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  2. Healthcare – Records That Don’t Disappear: Blockchain-Enabled Health Information Systems in Sub-Saharan Africa, with Kenya as a Case Study
Healthcare – Records That Don’t Disappear: Blockchain-Enabled Health Information Systems in Sub-Saharan Africa, with Kenya as a Case Study
Clinic Management Information Systems Digital Health Hospital Management Information Systems Science and Technology

Healthcare – Records That Don’t Disappear: Blockchain-Enabled Health Information Systems in Sub-Saharan Africa, with Kenya as a Case Study

  • November 18, 2025
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Abstract

Across Sub-Saharan Africa (SSA), health workers battle everyday frustrations that patients feel acutely: lost paper files, mismatched patient records across facilities, repeated tests because results cannot be found, and uncertainty about the authenticity of medicines. Electronic health records (EHRs) are slowly changing this picture, but fragmentation, under-investment and infrastructural gaps persist.Taylor & Francis Online+1 Blockchain technology—best known from cryptocurrencies—has been proposed as a complementary infrastructure for health information systems, promising tamper-resistant record-keeping, transparent audit trails and traceable supply chains.healthtechafrica.org+3NM-AIST Repository+3healthtechafrica.org+3

This secondary research paper examines how blockchain could help create “records that don’t disappear” in SSA healthcare, with Kenya as a primary case study. It synthesises academic articles, policy documents, industry reports and case descriptions on blockchain in African health systems, EHR adoption, and Kenya’s evolving digital health landscape. Key use cases include: (1) secure longitudinal patient records; (2) patient-controlled health data and universal patient portals; (3) anti-counterfeit pharmaceutical supply chains; and (4) secure telehealth and data exchange.Gas Publishers+8NM-AIST Repository+8eTraverse+8

In Kenya, pilots such as AfyaRekod’s blockchain-based universal patient portal, a blockchain EHR project for public hospitals, and experimental blockchain patient identification systems demonstrate technical feasibility and growing local expertise.African Journals Online+3Tech Blog Africa+3FurtherAfrica+3 These initiatives sit within a broader context of national eHealth policy, a Digital Health Agency Strategic Plan and new certification frameworks for digital health systems.africahealthitnews.com+4KIPPRA PPR+4Ministry of Health+4

The paper finds that blockchain can help address long-standing problems—record loss, duplication of tests, weak interoperability, and counterfeit medicines—by providing secure, verifiable data layers and shared ledgers across fragmented actors.Bitrabo+9NM-AIST Repository+9Taylor & Francis Online+9 However, most implementations remain pilot-scale, and adoption barriers include infrastructural constraints, governance and regulatory ambiguity, sustainability of business models and the need for strong data-protection regimes.ScienceDirect+7ResearchGate+7healthtechafrica.org+7

The paper argues that blockchain is not about replacing doctors or existing EHRs, but about making clinical data more reliable and portable, and making clinicians’ work faster and easier through trusted information flows. Policy recommendations include: integrating blockchain-ready standards in digital health certification, supporting national-scale pilots for patient identity and pharmaceutical traceability, embedding blockchain within Kenya’s digital health strategies rather than as stand-alone apps, and ensuring robust governance for security and equity.

1. Introduction

1.1 The everyday problem: health records that vanish

In many SSA facilities, patient records are still paper-based. A nurse may flip through a stack of dog-eared files, only to discover a folder is missing. A patient sent to another hospital arrives as a “new” case, because their notes never travel with them. A diabetic patient repeats lab tests that were done two weeks earlier because the results cannot be found, and the clinic information system does not talk to the lab’s software. These scenarios are not anecdotal; they are documented patterns in reviews of EHR implementation in SSA and surveys of Kenyan hospitals.Taylor & Francis Online+1

The consequences are serious: delayed or inappropriate treatment, increased costs for patients and health systems, and eroded trust. A scoping review of EHRs in SSA found that while digital records improve data management and patient care where implemented, adoption is uneven and hindered by infrastructural and financial constraints.Taylor & Francis Online+1 A mixed-methods survey of Kenyan public hospitals observed disparate, often non-interoperable systems, with stakeholders citing infrastructure gaps, usability challenges and policy limitations around data sharing.KIPPRA PPR

Against this backdrop, blockchain technology is being explored as an infrastructure for health records that don’t disappear: records that are tamper-evident, traceable and persist across institutions and time.

1.2 Blockchain: not magic, but a different way to trust data

Blockchain is a distributed ledger technology in which data are stored in blocks linked cryptographically, forming chains that are extremely hard to alter retroactively. Updates require consensus among participating nodes, and each transaction is time-stamped and auditable.NM-AIST Repository+1

In healthcare, this architecture can be used to:

  • Record patient identifiers and metadata so that clinical data from different systems can be consistently linked.
  • Hash and reference off-chain medical records, so that sensitive data stay in existing EHRs, but their integrity and provenance can be verified on-chain.
  • Manage consent and permissions, allowing patients to grant or revoke access to their records.
  • Trace the movement of pharmaceuticals from manufacturer to patient, making it harder for fake medicines to enter supply chains.healthtechafrica.org+10Advantage Health Africa+10theafricalogistics.com+10

Kenya is a compelling focal case. It has:

This paper therefore takes a regional view of blockchain in health information systems, while using Kenya to illustrate how these ideas play out in practice.

1.4 Research objectives and questions

Using only secondary data, this paper aims to:

  1. Describe the main health-information challenges in SSA that blockchain claims to address.
  2. Map key blockchain use cases in healthcare—particularly patient records and pharmaceutical traceability.
  3. Examine Kenyan blockchain-in-health pilots and their policy context.
  4. Analyse potential benefits, risks and implementation barriers.
  5. Offer recommendations for policymakers, technologists and funders.

The guiding questions are:

  • How can blockchain help reduce lost files, mismatched records and duplicate tests?
  • What role can blockchain play in combating counterfeit medicines?
  • How are SSA countries—especially Kenya—experimenting with blockchain in health?
  • What governance and design choices determine whether blockchain helps clinicians, rather than burdening them?

2. Methodology

This is a secondary research (desk review) paper.

2.1 Data sources

Four types of sources were reviewed:

  1. Academic articles and preprints on EHRs in SSA, blockchain in healthcare, and specific African case studies (e.g., Tanzania, South Africa, Nigeria, Kenya).ResearchGate+6Taylor & Francis Online+6ScienceDirect+6
  2. Policy and strategy documents from the Kenyan Ministry of Health, including the National eHealth Policy 2016–2030, digital health transformation communications, and the Digital Health Agency Strategic Plan and certification framework.PATH+5KIPPRA PPR+5Ministry of Health+5
  3. Industry and civil-society reports on blockchain in African healthcare and pharmaceutical supply chains.Bitrabo+8healthtechafrica.org+8Medical Mirror+8
  4. Case write-ups and news articles on AfyaRekod, Kenyan blockchain patient ID/EHR projects, and related digital health pilots.World Health Expo+4Tech Blog Africa+4FurtherAfrica+4

2.2 Inclusion criteria

Sources were included if they:

  • Focused on SSA or African countries, with at least some relevance to health information or pharmaceutical supply chains
  • Discussed blockchain or distributed ledger technology in a healthcare context, or provided essential background on EHR adoption
  • Were published mainly from 2015 onwards (to reflect recent blockchain developments), with older foundational work considered when relevant

2.3 Limitations

The emerging nature of blockchain in African health means many initiatives are described in blogs or news articles, not peer-reviewed literature. Details of system architectures, governance and outcomes are often sparse. The paper therefore interprets available evidence cautiously, triangulating across multiple sources where possible and framing some statements as inferred potential rather than proven impact.

3. Health Information Challenges in Sub-Saharan Africa

3.1 Fragmented and fragile record systems

Reviews of EHR initiatives in SSA emphasise major structural challenges: underdeveloped infrastructure, limited connectivity, and reliance on donor-funded vertical systems that do not interoperate.Taylor & Francis Online+1 In many facilities, paper remains the primary medium; where digital systems exist, they often cover specific disease programmes (e.g., HIV) rather than whole-of-facility records.

Kenyan surveys show that most public hospitals have adopted some form of digital system, but often for billing and administration rather than comprehensive clinical records. Interoperability within and across facilities remains limited.KIPPRA PPR

The result: records are frequently incomplete, duplicated or lost. Patients may have one identity in a maternal health register, another in an HIV database and another in a private lab’s system—with no reliable way to link them.

3.2 Patient identification and duplication

A fundamental problem is patient identification. Without a consistent, unique identifier, it is difficult to assemble longitudinal records or share data between facilities. A recent Kenyan project, Sim-Health, explicitly targets this issue, proposing a blockchain-based national patient identification system that ensures data security while linking scattered records.African Journals Online

Similar concerns appear in broader SSA analyses: identity systems are fragmented, and health information systems rarely integrate reliably with national ID regimes.NM-AIST Repository+2Taylor & Francis Online+2 This leads directly to mismatched records and repeated tests.

3.3 Repeated tests and inefficiencies

When records cannot be located or trusted, clinicians often repeat diagnostics “just to be sure.” Evidence from EHR studies in SSA suggests that digital records reduce such duplication by providing accessible histories, but only when systems are consistently used and available.Taylor & Francis Online+1

However, in many settings:

  • Connectivity failures block access to cloud-hosted systems
  • New staff are not fully trained on digital tools
  • Data are siloed across incompatible systems

In that landscape, lab results are often printed and carried by patients, vulnerable to loss and damage—precisely the kind of problem that a tamper-proof, shared data layer could help mitigate.

3.4 Counterfeit and substandard medicines

Africa’s pharmaceutical markets face high burdens of counterfeit and substandard medicines, with some studies and policy briefs noting serious risks in supply chains with limited transparency and weak enforcement.ScienceDirect+3Advantage Health Africa+3theafricalogistics.com+3

Key issues include:

  • Limited real-time visibility along the supply chain
  • Paper-based or easily falsified documentation
  • Informal distribution channels
  • Weak inventory and recall systems

Blockchain advocates argue that immutable, shared ledgers can help track drugs from manufacturer to patient, making it harder for fake products to enter unnoticed.eTraverse+3Advantage Health Africa+3theafricalogistics.com+3

4. Blockchain in African Healthcare: Conceptual Foundations

4.1 Core properties relevant to health

Across multiple African-focused articles, several blockchain features are highlighted as particularly relevant to health systems:World Health Expo+7NM-AIST Repository+7healthtechafrica.org+7

  • Immutability: Once data are recorded and confirmed, they cannot easily be altered without leaving a trace, supporting auditability.
  • Decentralisation: No single party “owns” the ledger; multiple stakeholders (e.g., hospitals, pharmacies, regulators) hold nodes that collectively maintain the record.
  • Transparency and selective privacy: Transactions can be visible to authorised participants, while cryptographic techniques (e.g., hashing, encryption) protect underlying data.
  • Smart contracts: Self-executing code that enforces rules—such as who can access what data, or when a drug shipment can change hands.

These properties align with health sector needs: strong data integrity, multi-stakeholder collaboration, and enforceable access rules.

4.2 HealthTech Africa’s framing

HealthTech Africa, a knowledge hub on digital health, notes that blockchain is still in early adoption stages in African healthcare, but highlights health data security, supply chain transparency and fraud reduction as leading use cases.Bitrabo+4healthtechafrica.org+4healthtechafrica.org+4 Examples referenced include pilot projects for patient identity, vaccine supply chains and telehealth data integrity.

4.3 Not “blockchain or EHRs” but “blockchain + EHRs”

A recurring insight in technical and implementation literature is that blockchain should not be imagined as storing full medical records (which are large, frequently updated and sensitive). Instead:

In SSA, where hospitals are slowly adopting EHRs, this layering can be advantageous: blockchain can tie together multiple existing systems without requiring a single monolithic EHR.

5. Kenya’s Digital Health Landscape

5.1 National eHealth policy and digital health strategy

Kenya’s National eHealth Policy 2016–2030 sets out a vision for using ICT to strengthen health systems, with strategic objectives around:

  • Strengthening health information systems
  • Improving service delivery and access
  • Enhancing efficiency and governance

It explicitly acknowledges the need for interoperable systems and secure data management.KIPPRA PPR+1

More recently, the Ministry of Health has accelerated digital transformation efforts, emphasising the role of digital tools in achieving universal health coverage.Ministry of Health+2PATH+2 In 2025, Kenya launched:

  • A Digital Health Agency Strategic Plan, defining priorities for the next five years
  • A Certification Framework for Digitization, setting standards for digital health solutions used in the health sector

These frameworks aim to ensure that digital systems, including any blockchain-based solutions, meet quality, security and interoperability requirements.Ministry of Health+1

5.2 EHR adoption in Kenyan public hospitals

The mixed-methods survey of Kenyan public hospitals found that all facilities surveyed had some form of digital system, but:

  • Systems often focused on billing and administration
  • Clinical modules (e.g., in-patient EHRs) were less common
  • Interoperability between different modules and with national systems was limited
  • Users reported issues with training, infrastructure and supportTaylor & Francis Online+2ScienceDirect+2

These findings underscore why “records that don’t disappear” remains an aspiration rather than a reality, and why blockchain proposals resonate.

5.3 Emerging blockchain initiatives

Several Kenyan initiatives are explicitly or implicitly blockchain-enabled:

  1. AfyaRekod Universal Patient Portal (UPP)
    AfyaRekod, a Kenya-based HealthTech firm, launched what has been described as the first blockchain-driven Universal Patient Portal in Africa.Tech Blog Africa+1 The system allows patients to:
    • Store and access health records via a consolidated data “passport”
    • Share data with health providers in real time
    • Access a marketplace of health services within the ecosystem
    The underlying blockchain architecture is used to ensure data integrity and track consented access.
  2. Blockchain EHR prototype for Kenyan public hospitals
    A publicly accessible project description on GitHub outlines a blockchain-based EHR system developed specifically in response to challenges faced by health record systems in Kenyan public hospitals—targeting interoperability, secure sharing and access control.GitHub
  3. Sim-Health: Blockchain patient identification
    A recent article in a Kenyan medical journal describes Sim-Health, a blockchain-based national patient identification system designed to address fragmentation of patient IDs and improve data security and sharing.African Journals Online

These initiatives remain early-stage but signal growing local interest and capacity in blockchain-for-health.

6. Blockchain Use Cases: Fixing Records and Fighting Fake Drugs

6.1 Patient records that don’t disappear

6.1.1 Linking identities and records

In Kenya and many SSA countries, poor patient identification leads to fragmented records. Blockchain-based identity systems—sometimes framed as “self-sovereign identity”—allow a patient to hold a cryptographic identity that can be recognised across systems.NM-AIST Repository+2African Journals Online+2

In practice:

  • A patient’s core identifier and cryptographic keys are anchored on-chain.
  • Different health facilities link their local records to that anchor, without exposing underlying data.
  • When a patient moves between facilities, clinicians can verify that they are referencing the same person and request access to relevant records.

Sim-Health is an example of such a design in Kenya, demonstrating the feasibility of a blockchain-based national patient ID that prioritises security and interoperability.African Journals Online

6.1.2 Verifiable medical histories

Blockchain can store hashes of clinical documents (e.g., discharge summaries, lab results). The full files live off-chain, but any attempt to tamper with them would change the hash, immediately detectable by comparing with the on-chain record.NM-AIST Repository+2ResearchGate+2

For clinicians, this means:

  • More confidence that “old results” are genuine, not modified
  • Reduced need to repeat tests due to doubt about validity
  • Easier cross-facility collaboration, because records come with verifiable provenance

For patients, it means they can carry digital copies of their records (on phones, cards or portals like AfyaRekod), knowing that any provider can quickly check integrity.

6.2 Patient-controlled access and portability

Solutions like AfyaRekod emphasise patient-centred data mobility: patients hold their records and decide who sees what.Tech Blog Africa+1

Blockchain supports this by using smart contracts to record:

  • Which provider can access which subsets of data
  • Under what conditions (e.g., emergency overrides)
  • For how long

Patients could grant temporary access to a new doctor or lab; once the period expires, the smart contract denies new retrievals unless renewed.NM-AIST Repository+2healthtechafrica.org+2

In SSA contexts where patients often seek care from multiple, unconnected providers, this model could significantly reduce history-taking burden and improve continuity—again, making clinicians’ work faster and more accurate rather than replacing them.

6.3 Pharmaceutical traceability and counterfeit prevention

Multiple African-focused articles argue that blockchain can be transformative for pharmaceutical supply chains:Medical Mirror+5Advantage Health Africa+5theafricalogistics.com+5

  • Each batch of medicine receives a unique identifier recorded on the blockchain at the point of manufacture.
  • Every transfer—from manufacturer to wholesaler, distributor, pharmacy, and ultimately health facility—is logged as a transaction.
  • Regulators or health workers can scan a code on a pack and verify its chain of custody; discrepancies can flag potential counterfeits.

Given the documented challenge of fake medicines in African markets, such a system could:

  • Protect patients from harmful products
  • Protect legitimate manufacturers’ reputations
  • Support recalls, by allowing quick identification of where affected batches went

Blockchain-based traceability pilots exist globally, and African-oriented commentaries argue for adapting these models to local pharmaceutical logistics and regulatory realities.tech-ceos.com+6Advantage Health Africa+6theafricalogistics.com+6

6.4 Secure telehealth and remote care

As telemedicine expands in Africa, concerns around data security and privacy grow. A Nigerian study on securing telehealth data proposes blockchain architectures and cryptographic algorithms (e.g., Smart Secure Telehealth, Controlled Isolated Data) to ensure that teleconsultation data are tamper-resistant and access-controlled.Gas Publishers+2Bitrabo+2

Similarly, a case from Malawi describes a blockchain-powered telemedicine platform connecting rural patients with urban specialists, emphasising integrity and trust in data exchange.eTraverse

In Kenya, while most telehealth services do not yet use blockchain, the same logic applies: integrating blockchain could strengthen security, audit trails and consent management for remote consultations, lab orders and e-prescriptions—especially where multiple providers and insurers are involved.

7. Benefits and Opportunities

7.1 Tackling record loss and duplication

By anchoring patient IDs and document hashes on a distributed ledger, blockchain addresses the core problem of disappearing or duplicated records:

  • Even if a local system fails or a paper file is lost, the proof of data’s existence and integrity persists on-chain.
  • Different facilities can verify that they are dealing with the same patient and can request or retrieve relevant records (subject to permissions).ResearchGate+4African Journals Online+4Taylor & Francis Online+4

For overburdened clinicians, this manifests as shorter history-taking, fewer repeated tests and more reliable longitudinal views.

7.2 Strengthening trust and accountability

Health systems depend on trust: patients need to trust providers; providers need to trust data; regulators need to trust reports. Blockchain’s immutability and auditability can:

  • Make tampering with health records or drug documentation more difficult
  • Provide transparent logs of who accessed what data and when
  • Support investigations into adverse events or fraud

Case studies of blockchain in African healthcare emphasise improved confidence in data and reduced opportunities for corruption or unauthorised changes.Bitrabo+5healthtechafrica.org+5Medical Mirror+5

7.3 Enabling regional and cross-border interoperability

SSA patients often cross borders for care. Regional initiatives, such as in the East African Community, increasingly talk about harmonising health and pharmaceutical regulations. Blockchain’s distributed architecture can support multi-country networks where:

  • Each country’s health ministry and major providers run nodes
  • Patient identities and drug traceability records can be verified across borders
  • Data-sharing agreements are encoded in smart contracts

This is still largely aspirational, but African policy discussions on digital health and blockchain in supply chains suggest growing interest in regional solutions.healthtechafrica.org+5NM-AIST Repository+5healthtechafrica.org+5

7.4 Stimulating local innovation and capacity

Kenyan projects like AfyaRekod, Sim-Health and blockchain EHR prototypes show that local developers are not just consumers but creators of blockchain health solutions.GitHub+3Tech Blog Africa+3FurtherAfrica+3 This can:

  • Build a cadre of engineers and informaticians versed in both health and advanced cryptographic technologies
  • Attract investment and partnerships
  • Generate solutions tailored to African realities rather than imported wholesale

8. Risks, Challenges and “Misses”

8.1 Infrastructure and cost constraints

Running blockchain networks requires computing resources, storage and network bandwidth. In low-resource settings, these requirements can clash with realities of:

  • Unreliable power
  • Limited connectivity, especially in rural facilities
  • Tight budgets for hardware and maintenance

Even permissioned (private) blockchains—less resource-intensive than public ones—can impose non-trivial costs. African-focused analyses caution that blockchain should not be pursued at the expense of basic digital infrastructure or core health services.tech-ceos.com+5NM-AIST Repository+5Taylor & Francis Online+5

8.2 Governance and regulatory ambiguity

Who runs the blockchain nodes? Who decides membership and rules? How are disputes resolved? These governance questions are complex even in high-income settings, and they are amplified in multi-stakeholder, cross-border African contexts.

While Kenyan policy has advanced in setting general digital health frameworks and certification, there is limited explicit guidance on blockchain governance in health.tech-ceos.com+6KIPPRA PPR+6PATH+6 Without clear rules, pilot projects may not scale or may create parallel infrastructures that are hard to integrate later.

8.3 Data protection, privacy and ethics

Storing health-related identifiers and metadata on immutable ledgers raises privacy concerns:

  • Even if clinical data are off-chain, metadata patterns could reveal sensitive information (e.g., visits to HIV clinics).
  • Errors—such as linking the wrong person—cannot simply be “deleted” on an immutable ledger; they must be corrected via additional entries, which requires careful design.

African commentators stress that data protection laws and ethical frameworks must guide blockchain implementations, not the other way round.PATH+6Medical Mirror+6healthtechafrica.org+6

8.4 Sustainability and “pilot-itis”

A framework paper on blockchain for medical records in Africa notes that, to date, most implementations are conceptual frameworks or small pilots rather than large-scale systems.ResearchGate+2NM-AIST Repository+2 There is a risk of “pilot-itis”: short-term projects that generate excitement but are not sustained or integrated into national systems.

Reasons include:

  • Lack of long-term funding
  • Misalignment with government priorities
  • Over-engineering relative to local needs
  • Poor engagement with end-users, especially clinicians

If blockchain is perceived as an expensive toy rather than a practical tool that makes doctors’ work easier, its legitimacy will erode.

8.5 Human factors: clinicians’ workflows and training

Ultimately, the success of any health information system depends on people using it. Reviews of EHR adoption in SSA emphasise usability, training and change management as major determinants of success.Taylor & Francis Online+1

Blockchain introduces additional complexity:

  • Clinicians may be asked to understand new identity or consent flows.
  • Workflows may require scanning QR codes or interacting with new interfaces.
  • Misconfigured permissions could lock clinicians out at critical times.

Designs must therefore prioritise minimal disruption: blockchain should sit under the hood, with interfaces and workflows tailored to existing practice and constraints.

9. Kenya as a Case Study: Pulling It Together

9.1 How blockchain addresses Kenya’s specific pain points

Kenya’s own analyses highlight fragmented HR information systems, interoperability gaps and data-sharing challenges between levels of care and between national and county systems.africahealthitnews.com+3KIPPRA PPR+3JKUAT+3 The AfyaRekod portal, Sim-Health, and EHR prototypes can be seen as responses to:

  • Lost/mismatched records: AfyaRekod gives patients a portable record, backed by blockchain-verified integrity; Sim-Health anchors patient IDs on-chain; EHR prototypes explore secure, interoperable sharing.GitHub+3Tech Blog Africa+3FurtherAfrica+3
  • Repeating tests: Clinicians accessing blockchain-verified labs and imaging histories can avoid unnecessary repeats, provided that integration with labs is achieved.GitHub+5NM-AIST Repository+5Taylor & Francis Online+5
  • Uncertain drug quality: While Kenya has not yet implemented a national blockchain traceability system, African logistics and pharma analyses suggest that Kenya could benefit from regional or national pilots, particularly for high-risk products (e.g., oncology drugs, antibiotics).eTraverse+4Advantage Health Africa+4theafricalogistics.com+4

9.2 Integrating blockchain into Kenya’s Digital Health Agency framework

The new Digital Health Agency Strategic Plan and certification framework provide an opportunity to:

  • Recognise blockchain as one of several architectural options for secure data exchange
  • Set minimum standards for permissioned blockchain networks in health (e.g., node governance, security, interoperability)
  • Encourage sandbox environments where blockchain health solutions can be tested with regulatory oversightafricahealthitnews.com+3Ministry of Health+3Xinhua News+3

By doing so, Kenya can avoid ad-hoc, siloed blockchain deployments and instead steer innovations towards national goals.

9.3 Lessons for the wider region

Kenya’s experience offers several lessons for SSA:

10. Recommendations

10.1 For governments and regulators in SSA (with Kenya as a lead)

  1. Embed blockchain considerations in national digital health strategies.
  2. Develop governance models for health blockchains.
  3. Prioritise high-value use cases.
  4. Strengthen data protection and ethics frameworks.

10.2 For health facilities and clinicians

  1. Focus on workflow-friendly designs.
    • Demand systems that integrate with existing EHRs and HIS, minimising additional steps.
    • Involve clinicians in user-testing blockchain-enabled applications.Taylor & Francis Online+1
  2. Advocate for interoperability and verifiable histories.
    • When procuring systems, ask vendors how they will ensure records remain accessible and verifiable over time, including if blockchain is used.
  3. Participate in pilots cautiously but constructively.
    • Engage with blockchain pilots that clearly demonstrate how they will solve real pain points (e.g., lost files, duplicate tests), not just showcase technology.

10.3 For technologists and HealthTech companies

  1. Treat clinicians as users, not obstacles.
    • Design interfaces that hide blockchain complexity and focus on clinical tasks.
  2. Use hybrid architectures.
  3. Plan for sustainability and integration.
  4. Collaborate on open standards.
    • Contribute to shared protocols that allow different platforms to interoperate, reducing vendor lock-in.

10.4 For donors and investors

  1. Fund infrastructure and capacity as well as pilots.
  2. Demand rigorous evaluation.
  3. Support regional learning platforms.

11. Conclusion

Blockchain will not magically fix all health information problems in Sub-Saharan Africa, and it certainly will not replace doctors. What it can do—if carefully governed and integrated—is make health data more trustworthy, more portable and more resilient.

The everyday frustrations of lost files, mismatched records and repeated tests are not just annoyances; they are symptoms of deeper structural issues in how health information is captured, stored and shared. EHRs have begun to address these issues in parts of SSA, but fragmentation and infrastructural constraints remain.Taylor & Francis Online+1

Blockchain offers a complementary layer: a way to ensure that once a record exists, its integrity and provenance are preserved; that patient identities can be consistently linked; and that drug movements can be transparently tracked. African-focused literature and Kenyan case studies—from AfyaRekod’s universal patient portal to Sim-Health’s patient ID system—show concrete steps towards this vision of “records that don’t disappear.”healthtechafrica.org+7Tech Blog Africa+7FurtherAfrica+7

Kenya’s evolving digital health policy environment, with a national eHealth policy, digital health agency, and certification framework, positions it as a regional leader that can pioneer responsible blockchain-in-health models.africahealthitnews.com+4KIPPRA PPR+4Ministry of Health+4 If these efforts keep clinicians’ workflows and patients’ rights at the centre, blockchain can quietly do what it does best in the background: keep records safe, make counterfeits harder, and allow data to tell the truth.

In that future, a clinician in a rural Kenyan clinic—or anywhere in SSA—could pull up a patient’s verified history, see past tests instead of ordering duplicates, confirm that the medicine in their hand came through a legitimate supply chain, and spend more of the consultation focused on the person in front of them, not on chasing missing files. That is what “healthcare – records that don’t disappear” really means.

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