Delivery In Africa Research Articles

Identifying interventions to reduce peripartum haemorrhage associated with caesarean delivery in Africa: A Delphi consensus study.

Women in Africa are fifty times more likely than in high-income settings to die following caesarean delivery, and peripartum haemorrhage is most strongly associated with mortality. We aimed to establish consensus on which interventions are considered most feasible to implement and most effective at reducing haemorrhage associated with caesarean delivery across Africa. We conducted a Delphi consensus study, including obstetric and anaesthesia providers from across Africa. In round one the expert group proposed key interventions for consideration. In rounds two and three the interventions were ranked on a 9-point Likert scale for effectiveness and feasibility. Round four was an online discussion to establish consensus on effectiveness and feasibility of interventions for which this had not been reached in round three. Twenty-eight interventions were considered both highly effective and feasible in Africa. Interventions covered a range of fields, categorised into direct- or indirect interventions. Direct interventions included: risk assessment and screening; checklists and protocols; monitoring and surveillance; availability of resources; ability to perform technical skills. Indirect interventions included: community and maternal education; contraception and family planning; minimum training standards; referral patterns and delays; advocacy to key stakeholders; simulation and team training; and 24-hour access to safe emergency caesarean delivery. Interventions considered both effective and feasible in reducing peripartum haemorrhage associated with caesarean delivery in Africa were identified. A multi-layered implementation strategy, including immediately developing a perioperative caesarean delivery bundle of care, in addition to longer-term public health measures may have a profound impact on maternal mortality in Africa.

Strengthening Health Systems Using Innovative Digital Health Technologies in Africa.

While effective health systems are needed to advance Universal Health Coverage and actualize the health Sustainable Development Goals, information system verticalization remains a challenge among African health systems. Most investments are vertical, partner-driven and program-specific with limited system-wide impacts. Poor linkages exist amongst different solutions as they are not designed to capture robust data across multiple programmatic areas. To address these challenges, the World Health Organization Africa Regional Office has proposed the adoption of a Digital Health Platform (DHP) to streamline different solutions to a cohesive whole. The DHP presents a pragmatic approach of bringing multiple platforms together using recognized standards to create a national infostructure, which bridges information solutions toward healthy and sustainable outcomes. It has capacities to curate accurate, high fidelity and timely data feedback loops needed to strengthen and continuously improve program delivery, monitoring, management, and informed decision-making at every level of the health system regardless of location. This paper contributes to the ongoing regional conversations on the need to harness innovative digital solutions to improve healthcare delivery in Africa.

A Model-Driven Optical Clinic Management Systems: Systematic Software Engineering Approach

INTRODUCTION: eHealth systems in a modern hospital and clinic require stringent measures to coordinate the operations of doctors, nurses, pharmacies for improved health care delivery.OBJECTIVES: The primary objective is to perform a comparative analysis to devise a novel approach to address the needs of a hospital information management system. This has triggered an urgent response to develop Optical Clinic Management System (OCMS) to address the limitation of the existing system. This intervention would promote the good health and well-being of humankind to meet the Sustainable Development Goals 3 (SDGs 3).METHODS: The study proposed a Design Science Research Methodology (DSRM) approach in Software Engineering as a catalyst to design OCMS to capture patients’ up-to-date records for medical diagnosis. The system is to assist Clinicians to prescribe medications based on a patient’s medical history by clicking a computer button.RESULTS: The limitations discovered during systems analysis and design of the existing systems were addressed during system evaluation and testing. It was observed that the proposed optical clinic management systems received a 98% acceptance for the implementation.CONCLUSION: This study explores the problem facing clinic and hospital administration and established major factors affecting the existing systems. It was discovered that the paper-based management systems used to keep patients’ medical records were found to be unreliable and therefore unsafe to be used as the basis to prescribe medication for patients, hence the need for this comprehensive system to address the problem for effective health care delivery. The situation in the existing system incidentally led to misplaced and unstructured handling of patient clinical records that may inadvertently make the clinicians administer medications with no reference to the patient’s previous diagnosis due to the lost file. Hence, the aftermath of the Covid-19 pandemic and its global destruction of human lives should motivate African leaders to invest adequate resources in the development of information technology applications for robust health information systems to improve health care delivery in Africa.

Protocol for scoping review of effective nursing leadership in Africa; Prospect and challenges

Background: Leadership is an essential aspect that contributes to the success of organizations through people who are organized, inspired, encouraged, and assessed to perform up to the standards that have been set. Leaders have the capacity and the talent to develop and shape attitudes toward the completion of objectives through the support they receive from group members. Since nursing, which is widely regarded as a respectable profession, accounts for the vast majority of the healthcare workforce involved in the provision of high-quality care, the nursing staff's leadership is of the utmost importance in reaching and sustaining high care standards. Effective nursing leadership requires the nurse manager to possess strong time management, organizational, and professional abilities to effectively communicate ideas to a team of nurses working in the healthcare institution. As such the nursing leadership is obligated to bring their profession to a level that will have a constructive influence on decision-making on a worldwide scale to fulfil their responsibilities. However, this is complicated by the politics of organizations, the high levels of stress and burnout that contribute to depression, and the fact that the majority of nurse leaders who compete for leadership roles are depressed. This protocol seeks to review available studies on effective nursing leadership and to determine the prospects, challenges, and the way forward in Africa. It will also assess previous work, identify and fill gaps, and add to the body of knowledge, particularly to nursing leadership in Africa. Conclusion: Researchers expect to find studies of effective nursing leadership in Africa that will enhance nurse managers effectively make appropriate decisions to determine the prospects and the challenges of effective nursing leadership to improving health care delivery in Africa. Systematic review registration: review registry 1392 The Objective of review: Effective nursing leadership in Africa; Prospects and Challenge: A scoping review protocol. Research questions: 1. Is there evidence of the prospects for effective nursing leadership in Africa? 2. To date what are the challenges to effective nursing leadership in Africa? 3. What is the way forward to effective nursing leadership in Africa? Purpose of review: Nursing leadership will be better equipped to design leadership practices in the future as these practices will assist nursing leadership to alleviate the problems that hinder successful nursing leadership and exhibit their professionalism and abilities. In addition to this, it will assist registered nurses in examining strategic roles, methods of performance evaluation, and the leadership paradigms that will be used in the future to enhance overall performance in the healthcare industry. Furthermore, the nursing community will benefit from more leadership mentorship as a result of this evaluation, which will help advance professional growth. Systematic review registration: This review was registered with the Research Registry for Systematic Reviews with unique number review registry 1392.

Digitising education in Nigeria: lessons from COVID-19

The sudden outbreak of coronavirus disease (COVID-19) dealt a great blow on the global educational sector, given the ill-preparedness of most countries to leverage digitisation. This study x-rayed the performance of the Nigerian educational sector and its response to COVID-19 pandemic with a view to underscoring the imperativeness of digitising education to forestall future shocks. The findings revealed the unimpressive performance of the Nigerian educational sector as learning came to a screeching halt during the pandemic, given the pervasive infrastructural deficits in the sector. Further result showed that Nigerian graduates are likely to face non-employability unless strategic steps are taken to expose them to digitisation, which the modern world of work requires. It, therefore, becomes pertinent to increase the budgetary allocation to the sector to bridge its infrastructural gaps. This would help Nigeria catch-up with global best practices in education and set the pace for improved educational service delivery in Africa.

Determinants of Penetration of Financial Technology Among the Heterogeneous African Economies

Wide-spread financial exclusion and the inability of banks to meet the customers’ expectations in service delivery in Africa have made most central banks seek technology-enabled solutions, especially as the global trend moves towards diversifying the range of financial service provider types. Some authors attributed these problems to the significant financial infrastructural gap in Africa. This study, therefore, investigated the determinants of fintech spreads in a panel of five emerging, 24 frontier, and three fragile African economies from 2002 – 2018. The dynamic panel system GMM estimation technique based on the epidemic and rank theories revealed heterogeneity and significant difference in internet and mobile banking penetration rate among economy types in Africa, with emerging markets reporting higher intercept and lower slope than frontiers and fragile markets. Also, information spread promoted penetration across units; whereas, population growth and literacy only increased it among frontiers and fragile economies but dampened it in emerging economies. This means that users of fintech among emerging markets began to diversify to new innovations aside from those used in this study, hence the decline. Moreover, Africa’s average fintech adoption rate stood at 24%; in South Africa and Morocco, it stood at 43% and 40%, respectively, compared to the global benchmark of 33%. We, therefore, recommend that banks should collaborate with fintech companies to enhance their benefits in Africa.

Democratic Governance and Social Service Delivery in Africa: the case of Taraba State, Nigeria

Postcolonial leadership is implicated in the distorted development and crisis of governance in Nigeria. The political leadership emerged from authoritarian traditions of the colonial state and pursued self-interests against collective societal interests; the mode of the emergence of the leaders as well as the context in which they operate usually impact on the nature and trend of social welfare provisioning. Relying on data from secondary sources, this study examined the impact of democratic governance on social service delivery with Taraba State and education as a case study. The data analysis was based on qualitative descriptive analysis. We found that the education sector under the two administrations between 1999 and 2014, was not prioritized in budgetary allocation, in contravention of UNESCO recommendation that 26% of the budget be dedicated to education. The study recommends, among others, that the government must show commitment to education as a matter of deliberate policy to allocate the required minimum percentage pecked by UNESCO to enhance educational development in Taraba state.

Digital health information technology utilization for enhanced health services delivery in Africa: Unravelling barriers to adoption among Primary healthcare providers

In tandem with the current drive to achieve the SDG 2030 goals, the Universal Health Coverage (UHC) is been projected as a strong propelling strategy with key indicators, all aimed at achieving universal access to health services without having to endure financial difficulties in individual countries. Currently, Africa is lagging in meeting the targets of the UHC with between 5% -25% coverage across countries. Adoption of new innovations are critical for the actualization of Universal Health Coverage in Africa. Digital health technology offers one of such novel approaches to providing quality healthcare services and can help countries achieve the Universal Health Coverage targets. It has been suggested that digital health provides an opportunity to overcome the longstanding problems of inefficiency of health information gathering, sharing, and access. In addition, literature is already replete with various factors that can aid countries to achieve UHC and one of such factors is the urgency of generating valid and quality evidence to inform decision-making. Although the Primary Health Care remains at the core of the achievement of Universal Health Coverage, the utilization of digital health technologies remains very poor at the grassroots in Africa and this poses a huge barrier to effectiveness and quality of healthcare delivery. Given the foregoing, it is obvious that there is an urgent need to understand the landscapes, issues and barriers to utilization of digital health at the Primary Health Care levels. However, there remains a paucity of data to support evidence-based decision making about full implementation of digital health services across the continent while also taking into cognisance the peculiarities of individual countries. Hence, there is a critical need to determine the current levels of knowledge, skills, attitude, practice and readiness to adopt digital health in service delivery by healthcare workers at the Primary Health Care levels across the continent. The generation of such data from major stakeholders such as health workers and health managers, providers among others will provide important evidence needed for attaining optimal utilization of digital health in the context of health for all. Summarily, a clear understanding of the contextual and implementation bottlenecks highlighted from such assessment(s), especially as it relates to individual African countries, will go a long way to guide decisions to address the low utilization of digital health technologies in health services delivery in Africa. Source of funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Acknowledgement The authors acknowledge the support of the Department of Environmental Health Sciences, University of Ibadan and contributions of Prof. G.R.E. E Ana, Prof. M.K.C. Sridhar, Dr. E.C. Uwalaka, Dr. O.T. Okareh and Dr. O.M. Morakinyo, in the writing of this paper CO is supported by Consortium for Advanced Research Training in Africa (CARTA) which is funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100029), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z). Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have influenced the writing of this paper. Author contributions CO: Conceptualization; CO, PO and OF: Writing- Original draft preparation, CO, PO and OF: Writing- Reviewing and Editing.

Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa.

PURPOSEThe COVID-19 pandemic has disrupted cancer care globally. There are limited data of its impact in Africa. This study aims to characterize COVID-19 response strategies and impact of COVID-19 on cancer care and explore misconceptions in Africa.METHODSWe conducted a web-based cross-sectional survey of oncology providers in Africa between June and August 2020. Descriptive statistics and comparative analysis by income groups were performed.RESULTSOne hundred twenty-two participants initiated the survey, of which 79 respondents from 18 African countries contributed data. Ninety-four percent (66 of 70) reported country mitigation and suppression strategies, similar across income groups. Unique strategies included courier service and drones for delivery of cancer medications (9 of 70 and 6 of 70, respectively). Most cancer centers remained open, but > 75% providers reported a decrease in patient volume. Not previously reported is the fear of infectivity leading to staff shortages and decrease in patient volumes. Approximately one third reported modifications of all cancer treatment modalities, resulting in treatment delays. A majority of participants reported ≤ 25 confirmed cases (44 of 68, 64%) and ≤ 5 deaths because of COVID-19 (26 of 45, 58%) among patients with cancer. Common misconceptions were that Africans were less susceptible to the virus (53 of 70, 75.7%) and decreased transmission of the virus in the African heat (44 of 70, 62.9%).CONCLUSIONFew COVID-19 cases and deaths were reported among patients with cancer. However, disruptions and delays in cancer care because of the pandemic were noted. The pandemic has inspired tailored innovative solutions in clinical care delivery for patients with cancer, which may serve as a blueprint for expanding care and preparing for future pandemics. Ongoing public education should address COVID-19 misconceptions. The results may not be generalizable to the entire African continent because of the small sample size.

MHealth and Health Care Service Delivery in Africa: A Systematic Review

We conducted a systematic review of studies on mHealth and health care services delivery that were carried out within Africa. Our search process was through MEDLINE, and then on PubMed, we searched key terms based on various keywords: “Whatsapp, health, Africa, Text messages, health impact, Africa, mHealth tools, Africa”. This was done in December of 2018. Only English written articles from journals indexed in Science Citation Index Expanded and Social Science Citation Index were incorporated in this review. In line with our inclusion criteria, only a total of 19 out of 155 studies were relevant. Inferences from these studies showed that mHealth tools are speedy and quality means for health care delivery in Africa. We also found out that there is less usage of internet devices in Africa as suspected. There is a serious need for improvement in the use of other online based mHealth tools as it was found that the use of Short Messaging Service (SMS) has been the nearly the sole mHealth intervention utilized in Africa. This, it is believed would foster better wider intervention and implementation of quality health outcomes in Africa, and other low and middle-income regions of the world.

Re-Engineering Public Service Delivery in Africa Post COVID-19

Re-Engineering Public Service Delivery in Africa Post COVID-19 James Shikwati (bio) Public service delivery in Africa is not meeting the demands and needs of the citizens. Research prior to the COVID-19 pandemic shows that African citizen's satisfaction with the provision of basic public services appears to have diminished over the last decade. This indicates that governments are not meeting public demand in areas such as health, education, justice, and safety and security. The Ibrahim Index of African Governance (IIAG) indicates progress in overall governance performance on average in Africa. Unfortunately, it demonstrates a concerning trajectory, with measurable declines in the provision of core public services, such as education.1 According to the report contributor, Afrobarometer, 12.7 percent of people surveyed in 2014–2015 stated that it was "very difficult" or "difficult" to obtain the services needed from teachers or school officials.2 With Africa's population set to double by 2050, efficient public service delivery in this area is vital to the continent's ability to deal with new challenges in the future. As of December 13, 2020, Africa had reported 1,606,252 COVID-19 cases and 24,000 fatalities according to World Health Organization estimates.3 The COVID-19 pandemic put public service delivery around the world in focus, particularly in Africa, because of inherent general system inefficiencies.4 The public service sector is a recent phenomenon in Sub-Saharan Africa's nation-states. Now sixty years old, the sector is a legacy of European colonialism and far younger than Asian societies whose bureaucratic traditions predate those of Western countries. Many scholars have conducted quantitative studies on the performance of service delivery and how governments can ensure effective service delivery. Achieving efficient and effective service delivery is a cardinal pillar in the act of governance through relevant Ministry Department Agencies (MDAs).5 Criticism over public sector expenditures on service delivery led to the drafting of the New Public Management (NPM) concept in 1982. The concept embraces new innovations such as managerialism, market-based governance, entrepreneurship, and reforms that bring about effective and efficient delivery of welfare, social, and essential services. The NPM was discussed as a major trend towards a politically neutral movement out to6 ensure efficiency, effectiveness, and accountability in infrastructural development and social/welfare services. Governments of emerging and developing economies are still searching for new ways of improving public sector efficiency. A departure from traditional public administration to public management model will impact the way the public sector operates in terms of service delivery.7 Key questions on accountability, measurement of public service outputs and the role of elected officials remain of topical concern.8 Despite the continent's young public sector, reengineering it to rely upon digital technology in response to the COVID-19 pandemic offers great promise. The COVID-19 factor in public service delivery The abrupt and brutal disruption by the COVID-19 pandemic has thrown the public service and its work force into a frenzy, forcing them to fight the pandemic's spread and manage its [End Page 206] accompanying socioeconomic fallout simultaneously. Corruption cases involving the pilfering of donor funds, procurement procedures, and overpricing of tools meant to fight the pandemic have dealt a major reputational blow to both governments and public service in general.9 While the pandemic catapulted public servants onto the frontlines, it also put the public servants and service under scrutiny in terms of accountability on both data and management of funds. Funding, management of resources, transparency, and accountability are major issues in public service delivery. Developing countries with weak governance institutions face a greater challenge of fund misalignment. Governments tend to fund the wrong goods—funds end up in private use rather than public and wrong target—service to rich people rather than poor people.10 It behoves government to be accountable to the entire citizenry as opposed to a few stakeholders. Peters (2001) notes the importance of equality and accountability for finances and responsibilities. Government is expected to ensure prudence, fairness and accountability in public service delivery.11 Dehn (2002) observes that while existing institutions of accountability overemphasize accountability for finance and fairness, they undercut performance and the...

Data science skills: Building partnership for efficient school curriculum delivery in Africa

Data science is a concept to unify statistics, data analysis, machine learning and their related methods in order to analyze actual phenomena with data to provide better understanding. This article focused its investigation on acquisition of data science skills in building partnership for efficient school curriculum delivery in Africa, especially in the area of teaching statistics courses at the beginners’ level in tertiary institutions. Illustrations were made using Big data of selected 18 African countries sourced from United Nations Educational, Scientific and Cultural Organization (UNESCO) with special focus on some macro-economic variables that drives economic policy. Data description techniques were adopted in the analysis of the sourced open data with the aid of R analytics software for data science, as improvement on the traditional methods of data description for learning and thus open a new charter of education curriculum delivery in African schools. Though, the collaboration is not without its own challenges, its prospects in creating self-driven learning culture among students of tertiary institutions has greatly enhanced the quality of teaching, advancing students skills in machine learning, improved understanding of the role of data in global perspective and being able to critique claims based on data.

Factors associated with COVID-19 infections and mortality in Africa: a cross-sectional study using publicly available data

IntroductionThe current COVID-19 pandemic is a global threat. This elicits questions on the level of preparedness and capacity of health systems to respond to emergencies relative to other parts of...

Adverse Effects of Labour Market Transformation on Public Health in Africa

Globally, the labour market has been changing fundamentally since the 1980s. This change is linked to the rapid removal of barriers to trade, such as geographical distance and government regulations, in a bid to facilitate the diffusion of technology and the mobility of goods, labour and, more importantly, financial capital across borders. Among other factors, the transformation of the labour market in the form of re-organisation, re-engineering, intensification of work, multi-tasking, outsourcing, privatisation, increased use of temporary workers, and restructuring, has heightened the sense of job insecurity among workers. This study examines the transformation of the labour market in the context of neoliberal globalisation. The methodological approach adopted was desktop research in the form of conducting a literature survey within an interpretative research paradigm. The study argues that the transformation of the labour market has not only impacted on the workplace but has subsequently also had adverse effects on public health in the African continent. The study further demonstrates that women, compared to men, are disproportionately affected by the adverse health effects emanating from this transformation. The study concludes that the transformation of the labour market, within the context of the phenomenon of neoliberal globalisation, affects public health and exacerbates poverty and inequality in society in so far as health outcomes are concerned, given the insufficiency and absence of effective social protection mechanisms and efficient service delivery in Africa.

Adverse Effects of Labour Market Transformation on Public Health in Africa

Globally, the labour market has been changing fundamentally since the 1980s. This change is linked to the rapid removal of barriers to trade, such as geographical distance and government regulations, in a bid to facilitate the diffusion of technology and the mobility of goods, labour and, more importantly, financial capital across borders. Among other factors, the transformation of the labour market in the form of re-organisation, re-engineering, intensification of work, multi-tasking, outsourcing, privatisation, increased use of temporary workers, and restructuring, has heightened the sense of job insecurity among workers. This study examines the transformation of the labour market in the context of neoliberal globalisation. The methodological approach adopted was desktop research in the form of conducting a literature survey within an interpretative research paradigm. The study argues that the transformation of the labour market has not only impacted on the workplace but has subsequently also had adverse effects on public health in the African continent. The study further demonstrates that women, compared to men, are disproportionately affected by the adverse health effects emanating from this transformation. The study concludes that the transformation of the labour market, within the context of the phenomenon of neoliberal globalisation, affects public health and exacerbates poverty and inequality in society in so far as health outcomes are concerned, given the insufficiency and absence of effective social protection mechanisms and efficient service delivery in Africa.

Reviewing the Common Barriers to the Mental Healthcare Delivery in Africa.

The current paper sought to thematically present common challenges associated with mental healthcare services in Africa. We largely limited our search for literature materials to studies published from 2003 to 2019 in African countries from which the findings showed that there are common challenges confronting mental healthcare services in Africa. The challenges include: inadequate mental healthcare facilities, funding constraints, shortage of professional healthcare workers, inadequate training and development scheme for mental health workers and weak mental healthcare policies. Implications for policy and practice are disclosed and recommendations are stated to trigger actions to remedy the situation. This information is beneficial for researchers, policymakers, mental healthcare providers and community members who are interested in mental healthcare issues. It was concluded that in order for Africa to enjoy successful mental healthcare service, critical and enduring attention must focus on sound and enforceable government policy on mental healthcare service, provision of adequate and regular funding, availability of adequate mental healthcare facilities, provision of training and development facilities for the mental health professionals and collaboration of mental healthcare providers.

EXTERNAL ACTORS, GOOD GOVERNANCE AND HEALTH CARE DELIVERY IN AFRICA

The structural adjustment programme imposed by the World Bank and IMF in the face of the serious economic crisis that confronted African states in the 1980s resulted in severe cuts in state spending on social services including health. State failure in the provision of social services led to the externalisation of responsibility for health and the proliferation of actors working in the field of health across the continent. Despite the positive and negative consequences of this development on Africa, the debate about the role of external actors in health care delivery in Africa has dwelt extensively on the degree they should participate neglecting the emphasis on how they participate, under what conditions and with what consequences. Using qualitative data techniques, this article examines the involvement of external actors in health care delivery in Africa illustrating the nature, pattern, dimensions, and dynamics of such engagements in the context of popular concerns with good governance. It found that governance challenges constitute a serious obstacle to better health outcome in Africa. It posits that African states can only maximise their gains from external assistance for health if they take leadership in coordinating health activities in their countries within the context of a comprehensive national health plan.

Analysis of government performance in service delivery in Africa and factors influencing results

Analysis of government performance in service delivery in Africa and factors influencing results

Public sector monitoring and evaluation in the Fourth Industrial Revolution: Implications for Africa

Background: The current era of transformative scientific and technological advances is reshaping traditional government business as it is blurring geographical boundaries and posing a challenge to existing regulatory frameworks. Aim: This article explores the implications of the Fourth Industrial Revolution (4IR) on current public sector monitoring and evaluation (M&E) in Africa. Setting: The 4IR (also called Industry 4.0) is thought to bring about enormous benefits associated with increased efficiency and effectiveness in service delivery. However, even with the highly anticipated opportunities related to automated and digital transformations in the 4IR, governments in African countries need to understand the challenges ahead and will need to measure and mitigate the impact of the unpredictable and rapidly changing products and services created for the public. Methods: Using the documentary review method to collect data, this research answers the following guiding questions: (1) How has the 4IR been harnessed in Africa to improve public sector service delivery? (2) How can the 4IR be harnessed to improve M&E in the public sector in Africa? and (3) What are the implications of the 4IR technologies on public sector M&E in Africa? Results: Findings reveal that various 4IR disruptive technologies have already been fully adopted in public service delivery in Africa. The 4IR disruptive technologies have the capacity to capture or collect and analyse multi-dimensional information or data from multiple contextual variables, with minimal costs and time in both qualitative and quantitative formats. However, findings disclose that the use of big data in evaluation requires extra new skills training and critical discussions among M&E specialists, technologists, economists, engineers and tech companies as a whole so as to significantly enhance the quality, validity and reliability of the data captured by the technologies. Conclusion: Deep integration, collaboration and embracing change are needed to efficiently manage and control the multi-stakeholder nature of the 4IR innovative technologies. This article asserts that policies on the 4IR technologies need to be adaptive, inclusive, sustainable and human centred in order to efficiently regulate or guide these innovative technologies without curtailing the future opportunities.

Prospects and Challenges of Population Health with Online and other Big Data in Africa: Understanding the Link to Improving Healthcare Service Delivery

Big data analytics offers promises to many health care service challenges and can provide answers to many population health issues. Big data is having a positive impact in almost every sphere of life in more advanced world while developing countries are striving to meet up. Even though healthcare systems in the developed world are recording some breakthroughs due to the application of big data, it is important to research the impact of big data in developing regions of the world, such as Africa and identify its peculiar needs. The purpose of this review was to summarize the challenges faced by big data analytics and the prospects that big data opens in health care services in Africa. The systematic review examined the key research questions to address whether big data applications can improve healthcare service delivery in Africa especially during epidemics or health crises and through the population health system. The paper examined prospects and challenges that are associated with the use of big data and healthcare service in relation to population health needs through influencing factors. In this study, literatures are reviewed to present cases of big data applications in healthcare in Africa and to understand the prospect and challenges of such applications to population health.