Implementing Blockchain for Health Sectors in Low- and Middle-Income Countries: Use Cases, Approaches and Challenges

Abstract

Background and Purpose: Despite its complexity and resource constraints, the healthcare sector in low- and middle-income countries (LMICs) faces a crucial challenge of ensuring data integrity, interoperability, and transparency. Blockchain technology emerges as a potential solution, offering secure and immutable platforms for managing health information. This study investigates the use cases, approaches, and challenges of implementing blockchain in LMIC healthcare, focusing on health services and sector-wide management.

Methods: The study employed a systematic review methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to ensure transparency and reproducibility in the review process.

Results: Results show that while a number of LMICs countries have embarked on the implementation of blockchain-based applications, most projects remain as proposals or experiments. The study found 26 (82%) projects had some form of implementation. Of these, 11 (42%) were simulations, 2 (8%) evolved into working prototypes, and only 3 (12%) achieved full-fledged deployments. The most implemented use case was Electronic Health Record systems (EHR), which constituted about 23% of all implementations, followed by Remote Patient Monitoring (15%).

Conclusions: Most of the blockchain initiatives in the health sector in LMICs are still in simulations and prototype stages. There is also low conversion of projects from this preliminary stage to fully-fledged solutions. To overcome this challenge more readiness programs both technical and administrative are required to ensure successful deployments of blockchain in the health sector in LMICs.