Table 1.

Presentation of current barriers to implementation of telemedicine in SSA and recommendations for scale-up.

Barriers	Recommendations for scale-up	Future/long term considerations
1. Health worker-related barriers •Persistent health workforce shortages, compounded by COVID-19 related morbidity and mortality among health workers •Lack of health care worker buy-in •Limited technological know-how •Language barriers	•Utilize virtual consultations for asymptomatic doctors unable to be physically present at hospitals due to COVID-19 isolation or quarantine. •Redesign health care workers' workload incorporating telemedicine •Mass technology training for both patients and health care workers •Incorporate different linguistics in TM relevant to the target population	Educational reforms that improve technological knowledge and inclusion of telemedicine training
2. Infrastructure hurdles •High cost of set up •Maintenance skills gap	•Global partnerships with manufacturers of equipment •Support private-public partnerships to unlock investment in TM infrastructure	Training or upskilling local engineers to attend to maintenance issues
3. Lack of policy and budgetary support •Lack of policy clarity •Limited budgetary support	•Development of national policy on TM with sufficient devolution •Increase budgetary support to health and specifically TM	Consistent policy and budgetary support