Digital Health
- What Does It Take to Be an Effective National Steward of Digital Health Integration for Health Systems Strengthening in Low- and Middle-Income Countries?
A purposeful literature review of peer-reviewed and gray literature identified 4 broad thematic areas of digital health stewardship—strategic direction, policies and procedures, roles and responsibilities, and health service delivery—that need further research and development in order for digital health to be better positioned to positively impact low- and middle-income country health systems.
- The Role of Digital Strategies in Financing Health Care for Universal Health Coverage in Low- and Middle-Income Countries
The development and adoption of effective digital health financing solutions that fit well in both coherent digital health information architectures and the universal health coverage agenda will require strong partnerships between entrepreneurs, developers, implementers, policy makers, and funders.
- Digital Technologies for Health Workforce Development in Low- and Middle-Income Countries: A Scoping Review
Digital health interventions have the potential to improve the health workforce by supporting training, supervision, and communication. More evidence is needed on the effectiveness of interventions implemented at scale, including the return on investment, the effect of government and donor policies on scale up, and the role of the private sector.
- The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps
Despite advances in digital technology to generate demand for health services, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. Future research should examine the long-term effects of, equity in access to, and cost-effectiveness and efficiency of digital demand generation interventions.
- Establishing Standards to Evaluate the Impact of Integrating Digital Health into Health Systems
The key milestones in the rise of digital health illustrate efforts to bridge gaps in the evidence base, a shifting focus to scale-up and sustainability, growing attention to the precise costing of these strategies, and an emergent implementation science agenda that better characterizes the ecosystem—the social, political, economic, legal, and ethical context that supports digital health implementation—necessary to take digital health approaches to scale.
- Strengthening Delivery of Health Services Using Digital Devices
Delivery of high-quality efficient health services is a cornerstone of the global agenda to achieve universal health coverage. Digital health interventions for service delivery, such as digital health-enhanced referral coordination and mobile clinical decision support systems, demonstrate considerable potential to improve the quality and comprehensiveness of care received by patients but require greater standardization and engagement of health workers at different levels of the health system for effective scale up.
- Effectiveness of SMS Technology on Timely Community Health Worker Follow-Up for Childhood Malnutrition: A Retrospective Cohort Study in sub-Saharan Africa
In Ghana, Rwanda, Senegal, and Uganda, we found positive association between community health workers (CHWs) using SMS data entry with reminder alerts and timely follow-up for childhood malnutrition screening visits compared with paper forms. This association was strongest when CHWs used SMS data entry consecutively over multiple visits than when they switched between SMS and paper forms.
- A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia
Using simple-feature mobile phones, CHWs sent weekly reports on disease caseloads and commodities consumed, ordered drugs and supplies, and sent pre-referral notices to health centers. Supervisors provided feedback to CHWs on referred patient outcomes and received monthly SMS reminders to set up mentoring sessions with the CHWs. Scale-up limitations include: (1) staff shortages at health centers to supervise the CHWs, (2) need for ongoing technical support to troubleshoot challenges with mobile phones and software, and (3) recurring costs for data bundles.
- Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam
The original intention was to deliver technical content through brief text messages to stimulate participants to undertake deeper learning. While participants appreciated the convenience and relevance of the text messages, their scores of higher-order knowledge did not improve. The intervention may not have been successful because the messages lacked depth and interactivity, and participants were not explicitly encouraged to seek deeper learning.
- mJustice: Preliminary Development of a Mobile App for Medical-Forensic Documentation of Sexual Violence in Low-Resource Environments and Conflict Zones
The MediCapt mobile app has promise for clinicians to capture medical and forensic evidence of sexual violence and securely transmit the data to legal authorities for potential use in prosecution. We believe this application broadens the traditional scope of mHealth to collecting evidence, and thus name it mJustice.