Konduri Niranjan, Aboagye-Nyame Francis, Mabirizi David, Hoppenworth Kim, Kibria Mohammad Golam, Doumbia Seydou, Williams Lucilo, Mazibuko Greatjoy
USAID/SIAPS Program, Pharmaceuticals and Health Technologies Group, Management Sciences for Health, USA.
USAID/UHSC Program, Pharmaceuticals and Health Technologies Group, Management Sciences for Health, Uganda.
Digit Health. 2018 May 3;4:2055207618771407. doi: 10.1177/2055207618771407. eCollection 2018 Jan-Dec.
The objective of this study was to describe the conceptual and implementation approach of selected digital health technologies that were tailored in various resource-constrained countries. To provide insights from a donor-funded project implementer perspective on the practical aspects based on local context and recommendations on future directions.
Drawing from our multi-year institutional experience in more than 20 high disease-burden countries that aspire to meet the 2030 United Nations Sustainable Development Goal 3, we screened internal project documentation on various digital health tools that provide clarity in the conceptual and implementation approach. Taking into account geographic diversity, we provide a descriptive review of five selected case studies from Bangladesh (Asia), Mali (Francophone Africa), Uganda (East Africa), Mozambique (Lusophone Africa), and Namibia (Southern Africa).
A key lesson learned is to harness and build on existing governance structures. The use of data for decision-making at all levels needs to be cultivated and sustained through multi-stakeholder partnerships. The next phase of information management development is to build systems for triangulation of data from patients, commodities, geomapping, and other parameters of the pharmaceutical system. A well-defined research agenda must be developed to determine the effectiveness of the country- and regional-level dashboards as an early warning system to mitigate stock-outs and wastage of medicines and commodities.
The level of engagement with users and stakeholders was resource-intensive and required an iterative process to ensure successful implementation. Ensuring user acceptance, ownership, and a culture of data use for decision-making takes time and effort to build human resource capacity. For future United Nations voluntary national reviews, countries and global stakeholders must establish appropriate measurement frameworks to enable the compilation of disaggregated data on Sustainable Development Goal 3 indicators as a precondition to fully realize the potential of digital health technologies.
本研究的目的是描述在不同资源受限国家定制的选定数字健康技术的概念和实施方法。从受捐助方资助的项目实施者角度,就基于当地情况的实际方面提供见解,并就未来方向提出建议。
借鉴我们在20多个疾病负担高的国家多年的机构经验,这些国家致力于实现2030年联合国可持续发展目标3,我们筛选了有关各种数字健康工具的内部项目文件,这些文件在概念和实施方法上提供了清晰的说明。考虑到地理多样性,我们对来自孟加拉国(亚洲)、马里(非洲法语国家)、乌干达(东非)、莫桑比克(非洲葡语国家)和纳米比亚(南部非洲)的五个选定案例研究进行了描述性综述。
吸取的一个关键教训是利用并建立在现有的治理结构之上。需要通过多利益相关方伙伴关系来培养和维持各级利用数据进行决策的做法。信息管理发展的下一阶段是建立系统,对来自患者、药品、地理映射和药品系统其他参数的数据进行三角测量。必须制定明确界定的研究议程以确定国家和区域层面仪表板作为预警系统减轻药品和商品缺货及浪费的有效性。
与用户和利益相关方的参与程度资源密集,需要一个迭代过程以确保成功实施。确保用户接受、所有权以及数据用于决策的文化需要时间和努力来建设人力资源能力。对于未来的联合国自愿国家审查,各国和全球利益相关方必须建立适当的衡量框架,以便能够汇编关于可持续发展目标3指标的分类数据,这是充分实现数字健康技术潜力的先决条件。