The journey to sustainable digital systems and architecture

With the 2019 launch of the WHO Digital Health Guidelines the role of digital technologies in support of universal health coverage is becoming more mainstream. In the last five years, South Africa’s National Department of Health (NDOH) has overseen a range of digital services to support maternal, new-born and child health (MNCH). MomConnect, a nationally scaled interactive messaging service and helpdesk for pregnant women and new mothers, has reached over 2.5 million women, with 35% of the userbase now on WhatsApp. NurseConnect has enrolled over 30,000 nurses and midwives. The electronic Road to Health app was recently launched as a digital complement to the paper-based paediatric health record. These initiatives collectively demonstrate a suite of digital tools – including outbound messaging, an AI-powered helpdesk, mobile websites and applications - that the NDOH can use to effectively communicate with clients and health workers across a range of population groups. The NDOH aims to target additional priority groups including HIV positive patients on treatment, adolescent girls, and community health workers. An NDOH app store will enable management of all mHealth applications that are endorsed by the NDOH. It will soon include a range of provider-based guides including TB and HIV guidelines and an Essential Medicines List. To further the vision of two-way interaction between the NDOH, patients and health workers, there is a need to upgrade and integrate multiple helpdesks within the NDOH, and harness artificial intelligence to ensure that routine interactions can be dealt with in a cost-efficient manner. This first example of a developing country institutionalising a vision for mHealth for the future, the NDOH is committed to creating an mHealth Unit with associated funding to fund core costs. This unit will partner with funders and technical service providers to drive implementation and ongoing innovation.

Uganda’s Ministry of Health (MoH) is required to revise its Health Management Information System (HMIS) data collection and reporting tools to cater for the ever changing and increasing national and international data demands. The revision is meant to enhance evidence-based planning, decision making and more targeted healthcare interventions for better health services delivery and population health outcomes. With support from Health Development Partners, the Ministry of Health steered the 2018 National HMIS Review where several stakeholder meetings were convened. Several technical programs were able to share their data requirements for the next strategic period as well as understand data collection tools developed. The 2018 HMIS revision exercise concluded with the customization of new instances of the national DHIS2 and mTrac Pro systems as the e-Health Information Management System (eHMIS). After development of the eHMIS from requirements gathered earlier, MoH conducted user experience testing which served as a trial run of the upgraded systems where users at various levels of the health sector were convened to test the systems against already gathered requirements to ensure readiness for roll-out. The user experience testing set out to experiment the use of the complete applications in a real-world scenario to generate feedback from all user categories regarding the functionality of the solution and considerations for roll-out. This activity also provided a means to validate business requirements and technical specifications prior to national roll-out. This session is set out to demonstrate how different institutions can mobilize resources to carry out design workshops and user experience testing meetings including methodologies that can be used to achieve the best out of such meetings / sessions.

This session will provide insights to participants on the motivation for Sierra Leone to conduct a nationwide mapping of digital health enabling environment. UNICEF in 2017 working with stakeholders in health and ICT sectors supported the establishment of an eHealth Coordination Hub. The Hub through UNICEF support then developed the national digital health strategy. To move from development to implementation, the eHealth Coordination Hub commissioned a mapping of digital health enabling environment in the country across all districts and representative health facilities in all the districts. This session will briefly present the process for gathering this information, and will move on to present key finding from this report which will be invaluable as it maps the infrastructure, solutions, funding, governance readiness, capacity, data and information sharing. This session will show participants what tool was adapted and how mobile data collection tool was critical for quality and analysis. The use of the taxonomy of digital health solution for solutions questionnaire development will be discussed. Challenges encountered during the process and how others can easily conduct similar mapping exercise will also be presented. • Participants will learn about suite of freely available tools used for the mapping exercise. • Participants will learn the key findings from the mapping exercise and opportunities in Sierra Leone