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Five strategic investments to reshape universal health coverage in Africa's digihealth landscapeFive strategic investments to reshape universal health coverage in Africa's digihealth landscape
Leverage digital solutions to expand care access while navigating implementation challenges for healthcare executives.
Kaakpema Yelpaala, Senior Fellow and Lecturer, Yale School of Public Health | Department of Health Policy and Management
May 19, 2025
5 Min Read
Canva
In the early 2010s many global health leaders, health technologists and funders predicted that rapid mobile-phone adoption and new fiber-optic backbones would usher African health systems into the digital age. The assumption was that African health systems would leapfrog from analog to digital. Cloud platforms paired with ubiquitous mobile phone access would facilitate the digitisation of paper records, expand access to care and accelerate progress toward universal health coverage (UHC).
One area of tremendous growth in Sub-Saharan Africa (SSA) has been Fintech. Kenya’s M-PESA and unicorns such as Flutterwave (Nigeria) and Wave (Senegal) illustrate what happens when digital rails, strong economic incentives and consumer adoption align. Digital health in the African context, however, has yet to experience a comparable breakthrough.
Health innovators have been experimenting with different technological approaches and models through the public, private and philanthropic sectors. GSMA’s Mobile for Development tracker logged more than 1,000 live m-health pilots in 2015, and these pilots have proliferated in the last 10 years. Some initiatives have scaled in the context of donor funded programs, but without long term sustainability.
Private sector, investor-backed models such as CarePay (East Africa) and Helium Health (Nigeria) have had some success. Governments are also establishing initiatives to support digital transformation, such as Kenya’s new Digital Health Hub. Platforms such as DHIS2 are used across SSA for data collection and reporting. Even so, most initiatives remain small, donor-dependent and poorly integrated, a phenomenon insiders call pilotitis.
Recent USAID and other funding cuts have exposed the fragility of projects that never moved beyond grants.
With the 2030 UHC deadline just five years away, African health leaders must decide how to leverage the next wave of cloud- and AI-enabled tools for sustainable, population-level impact—rather than another decade of pilots.
Digital infrastructure and the AI wave
The case for digital transformation of the health sector and associated infrastructure investments is picking up steam. A 2023 McKinsey report highlighted that paperless data in the health sector accounts for 30 per cent of potential efficiency gains by 2030 in Kenya (up to US$700 million), 26 per cent in Nigeria (up to US$900 million), and 30 per cent in South Africa (up to US$3.3 billion). A 2024 McKinsey survey on cloud penetration in African markets found that 17 per cent of survey respondents ran their enterprises fully on the cloud, while 55 per cent of those surveyed stated that the majority (>50 per cent) of their organisational data and processes run on the cloud.
From a consumer perspective, Sub-Saharan Africa leads the way globally in terms of mobile‐money adoption.
According to GSMA’s 2025 global annual report on mobile money, SSA had 283 million active 30-day accounts in 2024, representing a transaction volume of US$80 billion and a transaction value of US$1.1 trillion. This paves the road for the integration of fintech and digital health offerings. For example, CarePay in Kenya and Tanzania used the power of mobile money to create mobile health wallets linked to insurance IDs to cut fraud and pay providers within 48 hours.
Digital data and cloud infrastructure play a central role for African health innovators to benefit from the current and unprecedented global AI wave. Generative AI models thrive on large, clean data sets. However, fragmented, inconsistent data creates lag effects in high scale, reliable and “intelligent” AI systems tailored to African populations. Language adds complexity: mainstream large language models (LLMs) are trained primarily on English, reducing accuracy in non-English languages and dialects. Closing the gaps described above is both a challenge and a strategic opportunity.
Momentum is building on the compute side. In March 2025, Cassava Technologies and Nvidia announced Africa’s first dedicated AI factory: GPU super‑computers in South Africa, with Egypt, Kenya, Morocco and Nigeria in the pipeline. The investment—up to US$720 million — will have a positive impact across sectors. This can have significant implications for the health sector such as local, high-performance compute for hospitals to run radiology and pathology AI without exporting images, enabling start-ups to train clinical language models in African dialects, and supporting genomic analytics for precision medicine — all while meeting data-sovereignty requirements.
Five considerations for health leaders
Based on the points shared above, there are five priorities I recommend for health leaders in Sub-Saharan Africa in the context of UHC and digital innovation.
Treat digital infrastructure as a cross-benefit investment. Digital transformation of the health sector requires infrastructure investments. These investments can broadly benefit multiple sectors, if structured accordingly, and generate efficiency and substantial return on investment across the board.
Invest in data generation and stewardship. National registries, structured electronic records and regional biobanks will help close the data gap and attract AI investment.
Keep policy agile and multi-disciplinary. Rapidly shifting technology advancements require a dynamic, cross-disciplinary policy approach. Balancing the protection of consumer interests and data while fostering innovation is a tightrope regulator that will continue to walk.
Leverage digital for health workforce challenges. Any ways digital innovation can support the health workforce in SSA is critical for UHC. According to the WHO, Africa carries 17 per cent of the global disease burden but just 4 per cent of the health workforce.
Make digital health a cross-ministerial conversation. Digital transformation of the health sector should be seen as a conversation and collaboration between Ministers of Finance, Ministers of Health, Ministers of ICT and national security stakeholders.
Digital innovation is a powerful enabler of UHC, but not a shortcut.
Leaders should regard cloud, data and AI as the springboard, but core investments in health system strengthening and sustainable, scalable digital health models are essential. With only five years left before the 2030 UHC deadline, health systems must move from pilots to platforms and from isolated apps to integrated, tech‑enabled models that measurably expand healthcare access and improve outcomes.
