Aryee et al. Human Resources for Health (2024) 22:60 https://doi.org/10.1186/s12960-024-00924-x REVIEW Open Access © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creat​iveco​mmons.​org/​licen​ses/​by-​nc-​nd/4.​0/. Human Resources for Health Effectiveness of eLearning programme for capacity building of healthcare professionals: a systematic review Gifty Francisca Ben Aryee1, Mustapha Amoadu2, Paul Obeng2*   , Hammond Nii Sarkwah3, Ebenezer Malcalm4, Susanna Aba Abraham5, Jones Abekah Baah2, Dorcas Frempomaa Agyare5, Nartey Edmond Banafo1 and Daprim Ogaji6  Abstract  Background  The effectiveness of eLearning in enhancing healthcare professionals’ capacity has received substantial attention globally. This review sought to synthesis evidence on the effectiveness of various types of eLearning pro- grammes, and the facilitators and barriers to its use. Methods  The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four main databases (PubMed, Web of Science, JSTOR, and Scopus) in July 2023 and 44 articles met the eligibility criteria and were included in the review. The JBI critical appraisal checklist was used to appraise the methodological quality of the studies. The data were examined using narrative review to determine the effectiveness of the interven- tion as well as the barriers and facilitators to its use. Results  This review found that asynchronous, synchronous, blended, and self-learning methodologies are effective eLearning approaches for continuous professional development. Previous positive experiences, user-friendly inter- faces and relevance of the eLearning content to daily practice are critical elements that facilitate eLearning usage. Poor computer competence and literacy, lack of personal computers and high family duties were the main personal factors that hindered eLearning use. Some systemic barriers included; heavy workloads, shortage of specialised eLearning facilitators poor management involvement, and technical inadequacies within the ICT departments. Envi- ronmental issues such as poor infrastructure, including limited internet and frequent power outages acted as barriers. Conclusion  The review highlights the effectiveness of various eLearning approaches among health professionals and presents the disparities between developing and developed economies in relation to the facilitators and barriers. Keywords  eLearning, Capacity building, Healthcare professionals, Effectiveness, Barriers *Correspondence: Paul Obeng obengpaul155@gmail.com Full list of author information is available at the end of the article http://creativecommons.org/licenses/by-nc-nd/4.0/ http://crossmark.crossref.org/dialog/?doi=10.1186/s12960-024-00924-x&domain=pdf http://orcid.org/0000-0002-5564-9240 Page 2 of 20Aryee et al. Human Resources for Health (2024) 22:60 Introduction Globally, healthcare professionals are tasked to provide high-quality patient- and community-centred care for improved health outcomes [2, 21, 29]. In the current fast- paced and ever-changing healthcare landscape, staying abreast of the latest medical advancements and best prac- tices is essential in meeting patients’ needs [22]. Hence, the continuous development of healthcare profession- als has become increasingly vital to the global demands of healthcare. The purpose of the continued growth of healthcare is to provide a learning environment and an opportunity to enhance the knowledge and skills of healthcare professionals [29, 47]. This will enhance their capacity to provide patients with high-quality, evidence- based care [55]. Thus, eLearning has emerged as a prom- ising approach to capacity building and an opportunity for continuous development for healthcare professionals. eLearning leverages digital technologies to deliver educa- tional content and training programmes, offering flexibil- ity and accessibility to healthcare providers with diverse specialities across diverse settings [11, 35]. For the past decade, the effectiveness of eLearning in enhancing healthcare professionals’ capacity has received substantial attention from policymakers, global bod- ies, researchers, and educators [48]. The effectiveness of eLearning programmes refers to the extent to which elec- tronic learning interventions, delivered through digital technologies and online platforms, achieve their intended outcomes in enhancing the knowledge, skills, clinical performance, and overall professional competence of healthcare professionals [46, 50]. Key indicators include knowledge acquisition, examining the depth and rele- vance of eLearning content, skill development, assessing practical competencies within participants’ roles; clinical performance, gauging real-world application of knowl- edge and skills; and overall professional competence, encompassing holistic effectiveness in various dimen- sions of healthcare practice. eLearning has become a robust tool for delivering educational materials, interactive sessions, and virtual training experiences for healthcare professionals [46, 47, 49, 57]. In this era of widespread availability of tech- nological devices and internet connectivity, eLearn- ing has become increasingly accessible [46, 47]. It has transformed how healthcare professionals access and engage with educational content [1, 19]. eLearning allows learners to customise their learning experiences, catering to individual preferences and learning styles [21, 53]. Also, through self-paced modules and interac- tive sessions, eLearning offers opportunities for person- alised skill development and continuous professional growth and development [53]. Moreover, eLearning provides the flexibility to access educational content at learners’ convenience. This flexibility enables learners to balance their professional commitments and learn- ing pursuits effectively [36, 50]. Regardless of the benefits associated with eLearning programmes, there may be challenges that need to be explored, understood, and addressed to enable the effec- tive implementation of eLearning programmes for the continued professional development (CPD) of health- care workers [6, 50]. The challenges and effectiveness of eLearning programmes may have contextual variations. Thus, after decades of research into the implementation of eLearning for healthcare professionals, it is essential to assess the effectiveness and challenges facing eLearn- ing programmes in the capacity building of healthcare professionals. In this review, the effectiveness of the eLearning pro- gramme is measured by assessing the impact of eLearn- ing on the continuous development and capacity building of healthcare workers, considering factors such as knowl- edge acquisition, skill enhancement, adaptability to diverse learning styles, and the overall contribution to improved patient care and health outcomes [36, 50]. Hence, this systematic review qualitatively evaluated the effectiveness of eLearning interventions on healthcare professionals’ knowledge acquisition, skill development, clinical performance, and overall professional compe- tence. By synthesising evidence from a diverse range of studies, the review aimed to identify the strengths and limitations of eLearning programmes for the capac- ity building of healthcare professionals. In addition, the researchers explored the factors influencing the success- ful implementation of eLearning programmes. The pur- pose is to gain valuable insights into healthcare education and continuous professional development. Furthermore, this review aimed to inform healthcare institutions, edu- cators, and policymakers about the potential of eLearn- ing as an essential tool in enhancing the capabilities of healthcare professionals, especially for those in resource- limited and hard-to-reach settings. Methods This review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Anal- yses (PRISMA) and was guided by the guidelines of Ark- sey and O’Malley [5]. The procedures involve developing review questions, searching for relevant studies, selecting studies, extracting data, summarising data, synthesising results, reporting the results, and consultation [5]. Review questions The review questions were: Page 3 of 20Aryee et al. Human Resources for Health (2024) 22:60 1. What is the effectiveness of the eLearning pro- gramme for capacity building for healthcare profes- sionals? 2. What are the facilitators and barriers to the effec- tive implementation of eLearning programmes for healthcare professionals’ continued education and development? Search strategies The search for relevant studies was conducted in six pri- mary databases: PubMed (Platform: National Center for Biotechnology Information), Web of Science (Platform: Clarivate Analytics), JSTOR (Platform: ITHAKA), and Scopus (Platform: Elsevier). Additional search was con- ducted in: Google Scholar (Platform: Google), World Health Organization Library, Science Direct (Platform: Elsevier), Taylor and Francis (Platform: Taylor and Fran- cis), and ProQuest. The search was initially conducted in PubMed using Medical Subject Headings (MeSH) terms (see Table  1). The MeSH terms were developed using the Population, Intervention, Comparison, and Outcome (PICO) frame- work. These MeSH terms were then modified to suit the search in other data. A Chartered Digital Librarian, Kwame Kodua Ntim of Sam Jonah Library, University of Cape Coast, and his team were consulted during the data search and management of search results. The last search in all databases was conducted on July 30, 2023. Study selection Search records were transferred to the Mendeley soft- ware and duplicates were removed. Screening for eligible papers was done in three stages. In the first stage, titles and abstracts of search results were screened for rel- evance. This was done by 15 trained graduate students and supervised by authors. In the second phase, relevant papers were screened for full-text records, and reference lists of full-text records were further searched for other relevant papers. In the third phase of the screening pro- cess, full-text papers were screened based on the eligibil- ity criteria by the authors. Details of eligibility criteria are presented in Table 2. Full-text papers were screened independently by PO and GBA and reviewed by MA. PRISMA flow diagram presents search results and the screening process (Fig. 1). Appraisal of studies Briggs’s critical appraisal tools, developed and updated by Joanna Briggs Institute (JBI) in 2020 were used to Table 1  Search strategy for search conducted in PubMed #1: Search to identify intervention (eLearning) eLearning* [MeSH Term] OR Online learning* [MeSH Term] OR Digital learning* OR Virtual learning* OR Electronic learning* OR Internet-based learning* OR Web-based learning* OR Computer-based learning* OR Distance learning* OR Web-based education* OR Internet-based instruction Remote learning* Mobile learning* OR Cyberlearning* OR Digital education* OR Online education* OR Virtual education [MeSH Term]* OR Web-based training* OR Internet-based training* OR Computer-based training* OR Online training* OR Web-based instruction* OR Digital training* OR Online instruction [MeSH Term]* OR Internet-based education* OR Virtual training* OR Computer-assisted learning* OR eResource* #2: Search to identify Outcome (Effectiveness) Effectiveness* [MeSH Term] OR Efficacy* OR Efficiency* OR Impact* OR Success* OR Productivity* OR Performance* OR Achievement*OR Proficiency* OR Results* OR Outcomes* Patient safety* Reduced Mortality* Reduced disease prevalence* User satisfaction* OR Quality of care* OR Cost-effectiveness* OR Cost–benefit* OR improved knowledge* OR improved skills* OR better attitudes* responsiveness* Increase utilisation* Increase access to healthcare* #3: Search to identify outcome (Barriers) Barriers* [MeSH Term] OR Obstacles* [MeSH Term] OR Challenges* [MeSH Term] OR Hindrances* OR Impediments* OR Difficulties* OR Constraints* OR Limitations* [MeSH Term] OR Restraints* OR Blockades* OR Deterrents* OR Handicaps* OR Hurdles* OR Resistance* OR Problems* OR Disadvan- tages #4: Search to identify outcome (Facilitators) Facilitators* [MeSH Term] OR Enablers* OR protective factors* OR buffers* OR Support* OR Resilience [MeSH]* OR Enhancers* enabling factors* OR #5: Search to identify the Population (Health- care professionals) Healthcare professionals* [MeSH Term] OR Medical professionals* OR Healthcare providers* OR Health- care practitioners* [MeSH Term] OR Healthcare workers* [MeSH Term] OR Healthcare personnel* OR Medical practitioners* OR Medical staff* OR Clinicians* Public health workers* OR Caregivers* OR Allied health professionals* OR Nursing staff* OR Physicians* OR Doctors* OR Surgeons* OR Nurses* OR Pharmacists* OR Physical therapists* OR Occupational therapists* OR Speech-language patholo- gists* OR Radiographers* OR Radiologists* Mental healthcare workers* OR Mental practitioners* #5: Search strategy 1 #1 AND #2 AND #5 Not Animal* #6 Search strategy 2 #1AND #3 AND #5 Not Animal* #7: Search strategy 3 #1AND #4 AND #5 Not Animal* Filters activated English Language; (Date: 01/01/2000- 30/07/2023) Page 4 of 20Aryee et al. Human Resources for Health (2024) 22:60 appraise included studies [30]. The aim was to cer- tify all reviewed studies. However, it is noteworthy that the quality appraisal was not meant to exclude full-text papers but to report the quality of all included studies for readership. This tool comprises checklists for evalu- ating the quality of qualitative studies, cross-sectional studies, randomised controlled trials, etc. Mixed Method Appraisal Tool (MMAT) version 2018 was used to appraise all included mixed-method studies [26]. The scoring procedures adopted by Amoadu et  al. [3] were used in grading the included studies. Appraisals were conducted by PO and GBA, supervised by MA. Extracted Table 2  Eligibility criteria for screening of reviewed studies Inclusion criteria 1. Papers conducted using study designs such as randomised controlled trials, cohort/longitudinal studies, cross-sectional surveys, qualitative designs, mixed-method designs, case–control designs, etc. 2. Papers that sampled in-service healthcare professionals for the eLearning programme 3. Papers that assessed the effectiveness and the barriers associated with the use of eLearning among healthcare professionals 4. Papers that compared eLearning and traditional training or no training among healthcare professionals 5. Grey literature (dissertation or thesis) 6. Papers published in the English language 7. All appraised studies Exclusion criteria 1. Papers that did not report on variables of interest 2. Reviews, letters to editors, conference papers, preprint, opinions, manuscripts, abstracts, and pre-proofs 3. Papers conducted using pre-service or student healthcare professionals 4. Studies conducted in any other language apart from the English language Fig. 1  PRISMA flow diagram for search results and screening process Page 5 of 20Aryee et al. Human Resources for Health (2024) 22:60 data were analysed using thematic content analysis, sum- marised, and qualitatively synthesised. See Appendix A for appraised studies. Data extraction Data were extracted independently by PO and GBA and reviewed by MA. This was done to ensure that extracted papers were reliable and accurate and inconsistencies between extractors were resolved during regular online meetings. We extracted the data based on authors, year of publication, the purpose of study, study design, pop- ulation, sample, effectiveness, facilitators and barriers and critical appraisal score. See Appendix B for the data extraction form and characteristics of included studies. Data synthesis The authors gathered a diverse range of studies and extracted data from articles that address research ques- tions regarding eLearning programme effectiveness, and the facilitators and barriers involved in its implementa- tion. Once the data were compiled, the authors engaged in a thorough familiarisation process. This involved reading through the extracted data to become well- acquainted with the content. During this phase, authors worked on identifying key concepts, patterns, and recur- ring themes that emerge naturally from the extracted data. Authors systematically labelled text sections with descriptive codes that encapsulated the essence of the extracted data. Once coding was underway, authors started collating related codes into preliminary themes like Effectiveness of eLearning" and "Facilitators and Bar- riers". The authors then critically reviewed and refined these preliminary themes to ensure they accurately rep- resent the extracted data. Relevant information and findings extracted from the studies that directly support each theme were then organised. These extracted data points served as con- crete evidence to answer the research questions. While interpreting these themes, their significance to the effec- tiveness of eLearning programmes and the various fac- tors influencing their implementation were considered. Finally, the authors synthesised the findings for each research question, crafting a clear and concise narrative that directly addressed the core objectives of this review. Results Search results The search in the four main databases (PubMed, Web of Science, JSTOR, and Scopus) produced 6765 records. The additional search conducted in other databases for relevant papers produced 29 records. The Mendeley software was used to remove 1023 duplicates. The screening of titles and abstracts led to the exclusion of 5699 records that were not relevant to this review. Thus, 72 full-text articles were avail- able for further screening. Consultation with a librar- ian and checking the reference list of eligible full-text records produced an additional 10 records. In all, 44 records were included in this qualitative synthesis, and 38 records were excluded based on the eligibility crite- ria. See Figure for details on search results and screen- ing process. Characteristics of included studies Reviewed studies sampled 40,223 healthcare providers. The studies employed various research designs, includ- ing cross-sectional designs in the United Kingdom, Tai- wan, and globally [15, 38, 60], experimental designs in the USA, India, Ghana, Italy, Belgium, and others [1, 10, 12, 13, 18, 20, 28], longitudinal designs in sub-Saha- ran Africa and Italy [14, 45], mixed methods studies in Guinea, Ghana, China, Republic of Ireland, Northern Ire- land, Australia, and Nigeria [7, 11, 17, 22, 36, 41, 42, 51, 58] qualitative designs in Ukraine, Malawi, South Africa, the USA, India, Uganda, and Rwanda [7, 11, 23–25, 40], and randomised controlled trials in the Netherlands, the UK, and Australia [9, 16, 27, 31, 32, 44, 56]. Thus, most of the reviewed studies were experimental designs (15) and mixed-method designs (11) (see details in Fig. 2). Major- ity of studies were conducted in the United Kingdom (6), United States of America (4), the Netherlands (4), Taiwan (3), Ireland (3), India (2), Ghana (2), Italy (2), Belgium (2), Kenya (20), Malawi (2), China (2), Australia (2) and a study each from other countries (see details in Fig. 3). Most studies explored self-learning (10) (see details in Fig. 4). Appraisal results The results of appraised studies were categorised into low, moderate, and high-risk. Details are presented in Fig. 5. Operational definition of eLearning types found in studies These operational definitions clarify the key charac- teristics and approaches associated with each type of eLearning, helping to differentiate them in the context of educational delivery. 1. Self-learning: self-learning, also known as self-paced learning, is an eLearning approach where learners have full control over their learning process. They can access course materials, modules, and resources independently, often without a schedule or instruc- tor-led sessions. Learners can progress at their own pace, revisiting content as needed. Page 6 of 20Aryee et al. Human Resources for Health (2024) 22:60 2. Asynchronous: Asynchronous eLearning is charac- terised by a lack of real-time interactions. Learners access course materials, lectures, and assignments at their convenience. Communication and collabora- tion often occur through discussion boards or email, without the need for simultaneous participation. Fig. 2  Study designs included in the qualitative synthesis Fig. 3  Map of countries and continents where included studies were conducted Page 7 of 20Aryee et al. Human Resources for Health (2024) 22:60 3. Synchronous: Synchronous eLearning involves real- time interactions between learners and instructors or peers. This can include live webinars, video con- ferences, or virtual classrooms where participants engage simultaneously, promoting immediate feed- back and active engagement. 4. Blended asynchronous: Blended asynchronous eLearning combines asynchronous learning activities with limited synchronous components. Learners can access self-paced content and resources, but occa- sional synchronous interactions, such as live Q&A sessions or group discussions, may occur. 5. Blended synchronous and asynchronous: Blended synchronous and asynchronous eLearning com- bines two distinct modes of learning. Synchronous components involve real-time interactions, such as live webinars, video conferences, or chat sessions, where learners and instructors engage simultane- ously. Asynchronous components include self-paced activities, such as prerecorded lectures or discussion forums, allowing learners to access content at their convenience. 6. Blended synchronous: Blended synchronous eLearn- ing integrates real-time, instructor-led activities with 10 4 5 7 6 5 5 1 1 0 2 4 6 8 10 12 Self-learning Blended synchonous and asynchronous Blended synchronous Blended learning Asynchronous Synchronous Blended asynchronous Synchronous and Self-learning Self-learning and blended synchronous Fig. 4  eLearning types explored by reviewed studies 15 2 6 7 3 2 1 2 2 1 2 1 0 2 4 6 8 10 12 14 16 Experimental Designs (15) Cross-sec�onal surveys (3) Longitudinal/Cohort studies (2) Randomised controlled trials (7) Mixed-method studies (11) Qualita�ve Studies (6) Low risk Moderate risk High risk Fig. 5  Appraisal of reviewed studies Page 8 of 20Aryee et al. Human Resources for Health (2024) 22:60 asynchronous components. Learners participate in live sessions, discussions, or virtual classrooms at scheduled times, enhancing engagement and inter- action. However, some content and activities may be available asynchronously to accommodate different learning styles and time zones. 7. Blended learning: Blended learning combines tradi- tional face-to-face instruction with online elements. It offers a mix of in-person classroom sessions and eLearning components, allowing learners to access resources, collaborate online, engage in digital activi- ties, and attend physical classes. 8. Synchronous and self-learning: Synchronous and self-learning, also known as mixed-mode learning, allows learners to engage in real-time, instructor-led sessions and self-paced activities. This approach pro- vides flexibility while maintaining structured, inter- active learning opportunities. 9. Self-learning and blended synchronous: Self-learning and blended synchronous eLearning combine self- paced learning with scheduled synchronous inter- actions. Learners can access content independently while participating in live sessions, discussions, or collaborative activities when required. Effectiveness of eLearning programmes among healthcare providers Table  3 presents data on the effectiveness of eLearn- ing programme among healthcare providers. The table shows that,  asynchronous eLearning has proven to be highly effective in advancing healthcare professionals’ knowledge, attitudes, and practices. Chase et  al. [10] demonstrated its impact on increasing knowledge and confidence among oncology healthcare providers, specifi- cally in smoking cessation. Colaceci et al. [13] highlighted significant improvements in healthcare providers’ aware- ness and positive attitudes toward breastfeeding through asynchronous eLearning, showcasing its positive influ- ence on healthcare practices. The study by Erlandsson et al. [20] emphasised the role of asynchronous eLearning in skill development, introducing dynamic birthing posi- tions and enhancing the capacity of midwives in labour rooms. Additionally, Delf [17] showcased the improve- ment in reporting radionuclide bone scans among allied health workers, indicating the positive impact of asyn- chronous eLearning on specialised clinical skills. Col- aceci et al. [14] demonstrated the long-term effectiveness of asynchronous eLearning in shaping healthcare pro- viders’ attitudes and practices related to infant nutrition, particularly in promoting and supporting breastfeed- ing. Moreover, Barteit et  al. [7] explored self-directed asynchronous eLearning, resulting in improved clini- cal skills for patient management in a Malawian tertiary hospital. Synchronous eLearning Synchronous eLearning has demonstrated positive impacts on various healthcare practices, contribut- ing to enhanced outcomes. Choi et  al. [12] show- cased its effectiveness in improving care practices for severe acute malnutrition in resource-poor countries, emphasising its role in advancing healthcare practices. Fourré et  al. [22] observed increased knowledge and the development of positive beliefs regarding lower back pain management through synchronous eLearn- ing, highlighting its educational benefits in specialised healthcare areas. Chang et  al. [9] implemented a suc- cessful eLearning programme for nurses in Taiwan, revealing overall satisfaction with the programme. However, the study identified statistically significant differences between eLearning platforms and face- to-face settings, particularly in teaching and learn- ing methods and communication. Detroyer et  al. [18] investigated the impact of a delirium eLearning tool on healthcare workers’ delirium recognition, knowl- edge, and care practices, revealing improved recogni- tion and knowledge through synchronous eLearning approaches. Blended eLearning types Blended asynchronous  Blended asynchronous eLearn- ing has demonstrated notable effectiveness in various healthcare contexts. Nesterowicz et  al. [37] showcased its viability for continuing education in pharmacy, lead- ing to increased knowledge among participants. Similarly, Chernysh et  al. [11] reported improved knowledge and awareness among maternal and child health (MCH) pro- viders in Ukraine through eLearning. Furthermore, the study by Kulier et al. [32] comparing an integrated eLearn- ing course on evidence-based medicine to traditional lec- tures for postgraduates in the UK and the Netherlands revealed no statistically significant differences between the two methods, highlighting the flexibility offered by eLearning. Blended asynchronous and  synchronous  In blended asynchronous and synchronous eLearning, Jones et  al. [31] reported that physiotherapists exhibited a high level of confidence and readiness to apply their newly acquired skills and knowledge in patient consultations, highlight- ing the practicality of this approach. The studies collec- tively showcase the value of blended asynchronous and synchronous eLearning in improving healthcare provid- ers’ competence and readiness for real-world applications. Page 9 of 20Aryee et al. Human Resources for Health (2024) 22:60 Ta bl e  3  Eff ec tiv en es s of e Le ar ni ng a m on g he al th ca re p ro vi de rs Ty pe o f e Le ar ni ng St ud y ob je ct iv e In di ca to r o f e ffe ct iv en es s A ut ho rs Se lf- le ar ni ng To e xa m in e th e  sa tis fa ct io n an d  m ot iv at io n of  h ea lth ca re p ro vi de rs in  u si ng O PE N P ed ia tr ic s (o pe n- ac ce ss m ed ic al e Le ar ni ng p la tfo rm ) Pa ed ia tr ic ia ns re po rt ed a  h ig h fre qu en cy o f m ot iv at io n to  a cc es s th e  pl at fo rm s [1 5] Bl en de d sy nc hr on ou s To im pr ov e kn ow le dg e of  h ea lth p ro vi de rs re la te d to  fo ur m aj or m en ta l he al th p ro bl em s Si gn ifi ca nt in cr ea se in  k no w le dg e w as  re po rt ed [5 2] Bl en de d le ar ni ng A ss es s H IV -T B eL ea rn in g im pa ct o n  pr ov id er s’ sa tis fa ct io n, s ki lls , an d  pr ac tic e eL ea rn in g w as  a n  ac ce pt ab le a nd  e ffe ct iv e m od ul us o f c ap ac ity b ui ld - in g an d  de ve lo pi ng c om m un iti es o f p ra ct ic e to  s tr en gt he n in te gr at ed ca re [1 ] A sy nc hr on ou s To e va lu at e th e  us e of  a n  ev id en ce -b as ed , s m ok in g ce ss at io n eL ea rn in g ed uc at io n pr og ra m m e fo r o nc ol og y he al th ca re p ro vi de rs Th e he al th ca re p ro vi de rs in cr ea se d in  k no w le dg e an d  in  c on fid en ce in  s uc ce ss fu lly h el pi ng th e  pa tie nt s to  q ui t s m ok in g [1 0] Sy nc hr on ou s To in ve st ig at e w he th er  e Le ar ni ng u se a m on g  he al th ca re p ro vi de rs in  re so ur ce -p oo r c ou nt rie s le ad to  im pr ov ed d ia gn os is , m an ag em en t, an d  su rv iv al o f c hi ld re n w ith  s ev er e ac ut e m al nu tr iti on (S A M ) Im pr ov ed c ar e pr ac tic es fo r c hi ld re n w ith  S A M [1 2] A sy nc hr on ou s To a ss es s if  eL ea rn in g w as  e ffe ct iv e in  im pr ov in g he al th ca re p ro vi de rs ’ at tit ud es a nd  p ra ct ic es Th er e w as  a n  im pr ov em en t i n  th e  aw ar en es s an d  po si tiv e at tit ud es to w ar d  br ea st fe ed in g [1 3] Sy nc hr on ou s an d  se lf- le ar ni ng To d et er m in e th e  eff ec t o f a  d el iri um e Le ar ni ng to ol o n  he al th ca re w or ke rs ’ d el iri um re co gn iti on , k no w le dg e, a nd  c ar e Im pr ov ed h ea lth ca re w or ke rs ’ d el iri um re co gn iti on a nd  k no w le dg e [1 8] A sy nc hr on ou s To d et er m in e th e  fe as ib ili ty o f u si ng a n  in te rn et -b as ed c ap ac ity b ui ld in g pr og ra m m e co nt rib ut in g to  e ffe ct iv e m id w ife ry p ra ct ic es in  th e  la bo ur ro om s In tr od uc tio n of  d yn am ic b irt hi ng p os iti on s an d  im pr ov ed c ap ac ity of  m id w iv es to  b e m or e pr oa ct iv e w he n  w or ki ng in  in te rd is ci pl in ar y te am s [2 0] Se lf- le ar ni ng To in ve st ig at e th e  eff ec t o f t he  E -S O LA S tr ai ni ng p ro gr am m e on  p hy si - ot he ra py m an ag er s’ co nfi de nc e an d  kn ow le dg e in  s er vi ce d el iv er in g Th er e w er e si gn ifi ca nt in cr ea se s in  p hy si ot he ra pi st s’ co nfi de nc e an d  kn ow le dg e in  d el iv er y of  a ll E- SO LA S in te rv en tio n co m po ne nt s [2 8] Bl en de d as yn ch ro no us To a ss es s if  e- co ur se s w er e a  vi ab le m et ho d of  p ro vi di ng c on tin ui ng ed uc at io n in  p ha rm ac y Kn ow le dg e in cr ea se d af te r p ar tic ip at io n [3 7] Se lf- le ar ni ng A ss es s ’B re as tfe ed in g Ba si cs ’ im pa ct o n  M C H p ro vi de rs ’ k no w le dg e an d  ba se lin e us er k no w le dg e Im pr ov ed k no w le dg e [3 9] Bl en de d sy nc hr on ou s an d  as yn ch ro no us To v er ify if  e Le ar ni ng w as  a bl e to  e nh an ce h ea lth ca re p ro fe ss io na ls’ al co ho l-r el at ed p ro bl em s kn ow le dg e A s ig ni fic an t i nc re as e in  a lc oh ol -r el at ed p ro bl em s kn ow le dg e [4 3] Se lf- le ar ni ng To e xp lo re th e  ch an ge s in  h ea lth ca re p ro vi de rs ’ le ar ni ng o ut co m es re la te d to  e vi de nc e- ba se d br ea st fe ed in g su pp or t a nd  p ro m ot io n Im pr ov ed k no w le dg e an d  se lf- effi ca cy [5 9] Bl en de d sy nc hr on ou s A ss es se s eL ea rn in g’ s im pa ct o n  he al th ca re p ro fe ss io na ls’ s ex ua l a tt itu de s an d  be lie fs Im pr ov em en ts in  a tt itu de a nd  p er ce iv ed k no w le dg e an d  aw ar en es s of  p ro st at e ca nc er s’ im pa ct o n  se xu al w el l-b ei ng [3 4] Bl en de d le ar ni ng To in tr od uc e eL ea rn in g in  a dv an ce d ca rd ia c lif e su pp or t a m on g  he al th - ca re p ro fe ss io na ls a nd  a ss es s its e ffe ct iv en es s Eff ec tiv e in  in cr ea si ng th e  kn ow le dg e le ve l o n  ca rd ia c lif e su pp or t [4 ] A sy nc hr on ou s To e va lu at e th e  lo ng -t er m e ffe ct iv en es s of  a n  on lin e na tio na l p ro - gr am m e on  in fa nt n ut rit io n fo r H C Ps Eff ec tiv en es s in  im pr ov in g at tit ud e an d  pr ac tic e re ga rd in g  th e  pr ot ec - tio n, p ro m ot io n, a nd  s up po rt o f b re as tfe ed in g [1 4] Bl en de d sy nc hr on ou s To a ss es s th e  fe as ib ili ty a nd  a cc ep ta bi lit y of  W eb -b as ed tr ai ni ng to  s up - po rt H IV e du ca tio n ac ro ss  m ul tip le S SA c ou nt rie s In cr ea se d at te nd an ce fr om  4 0 pa rt ic ip an ts in  M on th 1 to  o ve r 1 60 in  M on th 1 0 [4 5] Bl en de d le ar ni ng To e va lu at e w he th er  a n  eL ea rn in g tr ai ni ng p ro gr am m e ca n im pr ov e TB he al th p er so nn el ’s kn ow le dg e an d  be ha vi ou r i n  C hi na Im pr ov ed k no w le dg e [5 8] Bl en de d sy nc hr on ou s an d  as yn ch ro no us To e va lu at e th e  eff ec tiv en es s of  e Le ar ni ng in  im pr ov in g pr ac tic es am on g  he al th ca re p ro vi de rs Eff ec tiv e in  re in fo rc in g th e  co m pe te nc e of  h ea lth ca re p ro vi de rs [5 4] Page 10 of 20Aryee et al. Human Resources for Health (2024) 22:60 Ta bl e  3  (c on tin ue d) Ty pe o f e Le ar ni ng St ud y ob je ct iv e In di ca to r o f e ffe ct iv en es s A ut ho rs Bl en de d le ar ni ng To id en tif y th e  sa tis fa ct io n am on g  he al th ca re p ro vi de rs o n  eL ea rn in g pl at fo rm s Le ar ne rs ’ s at is fa ct io n [3 3] Se lf- le ar ni ng To d es cr ib e th e  re su lts o f t he  n at io nw id e de pl oy m en t o f t he  In St ra t CO VI D -1 9 tu to ria l a pp to  fr on tli ne h ea lth w or ke rs a s  a  pu bl ic h ea lth in te rv en tio n du rin g  th e  CO VI D -1 9 pa nd em ic in  N ig er ia Im pr ov ed k no w le dg e [4 2] Se lf- le an in g To e xa m in e m en ta l h ea lth c lin ic ia ns Eff ec tiv e at  e nh an ci ng p ar tic ip an ts ’ p ra ct ic es , s uc h as  a ss es si ng th e  im pa ct o f m en ta l i lln es s on  p ar en tin g an d  ch ild d ev el op m en t an d  pr ov id in g in fo rm at io n an d  re so ur ce s to  fa m ili es [5 6] A sy nc hr on ou s To e xa m in e eL ea rn in g eff ec tiv en es s in  h el pi ng a lli ed h ea lth w or ke rs in  th e  U K to  re po rt ra di on uc lid e bo ne s ca ns Im pr ov em en t r ep or tin g of  ra di on uc lid e bo ne s ca ns [1 7] Sy nc hr on ou s To e va lu at e th e  fe as ib ili ty o f i m pl em en tin g an  in te ra ct iv e eL ea rn in g m od ul e on  th e  m an ag em en t o f l ow er b ac k pa in (L BP ) i n  he al th ca re pr of es si on al s in  F ra nc e an d  Be lg iu m In cr ea se le ve l o f k no w le dg e an d  po si tiv e be lie fs a bo ut  L BP [2 2] Bl en de d as yn ch ro no us To e xa m in e th e  eff ec tiv en es s of  im pl em en tin g eL ea rn in g fo r M C H pr ov id er s in  U kr ai ne Im pr ov ed k no w le dg e an d  aw ar en es s [1 1] A sy nc hr on ou s To e xa m in e se lf- di re ct ed e Le ar ni ng a t a  te rt ia ry h os pi ta l i n  M al aw i Im pr ov ed c lin ic al s ki lls in  p at ie nt m an ag em en t [7 ] Bl en de d le ar ni ng To a ss es s th e  in flu en ce o f e Le ar ni ng o n  th e  pe rf or m an ce o f h ea lth ca re pr ov id er s in  S ou th A fri ca Im pr ov ed k no w le dg e an d  sk ill s [4 0] Bl en de d as yn ch ro no us A ss es se s th e  ed uc at io na l i m pa ct o f a n  in te gr at ed e Le ar ni ng c ou rs e on  E BM a m on g  po st gr ad ua te s co m pa re d to  a  tr ad iti on al le ct ur e- ba se d co ur se in  th e  U K an d  th e  N et he rla nd s N o st at is tic al ly s ig ni fic an t d iff er en ce b et w ee n  bl en de d as yn ch ro no us an d  fa ce -t o- fa ce le ct ur es [3 2] Se lf- le ar ni ng To d et er m in e w he th er  e Le ar ni ng c an b e an  e ffe ct iv e m ea ns o f i m pr ov - in g th e  im pl em en ta tio n of  a  q ua lit y im pr ov em en t p ro je ct in  d el iri um ca re Im pr ov ed k no w le dg e an d  sc re en in g of  o ld er p at ie nt s w ith  d el iri um [5 6] Sy nc hr on ou s To d ev el op a n  eL ea rn in g ed uc at io n pr og ra m m e fo r s ta ff nu rs es a t a  7 00 - be d te ac hi ng m ed ic al c en tr e in  T ai w an N ur se s w er e sa tis fie d w ith  th e  eL ea rn in g pr og ra m m e. A ll nu rs es ’ kn ow le dg e w as  h ig h, a nd  a ll pa ss ed n ur si ng c ar e sk ill s. H ow ev er , s ta tis ti- ca lly s ig ni fic an t d iff er en ce s w er e fo un d on ly  in  te ac hi ng a nd  le ar ni ng an d  co m m un ic at io n am on g  nu rs es in  e Le ar ni ng p la tfo rm s an d  fa ce -t o- fa ce [9 ] Bl en de d as yn ch ro no us a nd  s yn ch ro no us To e xp lo re p hy si ot he ra pi st s’ ex pe rie nc es w ith  a nd  p er ce pt io ns of  a n  eL ea rn in g pr og ra m m e Ph ys io th er ap is ts e xp re ss ed a  h ig h le ve l o f c on fid en ce a nd  re ad i- ne ss to  g o in to  th ei r fi rs t p at ie nt c on su lta tio ns u si ng th ei r n ew s ki lls an d  kn ow le dg e th ey h ad a cq ui re d [3 1] Se lf- le ar ni ng To e va lu at e th e  eff ec t o f e Le ar ni ng o n  kn ow le dg e on  m en ta l h ea lth is su es a s  co m pa re d to  le ct ur e- ba se d le ar ni ng a m on g  oc cu pa tio na l ph ys ic ia ns in  th e  N et he rla nd s Im pr ov ed k no w le dg e an d  ca re p ra ct ic es [2 7] Bl en de d as yn ch ro no us To e xa m in e th e  re la tio ns hi p be tw ee n  th e  us e of  a n  eL ea rn in g si m ul a- tio n pr og ra m m e (M ic ro si m ) p rio r t o  at te nd in g an  A dv an ce d Li fe Su pp or t ( A LS ) C ou rs e an d  th e  su bs eq ue nt re la tio ns hi p to  c an di da te pe rf or m an ce in  th e  U K Im pr ov ed u nd er st an di ng o f A LS th eo ry a nd  s ki lls [4 4] Page 11 of 20Aryee et al. Human Resources for Health (2024) 22:60 Ta bl e  3  (c on tin ue d) Ty pe o f e Le ar ni ng St ud y ob je ct iv e In di ca to r o f e ffe ct iv en es s A ut ho rs Bl en de d sy nc hr on ou s Th e eff ec t o f a n  eL ea rn in g- su pp or te d Tr ai n- th e- Tr ai ne r p ro gr am m e on  im pl em en ta tio n of  s ui ci de g ui de lin es in  m en ta l h ea lth c ar e in  th e  N et he rla nd s Im pr ov ed c ar e pr ac tic es fo r s ui ci da l p at ie nt s am on g  m en ta l h ea lth ca re pr ov id er s [1 6] Page 12 of 20Aryee et al. Human Resources for Health (2024) 22:60 Blended (eLearning and face‑to‑face) Blended learning, incorporating elements of eLearning, has demonstrated significant positive impacts on health- care education across diverse contexts. Agarwal et al. [1] explored the effectiveness of HIV-TB eLearning, reveal- ing its acceptability and efficacy in capacity building for healthcare providers and community development. In the realm of advanced cardiac life support, Abdullah et  al. [4] introduced eLearning, resulting in increased knowl- edge levels in this critical area. Oluwadele [40] reported improvements in knowledge and skills among healthcare providers in South Africa attributed to eLearning. More- over, Wang et  al. [58] demonstrated the effectiveness of eLearning in enhancing knowledge and behaviour among TB health personnel in China. Blended synchronous  Blended synchronous eLearning approaches have been strategically employed to address specific healthcare challenges, yielding positive outcomes across various domains. Tirmizi et al. [52] demonstrated a significant increase in knowledge related to major mental health problems among healthcare providers through this method. McCaugan et al. [34] observed improvements in attitudes and awareness of the impact of prostate cancer on sexual well-being among healthcare professionals. In the context of web-based HIV education training in sub- Saharan African countries, Reid et al. [45] reported a suc- cessful increase in attendance, showcasing the potential of blended synchronous eLearning to enhance healthcare knowledge dissemination. Furthermore, De Beurs et  al. [16] documented improved care practices for suicidal patients among mental healthcare providers through an eLearning-supported Train-the-Trainer programme. Pereira et  al. [43] highlighted a significant increase in healthcare professionals’ knowledge of alcohol-related problems facilitated by eLearning. Tsai et  al. [54] rein- forced the competence of healthcare providers using eLearning, contributing to enhanced practices. Self‑learning  Self-learning within eLearning platforms has showcased its effectiveness across diverse healthcare education contexts, making significant contributions to knowledge acquisition, skill development, and compe- tency enhancement. Notably, studies have highlighted its positive impact on mental health clinicians, enabling them to assess the influence of mental illness on parenting and child development [51]. Paediatricians engaging in self- learning through platforms like OPENPediatrics reported high motivation and improved knowledge [15]. Maternal and child health providers accessing programmes like ‘Breastfeeding Basics’ experienced enhanced knowledge, illustrating the success of self-learning in targeted edu- cational modules [39]. Skill development was evident as physiotherapy managers participating in the E-SOLAS training programme reported significant increases in confidence and knowledge [28]. The role of self-learning during public health crises was exemplified by improved knowledge outcomes among frontline health workers using Nigeria’s InStrat COVID-19 tutorial app [42]. Addi- tionally, self-learning contributed to specialised fields, improving knowledge about mental health issues among occupational physicians [27] and enhancing delirium screening in quality improvement projects [56]. Facilitators and barriers to eLearning programme implementation Facilitators Personal factors, notably previous positive experiences [43], significantly motivate healthcare providers to engage with eLearning platforms. Furthermore, the ease of use and user-friendly interfaces are critical elements that encourage eLearning usage [23, 31, 33, 34, 36, 42]. The relevance of the eLearning content to daily medical practice is another crucial facilitator for its use [34, 36, 40, 45]. Peer support within the eLearning environment, as observed by Burkhardt et al. [8], creates a supportive and engaging atmosphere. Additionally, flexibility in sched- uling and opportunities for personal and group interac- tions [22, 33, 40, 54] contribute significantly to effective eLearning experiences. Discussion forums further enhance engagement and knowledge sharing [40], while a self-regulated learning environment promotes autonomy and motivation [8]. Constructive feedback from facilita- tors is another valuable facilitator [40]. Institutional policies and resources also play a role. Political commitment to eLearning initiatives [25] and mandatory e-training requirements [38, 39] drive partici- pation. Instructional support for facilitators [25] ensures a well-structured learning experience. The availability of standardised training materials [52] and adequate IT resources and facilities are essential for seamless eLearn- ing delivery. Lastly, ongoing appraisal of the eLearning facility and learner needs help to maintain and improve the eLearning environment [56]. Barriers Barriers to effective eLearning adoption among health- care providers encompass a range of personal, systemic, and environmental factors. Personal factors include a lack of perceived need for eLearning [38], poor com- puter competence and literacy [7, 23, 25, 41, 42, 45, 60], absence of personal computers [7, 10, 24, 41, 45, 60], financial constraints [8, 36, 60], low self-control [60], high family duties [60], and concerns regarding low knowledge retention after eLearning programmes [14, 58]. Page 13 of 20Aryee et al. Human Resources for Health (2024) 22:60 Other barriers include time constraints [8, 24, 31, 40], resistance to change [11], language barriers [25, 40], dis- satisfaction with eLearning content [11, 31, 58], heavy and conflicting content, and inadequate feedback within the eLearning environment [9, 23]. Environmental barriers include a lack of face-to-face interaction [10, 52], poor infrastructure, including lim- ited internet access [8, 24, 40–42, 45, 60] and frequent power outages [40, 42]. Systemic challenges involve heavy workloads [60], lack of incentives [58, 60]), a shortage of specialised eLearning facilitators [41], poor management involvement [41], uneven supply of learning materials [58], disorganised governance of eLearning programmes [58], limited training materials [8], and resource con- straints [25]. Technical inadequacies, such as those within the ICT departments, also contribute to these bar- riers [16]. See Table 4 for a thematic analysis of facilita- tors and barriers to effective eLearning implementation. eLearning situations in developing and developed countries In developing countries, the implementation of eLearn- ing for healthcare practitioners faces a distinct set of challenges. Nigeria, for instance, encountered significant barriers to eLearning adoption among healthcare profes- sionals. In the study conducted by Otu et al. [42], health- care workers in Nigeria reported poor digital literacy, frequent electricity supply outages, and limited internet connectivity as major hindrances. Similar situations have been reported by Osman [41] in Ghana and Oluwadele [40] in South Africa. These studies noted that financial constraints and a need for user-friendliness in eLearning platforms further exacerbated the difficulties. A similar situation was observed in Malawi, where Barteit et al. [7] highlighted that limited access to personal computers, insufficient ICT training, and a general lack of interest in eLearning content posed substantial obstacles. Despite these challenges, the studies found that healthcare pro- fessionals in these settings recognised the importance of user-friendly platforms and responsive user support as effective facilitators for successful eLearning experiences. Conversely, advanced countries like the United King- dom and the United States exhibit a different spectrum of challenges and facilitators in the context of eLearning implementation for healthcare professionals. Nicolaou et  al. [38] conducted a study in the United Kingdom, where healthcare professionals faced barriers such as a lack of perceived need for eLearning and varying levels of computer competence. Gagnon et al. [23] investigated physicians’ beliefs regarding their completion of online programmes in the United States and identified barriers related to complexity and internet connectivity. In these advanced settings, some common facilitators included healthcare institutions’ provision of mandatory online training programmes, as observed in the study by Pereira et al. [43]. Moreover, studies revealed that prior positive experiences with eLearning, the ease of use of eLearn- ing resources, and the relevance of content to clinical practice were factors that facilitated successful eLearn- ing adoption among healthcare professionals in these countries. In the context of eLearning adoption, developed coun- tries like the United Kingdom, the United States, and the Netherlands predominantly favour self-learning approaches, emphasising independent study through online resources [38]. Additionally, asynchronous learn- ing methods, allowing flexibility in accessing educational materials, are widely employed in these regions [39]. They also commonly utilise blended learning encompass- ing synchronous and asynchronous components, striking a balance between real-time interaction and self-paced learning [31]. Conversely, in developing countries such as Afghanistan, India, and sub-Saharan Africa, eLearning often takes the form of blended synchronous approaches, integrating online sessions with traditional methods to overcome limited internet access barriers [1, 52]. Some regions, like Nigeria and Kenya, employ blended asyn- chronous models, combining self-paced materials with occasional synchronous elements [8, 45]. Synchronous eLearning, though challenging due to internet limita- tions, is observed in Ghana and Rwanda, emphasising real-time online sessions [25, 41]. Overall, the choice of eLearning type reflects the available infrastructure and the need to accommodate varying access to digital resources in these regions. Discussion The effectiveness of eLearning programmes among healthcare providers varies based on the type of eLearn- ing employed. Asynchronous eLearning has demon- strated positive outcomes in enhancing healthcare Page 14 of 20Aryee et al. Human Resources for Health (2024) 22:60 knowledge and practices, with studies showing improve- ments in areas such as smoking cessation, breastfeeding awareness, and clinical skills. Synchronous eLearning has been effective in improving healthcare practices, particularly in resource-poor settings, and has shown benefits in knowledge acquisition and skill develop- ment. Blended eLearning types, including asynchronous and asynchronous–synchronous approaches, have also Table 4  Facilitators and barriers to eLearning implementation Main theme Sub-themes Specific factors Authors Facilitators Personal factors Previous positive experience [43] eLearning usage Ease of usage and interface [23, 31, 33, 34, 36, 42] Relevance of content to practice [34, 36, 40, 45] Peer support [8] Flexible time [22, 54] eLearning environment Addition of face-to-face interaction [36] Personal and group interaction [33, 40] Presence of discussion forum [40] Self-regulated learning environment [8] Feedback from facilitators [40] Policies/ resources Political commitment [25] Mandatory e-training [38, 39] Instructional support for facilitators [25] Availability of standardised training materials [52] Availability of IT resources and facilities Appraisal of eLearning facility and learners [56] Barriers Personal factors Lack of perceived need [38] Poor computer competence/literacy [7, 23, 25, 31, 41, 42, 45, 60] Lack of personal computer [7, 10, 24, 41, 45, 60] Financial constraints [8, 36, 60] Low self-control [60] High family duties [60] Low knowledge retention after eLearning programme [14, 58] Lack of time [8, 24, 31, 40] Fear of changes [11] Language barrier [25, 40] Poor eLearning content Irrelevant content [11, 31, 58] Heavy content Conflicting schedules and content [40] Poor eLearning environment Lack of feedback from facilitators [9, 23]) Absence of facilitators in discussion forums [36] Lack of face-to-face interaction [10, 52] Poor infrastructure Poor access to internet [8, 24, 40–42, 45, 60] Frequent power outages [40, 42] Policies/ resources Heavy workload [60] Lack of incentives [58, 60] Lack of specialised -eLearning facilitators [41] Poor management involvement [41] Uneven supply of learning needs [58] Disorganised governance of eLearning programmes [58] Limited training materials [8] Resources constraints [25] Technical inadequacy of ICT department [16] Page 15 of 20Aryee et al. Human Resources for Health (2024) 22:60 successfully enhanced healthcare competence and readi- ness for real-world applications. Self-learning approaches have proven effective across various healthcare contexts, empowering healthcare providers with knowledge and skills. However, the adoption of eLearning programmes faces both facilitators and barriers, including factors related to personal, systemic, and environmental aspects. These challenges vary between developed and developing countries, with differences in infrastructure, digital liter- acy, and access to resources influencing the adoption and effectiveness of eLearning in healthcare education. Effectiveness of eLearning implementation among healthcare professionals As discussed in the provided text, eLearning programs’ effectiveness among healthcare providers reveals sig- nificant insights into how asynchronous, synchronous, blended, and self-learning approaches impact health- care knowledge, attitudes, and practices. Asynchronous eLearning, characterised by self-paced learning, offers flexibility and accessibility for healthcare profession- als. Studies such as those by Chase et  al. [10], Colaceci et al. [13], and Delf [17] demonstrate that asynchronous eLearning can effectively enhance knowledge and skill development in various healthcare domains. For exam- ple, the smoking cessation programme by Chase et  al. increased both knowledge and confidence among oncol- ogy healthcare providers, empowering them to assist patients with smoking cessation. This is particularly important for public health and aligns with Sustainable Development Goal (SDG) 3 (Good Health and Well- being) by addressing tobacco-related health issues. Additionally, asynchronous eLearning has improved awareness and attitudes toward crucial healthcare prac- tices, such as breastfeeding [13] and clinical skill develop- ment [7]. For instance, Erlandsson et al. [20] highlighted the use of asynchronous eLearning to enhance the capac- ity of midwives in labour rooms, making them more proactive within interdisciplinary teams. This supports SDG 5 (Gender Equality) by advancing the role of mid- wives and promoting gender-inclusive healthcare prac- tices. Synchronous eLearning, characterised by real-time interaction, is vital in healthcare education. Choi et  al. [12] and Fourré et al. [22] demonstrated improvements in healthcare practices and knowledge acquisition, respec- tively, through synchronous eLearning. The study by Detroyer et  al. [18] further emphasises the potential of synchronous eLearning in enhancing critical healthcare competencies, specifically in delirium recognition and care. These findings contribute to the continuous devel- opment of healthcare workers, which aligns with SDG 4 (Quality Education) by ensuring that healthcare profes- sionals receive up-to-date and effective training. Blended eLearning approaches, combining asyn- chronous and synchronous elements, offer a balanced approach to healthcare education. The study by Jones et  al. [31] underscores the practicality of blended asyn- chronous and synchronous eLearning, which enhances healthcare providers’ competence and readiness for real- world applications. Blended learning can be instrumental in achieving SDG 17 (Partnerships for the Goals) by fos- tering collaboration between healthcare institutions and eLearning providers to deliver comprehensive training programmes. Self-learning in eLearning platforms has consistently shown its effectiveness across various health- care contexts [28, 42, 51]. It empowers healthcare provid- ers to access relevant resources, develop clinical skills, and stay updated, contributing to SDG 3 by improving overall healthcare quality and accessibility. Furthermore, during public health crises, such as the COVID-19 pan- demic, self-learning through platforms like the InStrat COVID-19 tutorial app [42] proves invaluable in rapidly disseminating critical information and supporting front- line health workers. The findings from these studies provide valuable insights into the effectiveness of various eLearning approaches among healthcare providers. Asynchronous, synchronous, blended, and self-learning methods all have their merits in enhancing healthcare knowledge, atti- tudes, and practices. These findings have implications for healthcare practice, including the continuous devel- opment of healthcare workers, improved patient care, and progress toward achieving Sustainable Development Goals, particularly in health and education. To maximise the benefits of eLearning in healthcare, institutions, and policymakers should consider a diverse and adaptable approach to training and education that aligns with the unique needs and contexts of healthcare professionals worldwide. Facilitators and barriers to eLearning implementation for healthcare providers Facilitators, such as positive prior experiences and user- friendly interfaces, underscore the importance of user acceptance and satisfaction. Positive experiences can motivate healthcare providers to engage with eLearn- ing platforms, while user-friendly interfaces ensure ease of navigation and accessibility, contributing to a posi- tive user experience [34, 43]. The relevance of eLearn- ing content to daily medical practice is crucial, as it aligns educational materials with the practical needs of healthcare professionals, making the learning experience more meaningful and applicable [45]. Peer support and interaction within the eLearning environment, as high- lighted by Burkardt et  al. [8], foster a sense of commu- nity and collaboration, which can enhance engagement Page 16 of 20Aryee et al. Human Resources for Health (2024) 22:60 and knowledge sharing. Flexibility in scheduling and the availability of personal and group interactions offer healthcare providers opportunities for personalised learning experiences, accommodating varying prefer- ences and learning styles [22, 33]. Discussion forums and self-regulated learning environments promote autonomy and motivation, enabling healthcare professionals to take ownership of their learning [8, 40]. Institutional support, including political commitment, mandatory e-training requirements, instructional support, and the availability of standardised training materials, plays a pivotal role in facilitating eLearning adoption [25, 39, 52]. Adequate IT resources and facilities are essential to ensure the seam- less delivery of eLearning programmes, minimising technical obstacles. Ongoing appraisal of the eLearning facility and learner needs helps maintain and improve the quality of the learning environment, ensuring its rel- evance and effectiveness [56]. On the other hand, barriers to effective eLearning adoption among healthcare providers are multi-faceted. Personal barriers, including low computer competence and literacy, limited access to personal computers, finan- cial constraints, and concerns about knowledge reten- tion, underscore the importance of addressing the digital divide and promoting digital literacy [7, 14, 45, 60]. Time constraints, resistance to change, language barriers, dis- satisfaction with content, and heavy workloads reflect the complexities of integrating eLearning into busy health- care professionals’ routines [11, 24]. Environmental bar- riers, such as limited internet access and power outages, are significant challenges, particularly in regions with inadequate infrastructure [8, 42, 45]. Systemic issues, such as a shortage of specialised eLearning facilitators, lack of incentives, poor management involvement, and resource constraints, highlight the need for comprehen- sive institutional support and strategic planning [41, 58]. Technical inadequacies within ICT departments further complicate eLearning implementation [16]. Addressing these facilitators and barriers is crucial for the successful implementation of eLearning programmes in healthcare education. Overcoming these challenges requires a multi-dimensional approach that encompasses digital literacy training, infrastructure development, institutional support, and the careful design of eLearning environments to meet the specific needs of healthcare providers. By doing so, healthcare organisations can har- ness the potential of eLearning to continuously develop their workforce, improve healthcare quality, and con- tribute to the achievement of SDGs related to health and education. eLearning for healthcare providers in developing and developed economies The disparities in eLearning adoption between devel- oping and developed countries highlight the profound impact of socioeconomic and technological factors on healthcare education. In developing countries like Nige- ria, Ghana, and South Africa, the challenges posed by poor digital literacy, unreliable electricity supply, and limited internet connectivity significantly impede health- care professionals’ access to eLearning resources. These barriers not only hinder continuous professional develop- ment, but also limit the dissemination of critical health- care knowledge and skills. As a result, addressing these challenges becomes pivotal in the context of achieving SDGs, particularly SDG 3 (Good Health and Well-being). By investing in improving digital infrastructure, digital literacy programmes, and user-friendly eLearning plat- forms, developing countries can bridge the educational gap and empower healthcare providers to deliver higher quality care. Additionally, responsive user support and targeted financial support for eLearning initiatives can help overcome financial constraints and further facili- tate effective eLearning experiences in these regions [7, 40–42]. Conversely, developed countries like the United King- dom and the United States exhibit more favourable conditions for eLearning adoption among healthcare professionals. However, they face challenges related to the perceived need for eLearning, computer competence, and connectivity issues. In these settings, eLearning has the potential to not only enhance healthcare practition- ers’ knowledge and skills but also improve healthcare quality and patient outcomes. The implementation of mandatory online training programmes in healthcare institutions can ensure that healthcare providers stay up to date with the latest medical advancements, align- ing with SDG 3. Furthermore, promoting prior posi- tive experiences with eLearning, ensuring user-friendly interfaces, and aligning eLearning content with clinical practice needs can accelerate the adoption of technol- ogy-enhanced learning. These findings underscore the importance of tailored eLearning strategies that consider the challenges and opportunities presented by the digital landscape in developing and developed countries [31, 38, 43]. While developing countries grapple with infrastructure and digital literacy challenges, developed countries face issues related to attitudes towards eLearning and ensur- ing technology’s seamless integration into healthcare education. To harness the full potential of eLearning in healthcare, efforts should focus on improving digital infrastructure, enhancing digital literacy, and promot- ing user-friendly eLearning environments. By doing so, Page 17 of 20Aryee et al. Human Resources for Health (2024) 22:60 healthcare providers across the globe can benefit from continuous education, ultimately leading to improved healthcare delivery and better outcomes for individuals and communities, aligning with the broader objectives of the SDGs. Limitations of this review and recommendations for future studies The scope of this review was limited to papers pub- lished in the English language, which may have had an impact on the number of studies included. The authors have presented an analysis of eLearning programmes for healthcare professionals in both developed and develop- ing countries. It is crucial to exercise caution when inter- preting the findings and discussions within this context, as the conventional classification of some countries as developed or developing may not accurately reflect the diverse and evolving nature of these nations. Addition- ally, the authors conducted an appraisal of the included studies, but it is important to note that the quality of the studies did not influence their inclusion in this qualita- tive synthesis. The appraisal of methodological qual- ity revealed that high-risk or low-quality studies were primarily found within qualitative, mixed-method, and cross-sectional studies. These studies are more suscepti- ble to biases and methodological flaws, which in turn can compromise the reliability and trustworthiness of their findings. Consequently, the inclusion of such studies in a review can introduce bias into the synthesis of evidence, potentially leading to skewed or misleading conclusions. Moreover, findings from high-risk or low-quality stud- ies may not be generalisable to broader populations or settings due to limitations in their design or execution. However, it is important to highlight that the authors handled low-quality studies with caution and transpar- ency. They placed a greater emphasis on higher-quality evidence, which helps maintain the credibility of the review and ensures that it provides valuable insights for decision-makers and practitioners. All studies, including those of lower quality, were appraised and included to showcase the available evidence and provide an overview of the quality of evidence regarding eLearning implemen- tation and its associated facilitators and barriers. In the future, a meta-analysis could be considered to establish the overall effectiveness of eLearning globally and in specific regions. Additionally, future studies focus- ing on the effectiveness of eLearning among healthcare professionals should adopt robust research designs, such as randomised controlled trials and longitudinal studies. These designs can help establish the independent effects of eLearning programmes more conclusively, contribut- ing to a stronger evidence base for informed decision- making in healthcare education and practice. Policy and practice recommendations Developing countries should prioritise investments in digital infrastructure, ensuring reliable internet con- nectivity and access to personal computers, especially among healthcare providers. Simultaneously, digital literacy programmes should be implemented to boost healthcare professionals’ computer competence and confidence in navigating eLearning platforms. Tailor- ing eLearning content to align with the practical needs of healthcare providers closely fosters engagement and applicability. Furthermore, responsive user support should be readily available, especially in regions and countries facing technical difficulties, to mitigate bar- riers and ensure the success of eLearning initiatives. In developed countries, the promotion of mandatory and flexible eLearning programmes can help health- care providers stay current with medical advancements, ultimately improving healthcare quality and patient outcomes. These recommendations collectively con- tribute to a more effective and equitable utilisation of eLearning in healthcare, supporting workforce devel- opment and progress towards SDGs related to health, education, and overall well-being. Conclusion This qualitative synthesis illuminates the multi-faceted landscape of eLearning implementation among health- care professionals, highlighting the effectiveness of vari- ous eLearning approaches, the pivotal role of facilitators and barriers, and the disparities between developing and developed economies. Asynchronous, synchronous, blended, and self-learning methodologies have all dem- onstrated their merits in enhancing healthcare knowl- edge, attitudes, and practices, providing valuable tools for continuous professional development, and aligning with Sustainable Development Goals related to health and education. The presence of facilitators, such as posi- tive experiences, user-friendly interfaces, and institu- tional support, underscores the importance of fostering a conducive eLearning environment. In contrast, barriers encompass personal, systemic, and environmental chal- lenges that necessitate a comprehensive and adaptable approach to eLearning implementation. Furthermore, the profound disparities observed in developing and devel- oped countries underscore the significance of address- ing digital infrastructure and literacy issues to ensure equitable access to eLearning resources. Future research should adopt robust study designs, including randomised controlled trials and longitudinal studies, to establish the independent effects of eLearning programmes. These findings and recommendations collectively contribute to the enhancement of eLearning’s role in healthcare Page 18 of 20Aryee et al. Human Resources for Health (2024) 22:60 education, ultimately advancing healthcare quality and accessibility on a global scale. Abbreviations CPD � Continued Professional Development ICT � Information Communication Technology GBA � Gifty Ben Aryee HIV � Human Immunodeficiency Virus MA � Mustapha Amoadu MeSH � Medical Subject Headings MMAT � Mixed Method Appraisal Tool PICO � Population, Intervention, Comparison, and Outcome PO � Paul Obeng PRISMA � Preferred Reporting Items for Systematic Reviews and Meta-Analyses SDG � Sustainable Development Goal TB � Tuberculosis Supplementary Information The online version contains supplementary material available at https://​doi.​ org/​10.​1186/​s12960-​024-​00924-x. Supplementary Material 1. Supplementary Material 2. Acknowledgements Not applicable. Author contributions GFBA, DO and HNS conceptualised the study. PO, MA, JAB, SAA, and DFA designed the study, collected and analysed the data, and wrote the initial draft. DO and HNS supervised the work. Each author reviewed and endorsed the ultimate version of the manuscript for publication. Funding This work received no funding support. Availability of data and materials All data generated or analysed during this study are included in this published article (and its supplementary information files). Declarations Ethical approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interest The authors of the study have no competing interest to declare. Author details 1 Department of Public Health, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria. 2 Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana. 3 Computer Science Department, University of Ghana, Accra, Ghana. 4 School of Graduate Studies and Research, Ghana Communication Technology University, Accra, Ghana. 5 Department of Public Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana. 6 African Centre of Excellence in Public Health and Toxicological Research (ACE‑PUTOR), Uni- versity of Port Harcourt, Port Harcourt, Nigeria. Received: 11 December 2023 Accepted: 19 May 2024 References 1. Agarwal R, Agarwal U, Das C, Reddy RA, Pant R, Ho C, Kumar BR, Dabla V, Moonan PK, Nyendak M, Anand S, Puri AK, Mattoo SK, Sachdeva KS, Yeldandi VV, Sarin R. 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Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in pub- lished maps and institutional affiliations. https://doi.org/10.1002/14651858.CD011736 Effectiveness of eLearning programme for capacity building of healthcare professionals: a systematic review Abstract Background Methods Results Conclusion Introduction Methods Review questions Search strategies Study selection Appraisal of studies Data extraction Data synthesis Results Search results Characteristics of included studies Appraisal results Operational definition of eLearning types found in studies Effectiveness of eLearning programmes among healthcare providers Synchronous eLearning Blended eLearning types Blended asynchronous Blended asynchronous and synchronous Blended (eLearning and face-to-face) Blended synchronous Self-learning Facilitators and barriers to eLearning programme implementation Facilitators Barriers eLearning situations in developing and developed countries Discussion Effectiveness of eLearning implementation among healthcare professionals Facilitators and barriers to eLearning implementation for healthcare providers eLearning for healthcare providers in developing and developed economies Limitations of this review and recommendations for future studies Policy and practice recommendations Conclusion Acknowledgements References