The last two decades have been marked by an improvement in Senegal’s overall health situation, with most health indicators evolving positively because of overall socio-economic development and specific efforts to improve public health However, Senegal has a low level of coverage of social protection. 

The country’s social security system doesn’t have the capacity to react quickly, much less to increase the scale and scope of responses to crises. Formal health insurance systems cover only 20% of the population, leaving out most Senegalese employed in the rural and informal sectors. This situation led the government to introduce the Universal Health Coverage (UHC) programme in 2012 to improve people’s access to quality health services. Despite that, access to a specialist remains problematic outside of Dakar, as 68% of the specialists are concentrated in the capital.

The aim of the Digital Health Strategy is to improve health outcomes for Senegalese populations through the use of digital health solutions, and advance UHC progress ensuring that stakeholders can make public health decisions based on high-quality, secure information. The Health and Social Map, Digital Health and Health Observatory Unit (CSSDOS), created in 2017, is responsible for developing, monitoring and evaluating the Digital Health Strategy, organising digital health and developing digital health projects. It is the gateway and contact point for the Ministry of Health and Social Action (MSAS) on innovation and digital issues.

The Ministry of Health and Social action (MSAS) has given due consideration to the critical connectivity needs of the health system, in the development of the digital strategy of the Senegalese government. This consideration stems from the understanding that both productivity and access to e-health services heavily rely on adequate bandwidth availability. Senegal is the African country where the internet contributes most to GDP (i-GDP estimated at 3.3%, compared with 3.8% for the United States – MGI 2013), thanks to its strong international connectivity and national transmission network. Telecommunications infrastructures are among the most developed and efficient in West Africa, thanks to major investment in capacity and modernisation. Senegal has launched a number of telemedicine initiatives, but the large-scale dissemination of these experiences is limited by the lack of human and material resources, as well as a lack of appropriate training.

The digital health ecosystem is characterised by a multiplicity of solutions with no links or interoperability between platforms. Hospitals have their own information systems and therefore use applications and platforms that are as diverse as they are varied.

To fully digitalise the healthcare system, it is essential that the CSSDOS plays its role as administrator of all digital healthcare systems and platforms.

The CSSDOS is not consulted by all MSAS divisions in their initiatives and has no authority nor responsibilities for healthcare platforms. For instance, it is unaware of the content of contracts between public healthcare organisations and suppliers, the technology used, or the coding logic. As a result, its roles as guarantor of consistency, reference and coordination are not always fulfilled, when the needs of interoperability require centralised management and design

Furthermore, with its current status as an administrative entity attached to the Senegalese government, the CSSDOS does not have the prerogative to bill for digital healthcare services (opening up of the electronic patient file, data hosting, electronic payments, perpetuation of healthcare APIs). 

With the current challenges of technical management of digital health systems (interoperability, definition of architectures) and the service function (billing for digital health services), the governance of digital health must evolve in ministries of health throughout the world.