Digital Health: Moving from Silos to Systems

From health officers conducting contact tracing with mobile phones in Ebola-affected countries to TB patients using apps to fulfill their treatment regimen, digital technology is playing an increasingly central role in global health.

In fact, over the past decade, the use of mobile and web-based technologies to improve health has grown significantly — not only in developed countries but in emerging economies as well.

Health officers use mobile phones to input data during a trachoma mapping project in Ethiopia. / Dominique Nahr, Sightsavers

The field of digital health, as it is now known, has seen an uptake in financial investments and the projects launched around the world, according to a recent study by Health Data Collaborative. Strong health systems are built around reliable data. As such, digital technologies are becoming an integral component of efforts to achieve and measure progress toward ensuring people have access to affordable and quality health care, a principle enshrined in the United Nations Sustainable Development Goals.

A woman holds a mobile phone in Ghana. /John O’Bryan, USAID

In our time leading the USAID Global Development Lab and Global Health Bureau, respectively, we have witnessed key transformations in the way USAID invests in and uses digital technologies to improve global health programming and outcomes. The Agency is moving away from business as usual and supporting game-changing initiatives like the Rumor Tracker in Liberia, which supported health workers to track and counter rumors on Ebola, and mHero, a two-way, mobile phone communications system that can facilitate the exchange of real-time data between Ministries of Health and frontline health workers.

The good news is that we are institutionalizing the best of what we have learned through years of project implementation, as captured in the Principles for Digital Development. In the past, digital health funding flows were driven by projects and programs in silos. We are gradually moving away from this, so we can make better-coordinated and aligned investments in scalable, sustainable and interoperable digital systems. Interoperability describes the extent to which systems and devices can exchange data and interpret shared information.

In Haiti, USAID has supported delivery of vouchers that can be read by a simple barcode reading app. / Naomi Logan, USAID

This past April, during a workshop organized by USAID, Dr. Sas Kargbo, director of the Department of Policy, Planning and Information at Sierra Leone’s health ministry spoke about his country’s experience in dealing with fragmented information during the Ebola crisis and how that impeded the ministry’s ability to have an accurate and reliable picture of what exactly was happening on the ground. His vision, he underscored, is to have an integrated health information system, down to the community level, to improve the coverage, quality and reporting of service delivery. His vision is our vision.

Many promising open source technologies are showing the potential to scale in a sustainable manner, enabling country governments to manage the use of the technology over the long term. Yet these tools often suffer from a lack of core funding as they are largely driven by disease-specific problems whose interests lie only in finding disease-specific solutions.

Health education efforts in Sierra Leone during the Ebola outbreak. / World Bank Group

This is why in September of this year, the Lab and Global Health Bureau created a new funding mechanism that will bring funds together across disease-driven platforms to break down silos in health programming. Our new digital health mechanism will dedicate a portion of its funds to financing some of these most promising tools and help them transition to sustainable business models.

Our bet is that by better aligning digital health investments and increasing adherence to best practice for digital health tools, we can accelerate global health outcomes and ultimately save more lives. As these digital systems grow, we expect to see a flourishing of best practice examples driven by an increased demand for data for decision-making at all levels of the health system, from central health ministries to remote health worker posts.

But here is a word of caution. Experience has taught us that the effective use of digital technologies relies not just on connectivity, software and devices, but also on the capacity of individuals and institutions. This means that training is as important as hardware.

This USAID project supports local manufacturing of smart phones and digital devices in Haiti. / Naomi Logan, USAID

This lesson must permeate all of our future investments. Training will be a central activity of our new digital health funding mechanism as it supports digital health implementations in specific countries.

Our vision for the future builds on these lessons to optimize our investments and increase global health returns. At the end of the day, we are accountable to two audiences: American taxpayers who are committed to ending extreme poverty and building resilient and democratic societies, and people in developing countries who measure returns in the number of lives saved.

About the Author

Ann Mei Chang, Chief Innovation Officer & Executive Director at The Global Development Lab, and Jennifer Adams, Acting Assistant Administrator, Bureau for Global Health
The Principles for Digital Development blog has been granted permission to cross-post the below post from Ann Mei Chang and Jennifer Adams at USAID.

Claudine Lim

Manager at The Principles for Digital Development

Claudine first joined the Digital Impact Alliance in October 2017, shortly after receiving a dual masters in international relations and public relations from the Maxwell School and S.I. Newhouse School at Syracuse University. After working as a Program Coordinator and Researcher for DIAL’s Business Operations, she is currently working with the Principles of Digital Development.