Digital policy and governance frameworks for EHR systems in Tanzania: a scoping review

Abstract

Purpose This study aims to examine Tanzania’s digital policy and governance frameworks for electronic health records (EHR) systems, focusing on data protection, cybersecurity and interoperability. The study provides insights into strengthening digital health governance and aligning with international standards by assessing policy gaps and comparing Tanzania’s approach with regional and global benchmarks. Design/methodology/approach The study uses a scoping review methodology, following Arksey and O’Malley’s framework, to systematically explore the literature on Tanzania’s digital health policies. A comprehensive search across Scopus, PubMed, JSTOR and Emerald was conducted to identify studies addressing EHR systems implementation, data protection laws, cybersecurity policies and digital health governance. The analysis includes comparisons with Kenya, Uganda, Ghana, Nigeria and South Africa, alongside international best practices from the USA, the UK, European Union and Germany. Findings The review reveals significant gaps in Tanzania’s digital policy landscape, particularly in health-specific cybersecurity regulations, interoperability enforcement and independent regulatory oversight. While the National eHealth Strategy and Tanzania Health Information Exchange provide a foundation for digital health, the absence of a legally mandated interoperability framework and weak enforcement of data protection laws pose challenges for secure EHR systems adoption. Comparative analysis shows that Kenya’s Data Protection Act (2019), South Africa’s POPIA and Germany’s alignment with the WHO’s Global Strategy on Digital Health 2020–2025 offer valuable models for strengthening Tanzania’s regulatory framework. The study recommends adopting national cybersecurity standards, independent regulatory oversight, capacity-building initiatives and emerging technologies such as blockchain-based EHR systems governance. Research limitations/implications The study is limited by the scarcity of research on EHR systems governance in Tanzania and the lack of regional studies detailing policy implementation outcomes. While global comparisons provide valuable insights, more empirical studies are needed to evaluate the real-world effectiveness of EHR systems policies in sub-Saharan Africa. Originality/value To the best of the authors’ knowledge, this study is one of the first comprehensive reviews of Tanzania’s digital policy and governance for EHR systems implementation, offering critical insights for policymakers, health-care administrators and researchers. The study highlights actionable pathways for improving Tanzania’s EHR systems security, interoperability and regulatory compliance by integrating regional and global policy comparisons.