Alunyu Andrew Egwar, Amiyo Mercy Rebekah, Nabukenya Josephine
Faculty of Engineering, Busitema University, Busia, Uganda.
Department of Information Systems, Makerere University, Kampala, Uganda.
PLOS Digit Health. 2024 Sep 12;3(9):e0000603. doi: 10.1371/journal.pdig.0000603. eCollection 2024 Sep.
Ignoring the need to contextualise international standards has caused low-resourced countries to implement digital health systems on the ad-hoc, thereby often failing to meet the local needs or scale up. Authors have recommended adapting standards to a country's context. However, to date, most resources constrained countries like Uganda have not done so, affecting their success in attaining the full benefits of using ICT to support their health systems. They apply the standards 'as is' with little regard for their fitness for potential use and ability to fulfil the country's digital health needs. A design science approach was followed to elicit digital health communication infrastructure (DHCI) requirements and develop the contextual DHCI standards for Uganda. The design science methodology's design cycle supported DHCI standards' construction and evaluation activities. Whereas two workgroup sessions were held to craft the standards, three cycles of evaluation and refinement were performed. The final refinement produces the contextualised DHCI standards approved by Uganda's DH stakeholders through summative evaluation. Results of the summative evaluation show that DH stakeholders agree that the statement of the standards and the requirements specification are suitable to guide DHCI standards implementation in Uganda. Stakeholders agreed that the standards are complete, have the potential to realise DHCI requirements in Uganda, that have been well structured and follow international style for standards, and finally, that the standards are fit to realise their intended use in Uganda. Having been endorsed by DH stakeholders in Uganda's health system, the standards should be piloted to establish their potency to improve health information exchange and healthcare outcomes. Also, we recommend other low middle income countries (LMICs) with similar challenges to those in Uganda adopt the same set of contextualised DHCI standards.
忽视将国际标准与具体情况相结合的必要性，导致资源匮乏的国家临时实施数字卫生系统，因此往往无法满足当地需求或进行扩展。作者建议使标准适应当地情况。然而，迄今为止，像乌干达这样的大多数资源受限国家尚未这样做，影响了它们充分利用信息通信技术支持其卫生系统的成效。它们原封不动地应用这些标准，很少考虑其是否适合潜在用途以及满足该国数字卫生需求的能力。采用设计科学方法来确定数字卫生通信基础设施（DHCI）的要求，并为乌干达制定符合当地情况的DHCI标准。设计科学方法的设计周期支持了DHCI标准的构建和评估活动。举办了两次工作组会议来制定标准，进行了三轮评估和完善。最后的完善产生了经乌干达数字卫生利益相关者通过总结性评估批准的符合当地情况的DHCI标准。总结性评估结果表明，数字卫生利益相关者一致认为，标准声明和要求规范适合指导乌干达实施DHCI标准。利益相关者一致认为，这些标准完整，有可能在乌干达实现DHCI要求，结构合理，遵循国际标准风格，最后，这些标准适合在乌干达实现其预期用途。这些标准已得到乌干达卫生系统数字卫生利益相关者的认可，应进行试点以确定其改善卫生信息交流和医疗结果的效力。此外，我们建议其他面临与乌干达类似挑战的低收入和中等收入国家（LMICs）采用同一套符合当地情况的DHCI标准。
