Learning from early adopters in digital health

November 10, 2021 by Pauline Achoka

PATH and partners are helping countries make better investments in digital health by learning from those leading the way.

A medical practitioner in Kenya searches for a health record in a data room in a national health facility. Photo: PATH.

A medical practitioner in Kenya searches for a health record in a data room in a national health facility. Photo: PATH.

In 2019, the Government of Tanzania put forward their National Digital Health Strategy—a catalytic and visionary agenda for digital transformation and increased data use developed with support from PATH. Since then, Tanzania—and other countries including Burkina Faso, Ethiopia, Malawi, and South Africa—have amassed many valuable lessons as they’ve advanced the digital transformation of their own health systems.

To help others benefit from the experiences of these early adopters (and maximize the impact of digital health investments), PATH and its partner Cooper/Smith have launched the Data Use Acceleration and Learning (DUAL) project: an effort to collect, synthesize, and share learnings from countries that are digitally transforming their health systems to support the better use of data.

The DUAL project is capturing these learnings and using them to inform a digital transformation for data use model that is meant to help countries mature their digital health systems, adopt current best practices, and meet their health targets.

Learning from countries leading in digital health

“The five countries participating in DUAL have embarked on a similar journey to deliver better health to their citizens through transformative digital health programming and have many rich lessons to share,” explained Auson Kisanga, Senior Technical Project Manager, PATH. “It’s rare that we see country lessons reflected back in global guidance and new funding recommendations. DUAL offers an unprecedented opportunity to share country learnings that could influence the direction of the digital health sector.”

“It’s rare that we see country lessons reflected back in global guidance and new funding recommendations.”
— Auson Kisanga, Senior Technical Project Manager, PATH

Using key informant interviews and cross-country conversations, DUAL has identified experiences, challenges, and enablers of success for the development, refinement, and implementation of digital health tools, approaches, and policies. Based on findings from the five focal countries, DUAL will develop a model for digital transformation for data use that will support other countries to replicate their success and better align financing, normative guidance, and programmatic approaches.

Putting practice into theory

The DUAL model is holistic in its view of digital health transformation, encompassing everything from data governance, to investment road maps, to the change management strategies required to build a culture of data use, and the need to train a health workforce to successfully operate in a new digital reality.

For example, the success of Tanzania’s National Digital Health Strategy required a comprehensive plan to align and advance digital health systems, tools, and applications despite ebbs in funding. PATH and Tanzania partnered together to develop an investment roadmap that prioritized the country’s digital health ambitions and costed them out. It proved to be critical for operationalizing Tanzania’s digital health agenda and the long-term sustainability of its digital health systems. The strategy has also helped to establish a culture of data use across the health system.

In another instance, when digitalizing its health system, Ethiopia had to fund the necessary human resources, infrastructure, and equipment for this digital transition, which can often be a costly, multi-year investment that requires streamlining systems and maintaining them over time. To support these efforts, Ethiopia established its own investment roadmap to create a clear vision for the country’s national digital health program and the resources necessary to carry out this vision. The roadmap allowed Ethiopia to secure complimentary funds that advance the country’s digital health goals.

Beyond clinics and care

By centering governments in the research and design process, DUAL is helping to build an evidence base for digital transformation that is centered on country experiences and realities. One critical finding has the been the need to establish a culture of data use to reinforce the new digital tools and systems taking root in facilities across Africa.

For example, Malawi’s Digital Health Division within the Ministry of Health now operates key technical systems and coordinates digital health investments with support from Cooper/Smith and Luke International Norway (LIN). Thanks to this coordination, the Ministry boasts a strong base of high-quality, consistently available data and a culture of data use among technicians and policy makers in the health sector. Following a 2018 data use campaign to promote access and use of health data in facilities across Malawi, 42 percent of participating staff downloaded a health management information system app demonstrating their initiative to use better quality data.

“There is hope for a digital revolution in the health sector considering the paradigm shift observed in the behavior and attitude of health workers, whose interest in using digital (as opposed to paper systems) has significantly increased over the last decade,” says Maganizo Monawe, Kuunika Project Team Lead in Malawi.

Monawe continues, “DUAL is a country-driven effort that allows ministries of health to define and inform the evidence base so they can help their peers in other countries implement successful digital health programs and achieve better health outcomes for their citizens. We are engaging stakeholders across the field to ensure the model is truly applicable to countries’ needs and digital realities.”