Barriers and Enablers of Post Pandemic Digital Health Sustainability in Ghanaian Public Hospitals

Abstract The period of Covid-19 pandemic witnessed an accelerated use of digital health tools in Ghana’s public hospitals. However, the rapid use of these technologies during crisis does not necessarily mean their usage will become routine after the crisis. This study explored barriers and enabling conditions that shape the sustainability of digital health technologies in public hospitals in Ghana, post Covid-19. The study used a qualitative descriptive design to analyse open-ended survey responses from 13 healthcare workers who participated in a larger mixed-methods study. The responses were analysed and interpreted using the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework. Four themes emerged: infrastructure, technical and clinical barriers; organisational and workforce enablers; conditions for sustainable digital health; and equity, access and perceived value. Participants described unreliable internet and electricity, limited access to devices, technical knowledge gaps and limitations in digitally mediated care as important challenges. Training, technical support, leadership, peer collaboration and organisational adaptability helped support digital health use. For continued use, participants emphasised reliable infrastructure, ongoing training, equipment maintenance, system integration, data security and regular evaluation. They also saw digital health as an opportunity to improve access to healthcare, particularly for rural and underserved populations. The findings suggest that successful digital health use during a crisis does not by itself create the conditions needed for long-term sustainability. Moving from crisis-driven adoption to sustained institutional use requires continued investment in infrastructure, people, organisational support and the capacity to adapt digital health systems over time.