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MEASURE Evaluation Strengthens the Drivers of Digital Health Success

December 6, 2017
MEASURE Evaluation

Manish Kumar is the senior technical specialist for health systems strengthening at MEASURE Evaluation, funded by the United States Agency for International Development (USAID), and led by the Carolina Population Center at the University of North Carolina at Chapel Hill.

Digital health, which is the use of electronic technologies, processes and services for improving access to and use of healthcare services, in low- and middle-income countries presents many opportunities to contribute to the achievement of the United Nations’ Sustainable Development Goal #3: “Ensure healthy lives and promote well-being for all at all ages.” Digital health also supports the measurement of work toward that goal.

The Global Digital Health Forum 2017 (GDHF) has been attended by a good mix of researchers, practitioners and innovators. After listening to speakers from Asia, Africa, Europe and the Americas at the GDHF Dec. 4–6, I could easily see the rapid growth in digital interventions and innovations. These innovations can improve health programs through improved capture, transmission, analysis and use of health data.

Nevertheless, leadership and governance; strategy and policy; digital health financing; in-country capacity; digital standards; and data ethics, quality and use are also essential if digital innovation is to make a difference. And these fundamentals are completely missing or only partially developed in many instances. Furthermore, lack of measures and evaluation methods limit the design and implementation of digital interventions based on evidence. I was gratified that at GDHF, there also were several speakers emphasizing the urgency to strengthen these attributes of a health system, without which it would be hard to achieve enhanced health system performance and outcomes or any long-term success for digital health interventions.

Speaking in the session on “Connecting the Dots: A Holistic and Local View on Building ICT Capacity,” presenters emphasized the need for and importance of collaborating with local universities and offering mentoring support to digital health users. This session addressed the necessary in-country capacity essential to digital health interventions. It reminded me of MEASURE Evaluation’s Global Evaluation and Monitoring Network for Health (GEMNet), comprised of nine academic partners across Africa, Asia and South America. Over the last five years, this network has contributed to strengthening in-country monitoring and evaluation (M&E) capacity and skilled human resources. GEMNet now drives its agenda based on country and regional M&E training needs and facilitates knowledge sharing across its members. MEASURE Evaluation’s experience in creating a strong and self-sustaining GEMNet consortium can prove handy in meeting the local capacity-building needs for information and communication technology (ICT).

The session on “Financing in Digital Health” integrated research and innovation. Two speakers presented evidence about the cost-effectiveness of digital health interventions, based on their research in Bangladesh and the East Asia region. A comment from the regional ICT specialist for program and system strengthening at the United Nations Children’s Fund (UNICEF) resonated with my own experience. She emphasized the importance of investing in systems, which I believe is at the heart of efforts to maximize the benefits of digital health. Unless these digital interventions are undertaken within a larger health system’s strengthening framework, the world will continue to grapple with siloed digital health interventions that are not supported by a health system and are, therefore, not sustainable. In the development world, investors are interested in the value proposition, potential for scalability and the sustainability of digital health innovations – in other words, digital health interventions that can survive.

In the International Telecommunications Union/World Health Organization Roadmap for Africa session, speakers from these organizations and the government of Nigeria emphasized the importance of strengthening strategy, leadership capacity and commitment and regional cooperation to leverage the benefits of digital health. Their roadmap plans to promote cross-sectoral collaboration, build a foundation for the success of large-scale digital health programs and support capacity building at all levels of a health system.

While digital health interventions continue to grow rapidly, their contributions to improving health system performance and health outcomes will depend on the strength of the drivers mentioned above. Countries with strong drivers will benefit more than those with weak ones. This means countries need practical tools and guidance to identify their gaps in leadership, strategy, financing, capacity, standards and data quality and use. And then they need to devise and implement appropriate interventions to fill those gaps. Some of those interventions may be digital.

For more information on MEASURE Evaluation’s work on digital health, visit the MEASURE Evaluation website.

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