Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Methods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthal-mology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some short-comings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth pol-icy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.

Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a population.As guided by the World Health Organization,antenatal care(ANC)attendance is one of the measures promoted to curtail the global health burden of maternal and infant mortality.ANC services are seldom utilized to their full potential in Zimbabwe.This study explores if any of the women's digital technology characteristics were associated with antenatal care visits.Methods:The study analyzed population-based cross-sectional data with a subsample of 1 932 women aged 15-49 years from the 2019 Zimbabwe Multiple Indicator Cluster Survey.Test of associations with chi-square test,bivariate,and multivariate multinomial logistic regression analyses were used to examine the predictors of adequate(4-7)and optimal(≥ 8)ANC visits relative to undesirable(1-3)antenatal care visits among women who had given births 2 years before the survey.Results:The results indicate that 64.5％(1246/1 932)of the women attained adequate ANC while about 9.8％(189/1 932)attained optimal ANC.Reading a newspaper/magazine at least once a week(odds ratio[OR]1.73,β'=0.551,t=2.030,P=0.043)and watching television at least once a week(OR 1.72,β'=0.545,t=2.454,P=0.015),listening to the radio less than once a week(OR 1.28,β'=0.247,t=1.750,P=0.080),and owning a mobile phone(OR 1.48,β'=0.394,t=3.020,P=0.003)were positively associated with adequate ANC.Optimal ANC was significantly associated with women being able to read a newspaper at least once a week(OR 2.93,β'=1.074,t=3.120,P=0.002),listen to the radio less than once a week(OR 2.07,β'=0.73,t=2.700,P=0.007)and have ownership of a mobile phone(OR 1.88,β'=0.631,t=2.620,P=0.009).Conclusion:Access to a newspaper,radio,television,and mobile phone were important predictors of a woman's ability to achieve her ANC attendance.Policies to improve the knowledge of ANC packages can be facilitated using digital technology to achieve adequate and preferably optimal ANC in Zimbabwe.It is important to improve digital infrastructure to support digital technologies in providing ANC services.

Emerging digital technologies continues to evolve posing unprecedented opportunities in health systems globally to improve healthcare services delivery.There has been significant progress in healthcare.However,the lack of emotive recognition coupled with a dearth of personalized and pervasive health applications and emotive smart devices calls for the integration of intelligent sensors health systems through emerging technologies.Although there has been significant progress in smart and connected health care,more research innovation,dissemination and technologies are needed to unbundle new opportunities and move towards healthcare 5.0.Healthcare is at the dawn of a paradigm change to reach the new era of smart disease control and detection,virtual care,smart health management,smart monitoring,and decision-making.Therefore,this study discusses the roles and capacities of sensors,their capabilities and other emerging technologies such as nanotechnology,5 G technologies,drone technology,blockchain,robotics,big data,internet of things,artificial intelligence,and cloud computing.Healthcare 5.0 provides healthcare services including patient remote monitoring,tracking and virtual clinics,emotive telemedicine,ambient assisted living,smart self-management,wellness monitoring and control,smart treatment reminders,compliance and adherence,and personalized and connected health care.However,building resilience and robust healthcare 5.0 is not immune to challenges.Organizational challenges,technological and infrastructural barriers,lack of legal and regulatory frameworks and e-health policies,individual perceptions,misalignment with hospitals' strategy,lack of funding,religious and cultural barriers are identified as potential barriers to the successful implementation of healthcare 5.0.Therefore,there is a need for building resilient technology-driven healthcare systems.To achieve this,there is a need for expanding technological infrastructure,provision of budgetary support based on sustainable business models,develop appropriate legal and e-health policies,standardization and synchronization of protocols,improving stakeholders' engagement and involvement and establishment of private and public partnerships and investments.

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01–1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.