In the current digital age, the way we interact with the world around us has been radically altered by the increasing adoption and use of digital technologies. Health systems and health service delivery are no exception. Digital health is already an important and growing part of most health systems, and with the majority of the world’s population now covered by some form of broadband internet network, digital health is an important driver to help countries achieve Universal Health Coverage (UHC) and health for all.
While digital health technologies and data present enormous opportunities, they must be developed and used in ways that are aligned with public health values and prioritise equity and human rights.
Transform Health’s goal is to achieve Universal Health Coverage by 2030 by harnessing digital technology and the use of data. This however, requires leadership and collective action to ensure that everyone can realise their right to health and enjoy the benefits of digitally-enabled care.
Digital health transformation, if implemented in an equitable, sustainable and inclusive manner, has the potential to strengthen and scale up access to primary health care services, build strong and resilient health systems, close equity gaps, and advance UHC progress.
Digital tools can extend the coverage of health services to remote and rural populations, and reach underserved and marginalised populations, while reducing direct and indirect costs associated with accessing services. Digital health can also help generate demand to increase uptake of health services.
Digital tools can improve the quality and efficiency of health services. It can address health system barriers by enhancing access to health information and services; ensuring more effective system integration including continuity of care between service levels. Digital tools can Increase efficiencies in the management of health budgets and reduce the cost of service delivery. It can also reduce the overall burden on health systems by enabling individuals to access health information and manage preventative and self-care services.
The digitisation of health systems is exponentially increasing the amount of health data being produced, used and stored. If governed effectively, health data can improve public benefits and health outcomes through improved data-driven decision-making; advancements in research and innovation; stronger and more equitable health systems; and improved health emergency and pandemic response. Importantly, it can help strengthen public trust in health and data systems, which is critical to foster data collection and use for public benefit.Digitisation of health information systems and health records can increase timeliness of data sharing and efficiency in use of health personnel and supplies, and the use of improved analytical tools support more effective and equitable policymaking, planning and allocation of resources.
Digitalisation can improve transparency and accountability, and increased participation of individuals and communities. The use of digital platforms can help foster inclusive processes by increasing opportunities for civil society and diverse communities to meaningfully participate in policy making and governance mechanisms. Digitalisation can also help increase accountability and transparency by making facility, regional, and national-level data available to the public online; and facilitating feedback mechanisms, allowing progress to be monitored.
To fully harness the opportunity of digital technologies to deliver health for all in the digital age, key barriers must be overcome.
Weak political understanding and support is preventing the right investment and action to strengthen the foundational areas and enabling environment needed to ensure the equitable and inclusive digital health transformation and the sustainable adoption of effective digital solutions that can help achieve health for all. In many countries and regions, particularly those with weak governance and health systems, digital technology is being implemented in a piecemeal fashion, based on external programmes and priorities rather than being driven by needs on the ground.
Many countries have a weak legislative, regulatory and policy environment to guide the development of the digital transformation of their health system so that it is inclusive, equitable and sustainable. This is needed to lay the legal foundations in terms of health data use, privacy, digital literacy and the policies for what kind of digitalised health system a country needs to ensure universal health coverage. A transparent public policy environment also increases planning and investment certainty for international donors and the private sector and clarifies the incentives and expectations. It is important that this includes multi-stakeholder engagement and the broad participation of civil society. To fully harness the potential of health data for public benefit and improved health outcomes, while also managing risks, protecting individual rights, and ensuring people’s data is protected from misuse, it is important to strengthen the governance of health data through more robust, effective and equitable legislation and regulation.
The fragmentation widely recognised across the digital health sector is partly due to the incentive structure generated by both the legislative and regulatory environment, and the funding and resourcing flows and levels. Most health funding is directed towards health specific programmes and it is very difficult to untangle the funding dedicated to the digital transformation of health systems. There is a lack of publicly available information on current funding levels, as well as gaps in domestic and external funding for digital health, particularly for low and lower-middle income countries. This lack of information poses a barrier to: mobilising additional resources for digital health; to more effective donor coordination; to better alignment around country priorities and needs; and to ensuring funding prioritises the right areas to ensure an equitable, inclusive and sustainable digital health transformation.. Our strategy for 2023 focused on continuing to elucidate this funding landscape at global, regional and national levels and to prioritise digital health investment and the need for action on political agendas.
Digital health approaches and solutions are often not informed by the needs of women, youth and marginalised groups – who are being left behind in the effort to achieve global health goals. As a result, health interventions may respond to the few rather than the many, and exclude the specific health needs of underserved communities. Moreover, civil society is often not included in various levels of planning, strategy, execution and monitoring of the transformation. It is imperative to ensure the meaningful engagement of civil society and communities, including representatives of the most marginalised and vulnerable persons as well as health workers, in the digital transformation. They must be empowered to contribute to this change and to hold decision-makers accountable.
Put communities at the centre of digital health
Transform Health is working with its partners to ensure the marginalised and hard to reach communities are included in national planning and implementation of digital health strategies.
Design and implement digital health strategies that will deliver UHC
Transform Health is engaging with governments in priority countries to ensure digital health solutions are being developed and implemented to achieve UHC.
Support health workforces to enable digital transformations
Transform Health is working with its partners to canvass the views of health worker to ensure digital health solutions are implemented in a way that support frontline health workers.
Ensure strong regulation and legislation to create an enabling environment for digital transformation while protecting rights and privacy
Transform Health is carrying our landscape analysis of legislation, regulation and policies in priority countries and aims to influence decision makers to ensure an enabling environment for digital transformation of health systems
Increase domestic and international investments to strengthen digitally enabled PHC systems and empower communities
Transform Health is conducting an assessment of the funding environment to better understand the funding modalities and how they are contributing to the digital transformation of health systems. Recommendations will feed into ou donor engagement work.
Create a global governance framework for health data to maximise the public benefits of data whilst safeguarding individual privacy, ownership and security
Transform Health is pressing government and multilateral institutions to develop a Global Health Data Governance Framework undermined by a set of principles based on equity, inclusion and human rights, to inform and guide national legislation.
