Beyond pilotitis
Taking digital health interventions to the national level in China and Uganda
Bibliographic Data
| ID | 19534724 |
|---|---|
| Authors | Fei Huang (0000-0002-3709-5053, National Center for AIDS/STD Control and Prevention,China CDC), Sean Blaschke, Henry C Lucas (0000-0002-8454-5344, Institute of Development Studies, corresponding author) |
| Year | 2017 |
| Volume | 13 |
| Issue | 1 |
| Pages | 49-49 |
| Publication date | 2017-12-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Globalization and Health (JOURNAL) |
| Journal identifiers | ISSN: 1744-8603 • E-ISSN: 1744-8603 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1186/s12992-017-0275-z |
| PMID | 28756767 |
| OpenAlex | W2739358083 |
| Language | EN |
| Citations received | 19 |
| References cited | 36 |
BACKGROUND: Innovation theory has focused on the adoption of new products or services by individuals and their market-driven diffusion to the population at large. However, major health sector innovations typically emerge from negotiations between diverse stakeholders who compete to impose or at least prioritise their preferred version of that innovation. Thus, while many digital health interventions have succeeded in terms of adoption by a substantial number of providers and patients, they have generally failed to gain the level of acceptance required for their integration into national health systems that would promote sustainability and population-wide application. The area of innovation considered here relates to a growing number of success stories that have created considerable enthusiasm among donors, international agencies, and governments for the potential role of ICTs in transforming weak national health information systems in middle and low income countries. This article uses a case study approach to consider the assumptions, institutional as well as technical, underlying this enthusiasm and explores possible ways in which outcomes might be improved. METHODS: Literature review and case study analysis. RESULTS: The two systems considered have had considerable success in terms of gaining and maintaining government support and addressing the concerns of providers without compromising their core elements. In Uganda, the system has flourished in spite of severe resource constraints, using a participatory approach that has encouraged a high level of community engagement. In China, concern with past failures generated the political will to build a high quality surveillance system, using the latest technology and drawing on a highly skilled human resource base. CONCLUSIONS: Both example stress the importance of recognising the political, social and historical context within which information systems have to function. Implementers need to focus as much on the perceptions, attitudes and needs of stakeholders as on the technology. Implementers should distinguish between factors which may influence engagement at an institutional level and those aimed at supporting and supervising individuals within those institutions. Finally, we would suggest that designing interoperability into systems at the outset, rather than assuming that this can be achieved at some point in the future, may prove far easier in the longer term
Business · Economic growth · Economics · Enthusiasm · Environmental health · Health care · Health services research · Political science · Population · Population health · Psychological intervention · Public economics · Public relations · Sustainability · ICT in Developing Communities · Medicine · Mobile Health and mHealth Applications · Nursing · Telemedicine and Telehealth Implementation · Health Policy
Scaling Digital Health Innovation
Informal mhealth at scale in Africa
Under-reporting of TB cases and associated factors
A tale of ‘politics and stars aligning’
Digital Health in East Africa
Fit for purpose? Assessing the accessibility, theory of action, and accountability of digital technology interventions for sexual and gender-based violence prevention and response
Formalising ‘informal’ mHealth in Ghana
Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages
Examining the challenges in sustaining user engagement with a mobile app to enhance multidrug-resistant tuberculosis (MDR-TB) care in Vietnam and its implications for implementing person-centred mHealth interventions
Factors influencing the sustainability of digital health interventions in low-resource settings
A laboratory-focussed desk review of health systems in Uganda, Kenya, and the UK to respond to current and future pandemics
Best practices in scaling digital health in low and middle income countries
Sustainable support solutions for community-based rehabilitation workers in refugee camps
What Supports and Constrains the Implementation of Robust and Rapid Evaluation Within Local Government Public Health Systems
Digital benefit sharing” for non-communicable disease risk factor surveillance in low – and middle-income countries
A socio-legal critique of the commercialization of digital health in Sub-Saharan Africa
Mobilizing pilot-based evidence for the spread and sustainability of innovations in healthcare
We are not done
What just happened? Ethnography as audit
Early appraisal of China's huge and complex health-care reforms
A conceptual framework for implementation fidelity
User Acceptance of Information Technology
Sustainability Failures of Rural Telecenters
Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system
Barriers and facilitators to health information exchange in low- and middle-income country settings
The diffusion of innovations
Transforming rural health care through information technology
A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda
Real Time Monitoring for the Most Vulnerable
The Struggle for District-Based Health Information Systems in South Africa
Information Systems and Developing Countries
| Citations per year | 2.38 |
|---|---|
| Citation span | 2018 - 2026 (9) |
| Highly cited | No |