Decoding digital health: understanding how digital innovations are strengthening health systems

Digital health interventions (DHIs) hold immense promise to revolutionize and strengthen health systems. However, governments have struggled to scale up these interventions and to integrate them successfully into existing services. Complexities arise not only from the design of many DHIs, but also from their poor fit with broader system capacities and from the lack of enabling legal frameworks. They can also have unintended consequences, harm other health system components, exacerbate inequities and raise ethical issues – especially concerning data privacy and safety.

In light of these issues, the Alliance and the WHO Department of Digital Health and Innovations (DHI), with support from the Bill and Melinda Gates Foundation, have launched an interdisciplinary project aimed at harnessing the power of digital interventions to strengthen health systems in low- and middle-income countries (LMICs). The project focuses on data solutions for primary care managers.

Ten research teams are being supported to:

1. generate health policy and systems research on the role of digital data solutions for primary care managers in complex health systems in LMICs;
2. stimulate learning and action on the integration of DHIs in health systems among policy- and decision-makers at the local and country levels; and
3. disseminate the knowledge broadly to policy- and decision-makers to inform strategies for the integration of DHI in health systems in different LMIC contexts.

Dr Garrett Mehl, Unit Head of Digital Health Technology at WHO, noted that: “digital health interventions have become a prominent strategy for countries to address shortfalls in health systems performance and increase their potential to achieve universal health coverage. This project fills a critical gap in helping countries build capacity to use research to assess the implementation of these initiatives.”

“This is a key project for the Alliance at an important point in the development of digital health solutions,” added Dr Lorena Guerrero Torres, who is working on the technical side of the project for the Alliance. "By generating relevant health policy and systems research, facilitating collaboration and promoting knowledge exchange, we hope to support countries to understand better the intended and unintended consequences of adopting and implementing digital health interventions."

After an open call for proposals that drew 58 entries from 24 countries across all WHO regions, ten multidisciplinary research teams were selected to carry out this work in: Bhutan, Ethiopia, Georgia, Ghana, India, Indonesia, Pakistan and Zimbabwe.

The project kicked off with a framework harmonization workshop in Tunis, Tunisia, from 24-25 May 2023. The workshop sought to foster collaboration, ensure alignment and establish a robust foundation for research. During the two-day workshop, the ten research teams presented their proposals, identified commonalities and exchanged resources. See the map table below to learn more about the projects and institutions we are supporting in this project.