Digital health maturity models for Human Resources for Health Information Systems in low- and middle-income countries in Africa: A scoping review

Abstract

Background: Health workforce challenges in Africa are exacerbated by fragmented and underdeveloped Human Resources for Health Information Systems (HRH-IS). While digital health maturity models exist, their applicability to HRH-IS in low- and middle-income countries (LMICs) remains unclear, with limited evidence of context-specific frameworks. Aim: This scoping review aimed to (1) map digital health and health information system (HIS) maturity models, frameworks, tools and guidelines relevant to HRH-IS, and (2) synthesise key domains to inform the development of a context-appropriate HRH-IS maturity model for African LMICs. Setting: The study was conducted in low- and middle-income countries in Africa. Methods: A scoping review was conducted following the Arksey and O’Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. PubMed, EBSCO-hosted databases, Google Scholar and grey literature sources, including institutional repositories and global health agency publications were searched. Data were extracted using a structured form and analysed descriptively, with thematic synthesis used to identify transferable domains. Results: A total of 3128 records were screened, and 41 were included. Only one tool targeted HRH-IS. Most identified frameworks addressed broader digital health or HIS. Six cross-cutting domains were synthesised: (1) governance and leadership; (2) workforce and organisational capacity; (3) financing and sustainability; (4) data architecture and interoperability; (5) data quality and analytics; and (6) equity, trust and system adoption. Conclusion: There is limited evidence of dedicated HRH-IS maturity models in African LMICs. However, existing digital health and HIS frameworks provide a strong foundation for adaptation. Contribution: The six synthesised domains offer a preliminary basis for developing and validating a context-specific HRH-IS maturity model to strengthen workforce data systems and support evidence-informed policy.