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Implementing digital health in developing countries has become a challenge (Herselman et al., 2016). Hence, researchers and health professionals are coming up with strategies on best practices to implement digital health in developing countries. An example of such strategies is Digital Health Innovation Ecosystems proposed by Herselman et al. (2016). Iyawa et al. (2016a) further suggest that digital health can be implemented in developing countries through the application of innovative principles.
Different studies on Digital Health Innovation Ecosystems have described the concept and what it consists of (Iyawa et al., 2016a; Iyawa et al., 2016b; Mehl et al. 2018; Labrique et al., 2013), both in developed and developing countries. Digital Health is the application of mobile technologies to support health care services (ITU, 2015). Digital health is thus being applied in both developed and developing countries where there is high dispersion of mobile connectivity (GSMA Intelligence. 2018). Over the past decade, numerous digital health strategies have emerged to address long-standing health system challenges, and achieve national and global goals including the United Nations Millennium Development Goals (MDGs) and United Nations Sustainable Development Goals (SDGs) (Asi and Williams, 2018; Labrique, et al., 2013; Mehl et al., 2014).
Since 2001, governments, donors, global development agencies, and civil society have been mobilized to action by the universally ratified United Nations Millennium Development Goals (MDGs) (UN Millennium Project, 2005). These eight ambitious objectives, established to improve quality of life across the globe, include three specific health objectives (MDGs 4, 5, 6) with others—such as the eradication of poverty and hunger and the promotion of gender equality—that are clearly necessary to enable significant improvements in health outcomes (Konduri, et al. 2018). MDG 4 focus on improving child mortality, MDG 5 focus on improving maternal health and MDG 6 focus on combating HIV/AIDS, malaria and other diseases (UN Millennium project, 2005). National health system–strengthening initiatives and multi-country and multisectoral programs were funded and launched to accelerate progress toward the MDGs by the 2015 target date (Konduri et al., 2018). Reliable information systems are crucial to support policymakers and leaders working toward the MDG 4, 5 and 6 targets, particularly ensuring quality, efficiency, and safety in Universal Health Coverage (Mehl et al., 2018).
Despite the global abundance of digital health implementations, few have achieved national-level scale or become institutionalised as a routine practice within the Ministries of Health (Mehl et al., 2018). Furthermore, successes are often defined as technical accomplishments, instead of demonstrated impact on programme or health outcomes (Huang, Blaschke, and Lucas, 2017). MomConnect, in South Africa, represents a rare example of a nationally scaled and government-supported digital health initiative (Mehl et al. 2018).