Barriers and Enablers of Health Information Systems Interoperability in Kenya: A Scoping Review
Abstract
The integration and interoperability of health information systems (HIS) are essential for efficient, data-driven healthcare delivery. Although Kenya has expanded the use of Electronic Medical Records (EMRs) and mobile health (mHealth) platforms, the extent and effectiveness of interoperability across public and private sectors remain uncertain. This scoping review examined current literature on HIS interoperability in Kenya, identifying key barriers, enabling factors, and the types of systems involved between 2015 and 2025. Studies were included if published in English during this period, addressed Kenya’s HIS, and explored interoperability-related barriers, enablers, or implementation of interoperable platforms. Using the Arksey and O’Malley framework with Joanna Briggs Institute (JBI) refinements, the researchers searched PubMed, Google Scholar, and Scopus, identifying 138 records, of which 27 met the inclusion criteria. Data were charted using a literature matrix and synthesised thematically. Twelve key themes emerged. Barriers included inadequate technological infrastructure, lack of standardised data formats, limited digital health readiness, and fragmented governance. Enablers included strong leadership, intersectoral collaboration, user-centred design, community engagement, and adoption of modular or open-source tools. Interoperability gaps were especially evident in chronic disease and HIV services, notably in underserved urban settlements. EMRs, diagnostics platforms, and mHealth applications were the most frequently referenced systems. Despite progress, Kenya’s HIS landscape continues to face substantial challenges in achieving seamless interoperability. Strategic investments in infrastructure, regulatory alignment, workforce capacity, and policy coordination are required. Further research should explore rural and marginalised contexts, incorporate patient perspectives, and evaluate the long-term impact and scalability of interoperability initiatives.
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Abima, B., Nakakawa, A., & Kituyi, G. M. (2023). Service-oriented framework for developing interoperable e-health systems in a low-income country. Digitalcommons.Kennesaw.Edu. https://digitalcommons.kennesaw.edu/ajis/vol15/iss3/1/
Archer, N., Lokker, C., Ghasemaghaei, M., & DiLiberto, D. (2021). eHealth Implementation Issues in Low-Resource Countries: Model, Survey, and Analysis of User Experience. Journal of Medical Internet Research, 23(6), e23715. https://doi.org/10.2196/23715
Arksey, H., methodology, L. O. of social research, & 2005, undefined. (2005). Scoping studies: towards a methodological framework. Taylor & FrancisH Arksey, L O’malleyInternational Journal of Social Research Methodology, 2005•Taylor & Francis, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Hailemariam, T., Atnafu, A., Gezie, L. D., Kaasbøll, J. J., Klein, J., & Tilahun, B. (2023). Individual and contextual level enablers and barriers determining electronic community health information system implementation in northwest Ethiopia. Springer, 23(1), 644. https://doi.org/10.1186/S12913-023-09629-8
Hung, Y. W., Hoxha, K., Irwin, B. R., Law, M. R., & Grépin, K. A. (2020). Using routine health information data for research in low-and middle-income countries: a systematic review. Springer, 20(1). https://doi.org/10.1186/S12913-020-05660-1
Jawhari, B., Keenan, L., Zakus, D., Ludwick, D., Isaac, A., Saleh, A., & Hayward, R. (2016). Barriers and facilitators to Electronic Medical Record (EMR) use in an urban slum. International Journal of Medical Informatics, 94, 246–254. https://doi.org/10.1016/j.ijmedinf.2016.07.015
Kiwanuka, A., Amiyo, M., & Nabukenya, J. (2023). Barriers and facilitators to health information exchange in low-and middle-income country settings: a systematic review. Academic.Oup.Com, 1, 1–5. https://doi.org/10.1093/oodh/oqad003
Kiwanuka, A., Amiyo, M., & Nabukenya, J. (2023). Constraints to and enablers for contextualizing digital health terminology standards in Uganda’s health services: a qualitative case study. Academic.Oup.Com, 1, 1–5. https://doi.org/10.1093/OODH/OQAD003/7087288
Mamuye, A. L., Yilma, T. M., Abdulwahab, A. I., Broomhead, S. I., Zondo, P., Kyeng, M., Maeda, J., Abdulaziz, M., Wuhib, T., & TilahunID, B. C. (2021). A multivariate statistical evaluation of actual use of electronic health record systems implementations in Kenya. Journals.Plos.Org, 16(9 September). https://doi.org/10.1371/JOURNAL.PONE.0256799
Manyazewal, T., Woldeamanuel, Y., Blumberg, H. M., Fekadu, A., & Marconi, V. C. (2021). The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia. Nature.Com. https://doi.org/10.1038/s41746-021-00487-4
McPherson, A., Durham, J., Richards, N., Gouda, H., Rampatige, R., & Whittaker, M. (2017). Constraints to and enablers for contextualizing digital health terminology standards in Uganda’s health services: a qualitative case study. Academic.Oup.Com, 32, 384–394. https://doi.org/10.1093/OODH/OQAD003/7087288
Ministry of Health. (2020). MoH | Ministry of Health. https://www.health.go.ke/
Mugauri, H. D., Chimsimbe, M., Shambira, G., Shamhu, S., Nyamasve, J., Munyanyi, M., Gongora, R., Zizhou, S., Gabida, M., & Makurumidze, R. (2025). A decade of designing and implementing electronic health records in Sub-Saharan Africa: a scoping review. Taylor & Francis, 18(1). https://doi.org/10.1080/16549716.2025.2492913
Muinga, N., Magare, S., Monda, J., English, M., Fraser, H., Powell, J., & Paton, C. (2020). Digital health Systems in Kenyan Public Hospitals: a mixed-methods survey. Springer, 20(1). https://doi.org/10.1186/S12911-019-1005-7
Ndlovu, K., Mars, M., & Scott, R. E. (2021). Interoperability frameworks linking mHealth applications to electronic record systems. Springer, 21(1). https://doi.org/10.1186/S12913-021-06473-6
Ndlovu, K., Scott, R. E., & Mars, M. (2021). Interoperability opportunities and challenges in linking mhealth applications and eRecord systems: Botswana as an exemplar. Springer, 21(1). https://doi.org/10.1186/S12911-021-01606-7
Ngugi, P. N., Were, M. C., & Babic, A. (2021). Users’ perception on factors contributing to electronic medical records systems use: a focus group discussion study in healthcare facilities setting in Kenya. Springer, 21(1). https://doi.org/10.1186/S12911-021-01737-X
Ngugi, P., Babic, A., & Were, M. C. (2021). A multivariate statistical evaluation of actual use of electronic health record systems implementations in Kenya. Journals.Plos.Org, 16(9 September). https://doi.org/10.1371/JOURNAL.PONE.0256799
Ntinginya, N. E., Kuchaka, D., Orina, F., Mwebaza, I., Liyoyo, A., Miheso, B., Aturinde, A., Njeleka, F., Kiula, K., Msoka, E. F., Meme, H., Sanga, E., Mwanyonga, S., Olomi, W., Minja, L., Joloba, M., Mmbaga, B. T., Amukoye, E., Gillespie, S. H., & Sabiiti, W. (2021). Unlocking the health system barriers to maximise the uptake and utilisation of molecular diagnostics in low-income and middle-income country setting. Gh.Bmj.Com, 6, 5357. https://doi.org/10.1136/bmjgh-2021-005357
Odhus, C. O., Kapanga, R. R., & Oele, E. (2024). Barriers to and enablers of quality improvement in primary health care in low-and middle-income countries: a systematic review. Journals.Plos.Org, 4(1). https://doi.org/10.1371/JOURNAL.PGPH.0002756
Oluoch, T., Muturi, D., Kiriinya, R., Waruru, A., Lanyo, K., Nguni, R., Ojwang, J., Waters, K. P., & Richards, J. (2015). Do interoperable national information systems enhance availability of data to assess the effect of scale-up of HIV services on health workforce deployment in resource. Ebooks.Iospress.Nl, 216, 677–681. https://doi.org/10.3233/978-1-61499-564-7-677
Otieno, P., Agyemang, C., Wainaina, C., Kageha Igonya, E., Ouedraogo, R., Omondi, E., Wambiya, A., Osindo, J., & Asiki, G. (2023). Perceived health system facilitators and barriers to integrated management of hypertension and type 2 diabetes in Kenya: a qualitative study. Bmjopen.Bmj.Com, 13, 74274. https://doi.org/10.1136/bmjopen-2023-074274
Shaikh, M., Vayani, A. H. M., Akram, S., & Qamar, N. (2022). Open-source electronic health record systems: A systematic review of most recent advances. Health Informatics Journal, 28(2). https://doi.org/10.1177/14604582221099828/ASSET/1D13033B-8E82-4856-AA53-BE7245569FFF/ASSETS/IMAGES/LARGE/10.1177_14604582221099828-FIG2.JPG
Walcott-Bryant, A., Ogallo, W., Remy, S. L., Tryon, K., Shena, W., & Bosker-Kibacha, M. (2021). Addressing Care Continuity and Quality Challenges in the Management of Hypertension: Case Study of the Private Health Care Sector in Kenya. Journal of Medical Internet Research, 23(2), e18899. https://doi.org/10.2196/18899
Wang, M., Huang, K., Li, X., Zhao, X., Downey, L., Hassounah, S., Liu, X., Jin, Y., & Ren, M. (2025). Health workers’ adoption of digital health technology in low- and middle-income countries: a systematic review and meta-analysis. Bulletin of the World Health Organization, 103(02), 126-135F. https://doi.org/10.2471/BLT.24.292157
World Health Organization. (2016). The Republic of Indonesia health system review. https://iris.who.int/handle/10665/254716
Yopa, D. S., Massom, D. M., Kiki, G. M., Sophie, R. W., Fasine, S., Thiam, O., Zinaba, L., & Ngangue, P. (2023). Barriers and enablers to the implementation of one health strategies in developing countries: a systematic review. Frontiers in Public Health, 11. https://doi.org/10.3389/FPUBH.2023.1252428.
Copyright (c) 2025 Peter Munyao Kithuka, Beatrice Amy Nesidai Kithuka, Erick Kioko Mekala, Lydia Muthamba Munuve, Geoffrey Juma Malachi, Daisy Khayeri Omutanyi
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