Since the earliest days of the COVID-19 pandemic, national and local governments have turned to digital technologies to help their citizens, health care providers, and policymakers navigate a quickly changing landscape of contact tracing, disease surveillance, symptom management, and, eventually, vaccine distribution.
However, donors, including USAID, often cannot identify and track their digital health investments and as a result it can be difficult to make evidence-based programmatic decisions about digital health.
Mapping & Matching Digital Health Tools
From our response during the West Africa Ebola outbreak in 2014, USAID learned that adapting existing digital tools is vital to fight outbreaks with information. USAID institutionalized these learnings in its Digital Health Vision, policy guidance for the agency’s investments in health-sector and partner country-based digital and data technologies.
To encourage this approach, we funded the Map & Match project via Digital Square to help countries, donors, implementers, and the global digital health community to understand what existing digital tools could be adapted and used in the COVID-19 response. The Map & Match project conducted a landscape analysis and collected information about over 2,900 digital health tools deployed in 156 countries – one of the largest known datasets of digital health tool deployments globally. Then, it matched those tools to potential COVID-19 use cases.
In summer 2021, as many countries were initiating vaccine distribution and tracking, Digital Square and USAID provided customized profiles to 22 countries to guide decision-making for their investments in digital technologies and data systems to meet COVID-19 response needs. In addition to these detailed country reports, in fall 2021 we conducted an analysis of the full dataset to identify trends among digital health tool deployments and opportunities to improve data collection and sharing about digital health globally.
Here are four top takeaways:
1. Global Goods Dominate
The top five most used digital health tools were software global goods that are free to access, open-source, adaptable to different countries and contexts, and recommended in USAID’s Digital Health Vision.
- DHIS2: 246 deployments
- CommCare: 152 deployments
- RapidPro: 115 deployments
- OpenMRS: 112 deployments
- ODK: 92 deployments
2. Case Management Uses Dominate
Many digital health tools were listed with multiple use cases; however, case management was a clear need in COVID-19 response. That finding aligns with the most popular tools, as CommCare and OpenMRS have strong case management functionalities and RapidPro and ODK can be used for routine and event-based surveillance.
- Case management: 374 use cases
- Routine & Event-based surveillance: 305 use cases
- Coordination & operations: 276 use cases
- Laboratory systems: 172 use cases
3. Donors Are Not Tracked
Nearly 50% of programs did not list a donor for their tool, suggesting that it is difficult for governments, implementers, and donors themselves to track their digital health investments. This also makes it difficult for donors to understand a country’s digital architecture and the true long-term support and maintenance costs of these tools.
Donors, governments, and implementers should outline expectations for collection, sharing, and maintenance of digital systems, their data, and a country’s digital architecture. In addition, programs should move beyond extractive data monitoring and promote the Digital Health Atlas as a data repository.
4. USAID Funds Most Projects
Of tools with a known funder, USAID is the top international funder of digital health tools globally with 363 documented deployments, followed by the Gates Foundation, the CDC, the University of Oslo, and UNICEF.
However, just 4% of digital health deployments are funded by donors based in-country. This finding is clouded by over-counting, attribution to a country instead of the World Bank, and under-counting, international donors are more likely to request public credit for supporting tools. Regardless, the involvement of local donors is key to sustain use of digital health tools beyond the immediate pandemic response.
Map & Match Influenced Changes
We shared these findings and more with country offices, other donors, and the Global Health Bureau at USAID; and they used this data to drive change in their own contexts.
- The German Agency for International Cooperation (GIZ) developed the Digital Pandemic Preparedness Assessment (DPPA) based on the Map & Match data model. The DPPA helps countries identify needs for digital tools that integrate with their existing digital infrastructure and improve their overall pandemic preparedness and response. It has been conducted so far in Cote d’Ivoire, Ghana, Nigeria, Sierra Leone, and Togo; and it is underway in more countries.
- UNICEF and the World Bank also leverage Map & Match data to quickly assess a country’s digital landscape when a country requests assistance, which allows them to respond more quickly and avoid duplication of work. The World Bank prepared recommendations and assessment reports for Burkina Faso, Niger, and Sierra Leone based on Map & Match findings.
- In addition, the data is being used in an ongoing USAID-supported initiative by Digital Square in Tanzania to resolve a substantial backlog of COVID-19 vaccination data and address root causes of that backlog. Accurate and updated vaccination data will help Tanzania make informed decisions about vaccination, and strengthen both routine immunization and their response in future pandemics. Digital Square also used the Map & Match findings to inform a community health information subsystem plan in Mozambique and are working to ensure that existing tools used in the country are interoperable.
The Map & Match project showed the importance of accurate digital data for country-specific and global activities. USAID and our partners will leverage insights from the comprehensive analysis in their continued involvement in digital health through the next phase of the COVID-19 pandemic. More information about the Map and Match project, including the full data repository, is available on the Digital Square website.
By Elise Garton, a Health Specialist at the U.S. National Cancer Institute Center for Global Health. She completed a rotation as a Presidential Management Fellow at USAID’s Center for Impact and Innovation (CII) from August 2021 – August 2022.
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