**10. Challenges, barriers and knowledge of digital health**

Despite the standard benefits and implications of digital health in clinical practice to diagnose, treat, disease management and prevention and wellness; challenges and issues arose such as doctors not having adequate information for prescription and use digital health technologies [46]. A perspective review on critical perspectives on digital health technologies reported a number of complexities on patients' perspective on the use of digital health such as telehealth; some patients felt that they had slight control over their doctors' decision to use technologies and wish to continue using the ordinary patient-doctor model [67]. A digital health: a path to validation review conducted in the United States of America (USA) stated that the concept of digital health continues to evolve and digital health technologies are being used worldwide in medicine to diagnose, treat and clinical decision support [68]. The impact of digital health technologies on optimising individuals' health and well-being is extraordinary as the technologies have transformed clinical practice from prevention to disease management and self-management [69]. However, despite the uprising of digital health in clinical practice, challenges were noted during the path to validation of digital health hindering the extensive implementation of evolving approaches such as health digital scorecard and requirements-driven approach [68]. Three challenges were noted namely; conceptual, financial and organisational and operational challenges.

In a study conducted in the United States, lack of technical support, lack of authentication of expertise and lack of expertise usability were the barriers to implementation of digital health by patients with hypertension [70]. There is a number of contributing factors hindering the implementation of electronic health (e-Health) programmes in Uganda such as poor coordination and communication, untrained health personnel, loss of network connection, lack of knowledge and skills about telehealth, illiterate community and people financial status [71]. A study in the implementation of digital health technology such as mHealth applications in Botswana aiming to reduce patients and HCP barriers inaccessibility to care and knowledge, respectively, indicated that numerous social and technical challenges were faced; such as cultural misalignment between the Information technology (IT) and HCP, unreliable IT, infrastructure accidental damage to mobile devices and malfunctioning mobile devices [72]. There are unravelling barriers in adoption of digital health at the primary health care level in African Countries by health care providers such as lack of technology knowledge, lack of innovation acceptance, limited knowledge and abilities of utilisation of digital health, absence of enthusiasm and poor organisational and management level [73]. Furthermore, study conducted in Iran shown significant poor knowledge of health care providers in utilisation of digital health and most probably due to lack of training [73].

Approximately 79% of pregnant women utilising mom connect in the year 2017 asked questions related to health and others were about disrespect and abuse from the midwifery practitioners, showing significant utilisation of digital health [58]. Further showing that improper communication amongst the midwifery

*Utilisation of Digital Health in Early Detection and Treatment of Pre-Eclampsia in Primary… DOI: http://dx.doi.org/10.5772/intechopen.101228*

practitioners and gravid women can further hinder the utilisation of digital health by gravid women. However, despite the improper communications, approximately 2.5 million pregnant women registered for the digital health initiate by 2019. Evidence shows effective usage of digital health amongst pregnant women [41]. The working conditions can hinder optimal midwifery care to the patient such as the implementation of digital health; this supported [74] that absenteeism, shortage of staff, work overload of staff and overcrowding of patients in healthcare facilities are contributing factors to perinatal morbidity and mortality. This significantly remains a major common barrier in the provision of standardised care such as improper teaching of pregnant women such as the utilisation of mom connect.
