Federated learning in low-resource settings: A chest imaging study in Africa -- Challenges and lessons learned

This study explores the use of Federated Learning (FL) for tuberculosis (TB) diagnosis using chest X-rays in low-resource settings across Africa. FL allows hospitals to collaboratively train AI models without sharing raw patient data, addressing privacy concerns and data scarcity that hinder traditional centralized models. The research involved hospitals and research centers in eight African countries. Most sites used local datasets, while Ghana and The Gambia used public ones. The study compared locally trained models with a federated model built across all institutions to evaluate FL's real-world feasibility. Despite its promise, implementing FL in sub-Saharan Africa faces challenges such as poor infrastructure, unreliable internet, limited digital literacy, and weak AI regulations. Some institutions were also reluctant to share model updates due to data control concerns. In conclusion, FL shows strong potential for enabling AI-driven healthcare in underserved regions, but broader adoption will require improvements in infrastructure, education, and regulatory support.