Implementing Digital Health Transformation in Zambia: A Case Study of Data Governance and Interoperability (2021–2025)

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DOI: 10.21522/TIJAR.2014.13.01.Art005

Authors : Andrew Kashoka

Abstract:

Digital health systems are central to achieving Universal Health Coverage in low- and middle-income countries, yet many national implementations remain fragmented, donor-driven, and weakly governed. This study examines Zambia’s digital health transformation between 2021 and 2025, with a specific focus on interoperability and health data governance. Using a government-led case study approach, the research evaluated four core national platforms: SmartCare Pro, the National Health Insurance Management Authority system, the Zambia Medicines and Medical Supplies Agency system, and the National Data Warehouse. A convergent mixed-methods design combined system performance logs, interoperability testing, stakeholder surveys, document reviews, and governance compliance audits. Findings demonstrate a 78 percent national data exchange success rate, over 90 percent facility-level compliance with the Data Protection Act, and an average system usability score of 3.7 out of 5. The study shows that the implementation of a national Interoperability Architecture Framework and Health Data Governance Framework significantly improved system integration, accountability, and evidence-based decision-making. The results contribute practical implementation evidence for low- and middle-income countries seeking to transition from fragmented digital health investments to sustainable, government-owned, interoperable health information ecosystems.

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