01 — Overview
African Health OS is a conceptual health digital public infrastructure (DPI) architecture designed for pan-African interoperability: unique patient records, clinical data exchange and traceability of care events.
- Field
- Digital Public Infrastructure (Health)
- Data standard
- HL7 FHIR Release 4
- Reference
- Africa CDC digital health strategy
- Stage
- Concept
02 — Problem
In many West African health systems, medical records are still kept on paper or locked into non-communicating proprietary software. When a patient is transferred from a rural clinic to a university hospital, their history, allergies and prescriptions are frequently lost.
This information gap leads to diagnostic delays, costly duplicate tests and an inability for ministries to steer health policy and epidemic alerts in real time.
03 — Objective
To describe an interoperability layer able to interconnect health actors without forcing the replacement of existing tools, while guaranteeing data residency and the protection of clinical data.
04 — Proposed solution
- Unique patient identifier: identity reconciliation enabling a lifelong record regardless of facility.
- Offline & USSD access: asynchronous synchronisation for rural centres and code-based access for users without smartphones.
- Pharmaceutical supply chain: traceability of essential medicines and detection of stock-outs.
- Epidemiological surveillance: anonymised aggregation of diagnoses at national level.
05 — My role
Architecture design, drafting of the FHIR patient identity profile and development of a cryptographic audit-ledger prototype. A personal applied-research effort, with no institutional commission at this stage.
06 — Technology / methodology
A data profile compliant with HL7 FHIR R4, a Python prototype of a hash chain (SHA-256) guaranteeing the non-repudiation of care events, and granular-consent principles inspired by SMART on FHIR.
07 — Governance & policy dimension
- Granular consent: citizens control who may access their record, with the ability to revoke.
- Territorial residency: hosting in national data centres.
- Immutable audit log: a timestamped proof for every access.
- Framework: the Malabo Convention on cybersecurity and personal data protection.
08 — Current status
Concept. The architecture, the patient schema and an audit-ledger prototype exist. No deployment, pilot or health partnership is in place.
09 — Evidence
- HL7 FHIR R4 patient identity profile (JSON).
- Cryptographic audit-ledger prototype (Python).
- System specification (technical README).
10 — Roadmap
- Consolidate the FHIR profiles and adapt the schemas to national identity systems.
- Document consent and emergency cross-border sharing scenarios.
- Study a pilot with an academic or health actor — to be defined.
No health partnership is engaged. Any real implementation would fall to the competent health authorities.
11 — Potential impact
Better continuity of care between facilities, fewer redundant tests and real-time health surveillance capacity — subject to validation by health authorities and compliance with data protection frameworks.
12 — Documents
13 — Links
- Public code repository
- Related projectsBITC — AI Governance