International Development Research Centre (IDRC), Ottawa, Canada.
Nairobi, Kenya.
J Public Health (Oxf). 2018 Dec 1;40(suppl_2):ii1-ii5. doi: 10.1093/pubmed/fdy171.
A growing body of evidence shows the use of digital technologies in health-referred to as eHealth, mHealth or 'digital health'-is improving and saving lives in low- and middle-income countries. Despite this prevalent and persistent narrative, very few studies examine its effects on health equity, gender and power dynamics. This journal supplement addresses these invisible imperatives by going beyond traditional measures of coverage, efficacy and cost-effectiveness associated with digital health interventions, to unpack different experiences of health workers and beneficiaries. The collection of papers presents findings from a cohort of implementation research projects in Africa, Asia, Latin America and the Middle East, and two commentaries offer observations from learning-oriented evaluative activities across the entire cohort. The story emerging from this cohort is comprised of three themes: (i) digital health can positively influence health equity; (ii) gender and power analyses are essential; and (iii) digital health can be used to strengthen upward and downward accountability. These findings, at the individual project level and at the level of the cohort, provide encouraging recommendations on how to approach the design, implementation and evaluation of digital health interventions to address the Sustainable Development Goals agenda of leaving no one behind.
越来越多的证据表明，在卫生领域使用数字技术——称为电子卫生、移动卫生或“数字卫生”——正在改善和拯救低收入和中等收入国家的生命。尽管存在这种普遍而持续的说法，但很少有研究探讨其对健康公平、性别和权力动态的影响。本期刊增刊通过超越与数字卫生干预措施相关的传统覆盖范围、功效和成本效益衡量标准，来解决这些看不见的当务之急，深入研究卫生工作者和受益人不同的体验。该论文集介绍了来自非洲、亚洲、拉丁美洲和中东的一系列实施研究项目的研究结果，两篇评论文章则提供了整个项目队列中从学习导向评估活动中得出的观察结果。从该队列中得出的故事包含三个主题：(i)数字卫生可以积极影响健康公平；(ii)性别和权力分析至关重要；(iii)数字卫生可用于加强上下问责制。这些发现，无论是在单个项目层面还是在队列层面，都为如何设计、实施和评估数字卫生干预措施以实现可持续发展目标议程中“不让任何人掉队”的目标提供了令人鼓舞的建议。
