In global digital health, the focus is on outcomes and having accurate data that both proves and informs those outcomes. Testing a new digital health intervention can take years of effort and funding, readying the system to be implemented. Positive outcomes are proof-of-concept and can be lifechanging both for the service recipients and the innovator.
When a new tool is ready or a country wants to think about a more digitally focused approach to their healthcare system, there’s a push to implement and start measuring results. The implementation team may be ready, but is the country?
This is a question we recently asked ourselves after observing one too many great theories falter in practice because the country, while enthusiastic about the possibilities opened by the services, were not actually ready to receive them – and funders weren’t always sure how to fund them in a strategic and coordinated way. Vital infrastructures often were not in place.
How do you assess if a country is ready to implement a new system? What are the identifiers and how do we measure them? How can the country ensure it is clearly articulating its needs to funders and aligning those funders around its most critical needs? We’ve got a tool for that.
With support from the Bill & Melinda Gates Foundation, Kati Collective has developed the Early Stage Digital Health Assessment to facilitate a discussion between a country and its stakeholders around the building blocks that need to be in place before designing a digital health solution.
The Assessment focuses on countries who are in the early stages of developing a more coordinated strategic approach to digital health or are in the early stages of assessing their readiness to develop a plan.
The tool identifies a set of critical indicators the country should meet prior to planning and implementing a new digital health intervention. From there, the tool digs more deeply into a set of essential building blocks: human capacity, investments and funding, data capture and use, infrastructure, standards and interoperability, and governance and policy.
The Assessment employs a simple scale of one to five. If a country scores lower than a three in a certain area, the results are used to guide conversations between countries and stakeholders to develop a roadmap that can be taken to improve readiness, therefore increasing the chances of positive future outcomes.
We recently used the Assessment for the first time in Malawi which allowed us both the opportunity to use the tool in a familiar setting and to finetune the instrument. This is not a lengthy process – the Assessment can be done in less than a week which is ideal for the principal users of the tool: health ministries and donors who have little time and want results for the health of their citizens now.
Starting with an understanding of current tools available, we identified the gaps in those tools (see diagram below) and used this information to develop the Assessment. In Malawi, we interviewed key stakeholders, reviewed relevant policy, strategy, and assessment documents, and identified strengths and areas for improvement. We also took recommendations from previous assessments into account. By codifying existing data, we are able to identify gaps and create a more defined picture of how the country aligns within the ecosystem. We then identified, scored, and prioritized the key strengths and gaps in each building block, and made recommendations in each area.
The Assessment is flexible and can be adapted to work across the digital health ecosystem. Our next step is to test the Assessment in other countries. Once we have more results (we love outcomes as much as anyone!), we will work with the global digital health ecosystem to determine how to best ensure that the Assessment becomes a tool for the global good, ensuring it is available to anyone in the ecosystem to use. For those who want professional guidance, we offer both remote support and in-country facilitation.
We believe the Early Stage Digital Health Assessment could be a gamechanger for LMICs. We’ve posted an overview of the assessment and analysis. Tell us what you think!