganda: Trending issues and future prospects,” KIULJ, vol. 6, no. 2, pp. 224–240, 2024, https://doi.org/10.59568/KIULJ-2024-6-2-12.
B. Odunsi, O. O. Ogancha, and O. O. Oduniyi, “Fundamental objectives and directive principles of state policy in the Nigerian Constitution: Re-examining the non-justiciability of socio-economic rights,” Journal of Indonesian Constitutional Law, vol. 2, no. 3, pp. 274–298, 2025, https://doi.org/10.71239/jicl.v2i3.191.
S. N. B. Hamdan and R. B. Nordin, “Critique against the government: Freedom of speech and expression in Malaysia,” Journal of Indonesian Constitutional Law, vol. 2, no. 3, pp. 299–331, 2025, https://doi.org/10.71239/jicl.v2i3.70.
J. N. Sekandi et al., “Ethical, legal, and sociocultural issues in the use of mobile technologies and call detail records data for public health in the East African region: Scoping review,” Interactive Journal of Medical Research, vol. 11, no. 1, e35062, 2022, https://doi.org/10.2196/35062.
B. A. Bene et al., “Regulatory standards and guidance for the use of health apps for self-management in Sub-Saharan Africa: Scoping review,” Journal of Medical Internet Research, vol. 26, p. e49163, 2024, https://doi.org/10.2196/49163.
B. P. Ngongo, P. Ochola, J. Ndegwa, and P. Katuse, “The technological, organizational and environmental determinants of adoption of mobile health applications (m-health) by hospitals in Kenya,” PLoS One, vol. 14, no. 12, e0225167, 2019, https://doi.org/10.1371/journal.pone.0225167.
S. Lee, Y.-M. Cho, and S.-Y. Kim, “Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: An application of exploratory spatial analysis,” Globalization and Health, vol. 13, no. 1, p. 63, 2017, https://doi.org/10.1186/s12992-017-0286-9.
T. Neumark and R. J. Prince, “Digital health in East Africa: Innovation, experimentation and the market,” Global Policy, vol. 12, pp. 65–74, 2021, https://doi.org/10.1111/1758-5899.12990.
A. O. Agbeyangi and J. M. Lukose, “Telemedicine adoption and prospects in sub-Sahara Africa: A systematic review with a focus on South Africa, Kenya, and Nigeria,” Healthcare, vol. 13, no. 7, p. 762, 2025, https://doi.org/10.3390/healthcare13070762.
S. S. Kaboré, P. Ngangue, D. Soubeiga, A. Barro, A. H. Pilabré, N. Bationo, Y. Pafadnam, K. M. Drabo, H. Hien, and G. B. L. Savadogo, “Barriers and facilitators for the sustainability of digital health interventions in low and middle-income countries: a systematic review,” Frontiers in Digital Health, vol. 4, p. 1014375, 2022. https://doi.org/10.3389/fdgth.2022.1014375
T. Alsamara and G. Farouk, “Legal mechanisms for digital healthcare transformation in Africa: state and perspective,” Cogent Social Sciences, vol. 10, no. 1, p. 2410363, 2024. https://doi.org/10.1080/23311886.2024.2410363
J. Early, C. Gonzalez, V. Gordon-Dseagu, and L. Robles-Calderon, “Use of mobile health (mHealth) technologies and interventions among community health workers globally: a scoping review,” Health Promotion Practice, vol. 20, no. 6, pp. 805–817, 2019, https://doi.org/10.1177/1524839919855391.
D. Opoku, R. Busse, and W. Quentin, “Achieving sustainability and scale-up of mobile health noncommunicable disease interventions in sub-Saharan Africa: views of policy makers in Ghana,” JMIR mHealth and uHealth, vol. 7, no. 5, p. e11497, 2019, https://doi.org/10.2196/11497.
I. Holeman, T. P. Cookson, and C. Pagliari, “Digital technology for health sector governance in low and middle income countries: a scoping review,” Journal of Global Health, vol. 6, no. 2, p. 020408, 2016, https://doi.org/10.7189/jogh.06.020408.
R. Pankomera and D. Van Greunen, “A model for implementing sustainable mHealth applications in a resource‐constrained setting: A case of Malawi,” The Electronic Journal of Information Systems in Developing Countries, vol. 84, no. 2, p. e12019, 2018, https://doi.org/10.1002/isd2.12019.
O. Olu, D. Muneene, J. E. Bataringaya, M.-R. Nahimana, H. Ba, Y. Turgeon, H. C. Karamagi, and D. Dovlo, “How can digital health technologies contribute to sustainable attainment of universal health coverage in Africa? A perspective,” Frontiers in Public Health, vol. 7, p. 341, 2019, https://doi.org/10.3389/fpubh.2019.00341.
J. A. Namuhisa, “Political factors, sustainability and scale up of mobile health projects as early warning systems in public health surveillance in Kenya: A critical review,” International Academic Journal of Information Sciences and Project Management, vol. 3, no. 6, pp. 113–132, 2020, https://www.iajournals.org/index.php/8-articles/821-iajispm-v3-i6-113-132.
A. Y. Mustapha et al., “Systematic review of mobile health (mHealth) applications for infectious disease surveillance in developing countries,” Methodology, vol. 66, 2018, https://doi.org/10.54660/.IJMRGE.2022.3.1.1020-1033.
N. Al-Shorbaji, Improving Healthcare Access through Digital Health: The Use of. Healthcare Access, 315. 2022. https://books.google.co.id/books?hl=id&lr=&id=VARgEAAAQBAJ.
D. F. Cuadros, A. Kiragga, L. Tu, S. Awad, J. M. Bwanika, and G. Musuka, “Unpacking social and digital determinants of health in Africa: a narrative review on challenges and opportunities,” MHealth, vol. 11, p. 41, 2025, https://doi.org/10.21037/mHealth-24-73.
A. Wahbi, K. Khaddouj, H. Aziz, L. Naoufal, M. Mkik, and A. Hebaz, “Digital health transformation and decision-making in Africa,” in Proc. Int. Conf. Advances in Communication Technology and Computer Engineering, pp. 464–481, 2024, https://doi.org/10.1007/978-3-031-94620-2_41.
L. Huisman, et al., “A digital mobile health platform increasing efficiency and transparency towards universal health coverage in low- and middle-income countries,” Digital Health, vol. 8, p. 20552076221092213, 2022, https://doi.org/10.1177/20552076221092213.
S. Latif, R. Rana, J. Qadir, A. Ali, M. A. Imran and M. S. Younis, "Mobile Health in the Developing World: Review of Literature and Lessons From a Case Study," in IEEE Access, vol. 5, pp. 11540-11556, 2017, https://doi.org/10.1109/ACCESS.2017.2710800.
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Copyright (c) 2025 Paul Atagamen Aidonojie, George Mulingi Mugabe, Esther Chetachukwu Aidonojie, Muwaffig Jufri, Mundu M. Mustafa , Collins Ekpenisi, Obieshi Eregbuonye, Godswill Antai Owoche, Mercy Okpoko, Uzoho Kelechi, Khalid Saleh Y Alammari

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