In South Sudan, FHIR (Fast Healthcare Interoperability Resources, a standard for exchanging health data electronically) is only used in a few early cases. Adoption is still at an early stage, and the country is just beginning to explore its potential.

The main version in limited use is STU3. Newer versions like R4, R4B, R5, and R6 are not yet active in the country.

Looking ahead, we expect a strong increase in FHIR adoption in the coming years.

Rules and Support

Health data regulation in South Sudan is still developing:

  • There are no regulations currently in place that require standards for electronic health data exchange.
  • Because no rules exist, there are no FHIR requirements, no compliance deadlines, and no fines.
  • There is no government funding available to support FHIR adoption.
  • Discussions are underway to put regulations and funds in place, but nothing has been finalized yet.

National Setup

Here is the current state of national infrastructure for health data standards:

  • A national organization responsible for health data standards exists in South Sudan.
  • There is no base or core FHIR implementation guide for the country yet.
  • There is no national FHIR terminology server, and no plans to build one at this time.
  • There is no known activity related to the FHIR Community Process (FCP), but in the next 2–3 years, we expect one or more organizations to explore becoming FCP participants.

Active Use Cases

FHIR use in South Sudan is still very limited:

  • No successful FHIR use cases have been identified yet.
  • No specific FHIR standards have been developed locally for particular use cases.
  • The country has not yet adopted international specifications such as the International Patient Summary or IHE profiles.

Who's Using FHIR

The following groups are starting to engage with FHIR in South Sudan:

  • Care providers
  • Payers and insurers
  • EHR (Electronic Health Record) system vendors
  • Diagnostic system vendors, such as imaging and lab providers
  • App developers
  • Government agencies
  • Researchers

The main reasons driving FHIR adoption are:

  • Improving health outcomes
  • Improving care workflows
  • Giving patients access to their data
  • Supporting innovation

In terms of how FHIR is being applied, FHIR Messaging sees the most use, with FHIR Documents, REST APIs, and SMART on FHIR (a way to build secure healthcare apps) being used in only limited ways. Other tools like CDS Hooks, CQL on FHIR, Bulk Data, Subscriptions, and Questionnaires are not yet in use. The software mix leans slightly toward open source.

Successes and Challenges

There are no documented success stories yet. The main challenges holding back FHIR adoption include:

  • Unclear benefits — stakeholders are not yet sure what FHIR can deliver.
  • Unclear regulations — without rules, there is little guidance.
  • Lack of FHIR knowledge — more training and capacity building are needed.

As one respondent shared, "capacity on FHIR would enlighten the country on the early benefits of FHIR."

Future Plans

AI and machine learning are seen as somewhat helpful for FHIR efforts, especially in speeding up the mapping and transformation of data into FHIR format. There is strong disagreement with the idea that AI removes the need to invest in structured data.

Looking forward, satisfaction with current adoption is neutral, but expectations for the future are positive. The next steps we expect in the coming year include:

  • Establishing a national standards organization
  • Developing a national FHIR data model
  • Introducing new regulations that require standards for electronic health data exchange
  • Developing new FHIR standards for specific use cases

Overall, we agree that within the next three years, South Sudan can begin to see real benefits from FHIR adoption, including better care coordination and a stronger digital health ecosystem.

Contributors

  • Lino Ch, Chief Digital Health Innovation Officer, South Sudan Health Informatics Association

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.