The State of Healthcare Digitisation in the CEMAC Region

Introduction: Central Africa's Digital Health Moment

The CEMAC region — comprising Cameroon, the Central African Republic, Chad, the Republic of Congo, Equatorial Guinea, and Gabon — is home to more than 60 million people. It is a region of extraordinary natural wealth and, simultaneously, of some of the most significant unmet healthcare needs on the continent.

Healthcare systems across CEMAC are under-resourced, overburdened, and — with few exceptions — largely paper-based. In a region where communicable disease burdens remain high, where maternal and child mortality rates significantly exceed global averages, and where the healthcare workforce is concentrated in a handful of urban centres, the consequences of an inefficient health system are measured not in inconvenience but in preventable deaths.

Digital health — the use of technology to improve the efficiency, quality, and accessibility of healthcare — offers CEMAC a rare opportunity: to skip the slow, expensive analogue intermediate stage that Western healthcare systems spent decades on, and move directly to modern, integrated, data-driven health delivery.

Whether CEMAC seizes that opportunity depends on choices being made right now by governments, donors, hospitals, and technology companies.

The CEMAC Health Context: Shared Challenges, Different Starting Points

While CEMAC nations share many structural health challenges, their digital health starting points vary considerably.

Cameroon is the most advanced within the region. It has a functioning dual-language health system, a relatively developed private hospital sector, a national DHIS2 deployment managed by the Ministry of Public Health, and a growing ecosystem of health technology companies. Challenges persist around data quality, system fragmentation, and the gap between pilot programmes and at-scale deployment.

Gabon has the highest GDP per capita in the region and has invested in health infrastructure — including some technology systems — for its relatively small population. However, technology adoption in health facilities remains uneven, with significant gaps between the capital Libreville and secondary cities.

Republic of Congo has made targeted investments in health digitisation, particularly in the context of HIV/AIDS programmes funded by international organisations. Systematic nationwide deployment of hospital management systems remains limited.

Chad faces the most significant structural challenges — extreme poverty, frequent conflict, and very limited health infrastructure outside N'Djamena. Digital health in Chad is primarily driven by international NGOs and UN agencies, with limited commercial health technology activity.

Central African Republic shares many of Chad's challenges and has been further set back by years of civil conflict. Digital health initiatives are mostly donor-driven and humanitarian in focus.

Equatorial Guinea has oil revenues that have funded some health infrastructure improvements, but overall health system performance remains poor relative to the country's economic resources.

What Has Been Achieved: Progress Worth Acknowledging

Despite significant barriers, measurable progress has occurred across CEMAC in digital health.

National Health Information Systems

All CEMAC member states have adopted or are deploying DHIS2 — the open-source health information system used in more than 70 countries worldwide. In Cameroon and Gabon, DHIS2 is used to aggregate disease surveillance data, immunisation coverage, and facility-level health statistics. This gives health ministries a real-time (or near-real-time) view of health system performance at a national level — something that was simply impossible with paper-based reporting.

Donor-Funded Electronic Medical Record Pilots

The Global Fund, PEPFAR, and bilateral donors have funded electronic medical record (EMR) implementations in facilities managing HIV, tuberculosis, and malaria programmes across the region. These programmes have generated important lessons about what works — and what fails — when implementing digital tools in low-resource settings.

Mobile Health (mHealth) Programmes

Mobile phone penetration across CEMAC is high relative to fixed infrastructure. Several mHealth programmes have leveraged this, using SMS and USSD-based tools to deliver health information, appointment reminders, and disease surveillance reporting to community health workers. These programmes have demonstrated the viability of mobile-first health technology in CEMAC contexts.

Telemedicine Expansion Post-COVID

The COVID-19 pandemic accelerated telemedicine adoption across CEMAC, particularly in urban areas. In Cameroon and Gabon, telemedicine platforms emerged to connect patients with doctors during lockdowns. Many patients who used telemedicine for the first time during the pandemic have continued using it — creating a permanent shift in health-seeking behaviour.

Where the Gaps Remain: An Honest Assessment

Progress in digital health across CEMAC has been real but fragile. Four structural gaps remain that prevent digital health from delivering its full potential.

Gap 1: Fragmentation

Digital health in CEMAC is a patchwork of disconnected tools. A hospital may use one system for HIV patient records (funded by PEPFAR), another for general patient registration (funded by a bilateral donor), a paper ledger for billing, and nothing at all for pharmacy inventory. These systems do not talk to each other. The result is that clinicians cannot see a complete picture of any patient, and hospital managers cannot see a complete picture of their facility.

True digital transformation requires integration — a single platform, or a set of interoperable platforms, that shares data seamlessly.

Gap 2: Dependency on External Funding

Most significant digital health implementations in CEMAC have been funded by international donors, not by health facilities or governments themselves. When donor funding cycles end, systems are frequently abandoned. The files exist but nobody updates them. The servers stop receiving maintenance. The trained staff move on.

Sustainable digital health requires commercial health technology companies building products that facilities pay for because they deliver a return — not donor-funded pilots with expiry dates.

Gap 3: Urban-Rural Divide

Digital health tools are concentrated in urban health facilities, particularly teaching hospitals and large private clinics. District and community-level health facilities — where the majority of CEMAC citizens access care — remain largely analogue. Any strategy that focuses only on urban facilities will leave most of the population behind.

Gap 4: Local Technology Ecosystem Underdevelopment

Very few health technology companies are building products specifically for CEMAC contexts. Most digital health tools used in the region are either imported from international vendors (expensive, poorly adapted) or provided free through donor programmes (fragile, unsustainable). A commercial local health technology ecosystem — companies building and selling products designed for CEMAC realities — barely exists.

This is where the greatest opportunity lies.

The Policy Environment: What Governments Are Doing

Health digitisation is on the policy agenda across CEMAC, with varying levels of commitment and implementation.

Cameroon's Ministry of Public Health has published a digital health strategy that aligns with the African Union's Digital Transformation Strategy for Africa and the WHO's Global Strategy on Digital Health. The strategy prioritises interoperability, data sovereignty, and universal health coverage.

The CEMAC regional body has also begun discussing a coordinated approach to digital health standards, which could eventually create a unified market for health technology products across member states — significantly expanding the potential market for regional health tech companies.

These policy signals are encouraging. But policy documents are not implementations. The transition from strategy to deployed, functional digital health systems at the facility level requires sustained commitment, adequate financing, and capable technology partners.

The Role of the Private Sector

Governments and donors alone cannot digitalise CEMAC's health systems. The private sector — and specifically, commercially viable health technology companies — is essential.

Commercial health technology companies have structural advantages over public or donor-funded initiatives:

They are incentivised to build products that actually work — if their software fails, they lose customers
They iterate and improve continuously, unlike donor projects that have fixed scopes
They build support structures that outlast any single funding cycle
They understand the commercial realities of health facilities and build accordingly

The emergence of platforms like OPES Health Systems — purpose-built for Cameroon and the CEMAC region, commercially viable, and locally supported — represents the kind of private sector health technology development that the region needs more of.

Frequently Asked Questions

What is CEMAC? CEMAC (Communauté Économique et Monétaire de l'Afrique Centrale) is the Economic and Monetary Community of Central Africa, comprising Cameroon, Central African Republic, Chad, Republic of Congo, Equatorial Guinea, and Gabon. The six nations share a common currency (the Central African CFA franc) and a degree of economic integration.

Which CEMAC country is most advanced in digital health? Cameroon is generally considered the most advanced in the CEMAC region in terms of digital health infrastructure, ecosystem development, and health technology company activity.

What is DHIS2 and why is it important for CEMAC? DHIS2 (District Health Information Software 2) is an open-source platform used as a national health information system across more than 70 countries. All CEMAC member states have adopted or are deploying DHIS2 for disease surveillance and health system reporting.

What are the biggest barriers to digital health in Central Africa? The four primary barriers are: fragmentation of existing systems, dependency on external donor funding, the urban-rural technology divide, and the underdevelopment of a local commercial health technology ecosystem.

Conclusion: The CEMAC Digitisation Window Is Open — For Now

CEMAC is at a critical inflection point in digital health. The infrastructure is improving, the policy environment is increasingly favourable, and the commercial case for health technology investment is becoming clearer.

The organisations that move now — hospitals that implement integrated management systems, governments that create enabling policies, and technology companies that build for the CEMAC context — will define what healthcare looks like across Central Africa for the next generation.

The window is open. The question is who walks through it.

OPES Health Systems operates across the CEMAC region, supporting hospitals and clinics in Cameroon and beyond with integrated health technology built for Central African realities.