Health Systems, Digital Health and COVID-19: Insights from Bangladesh, Myanmar, Pakistan, Benin, Nigeria and Rwanda
This research unpacks the health systems and digital health solutions in six developing countries: Bangladesh, Myanmar, Pakistan, Benin, Nigeria and Rwanda. This report expands on another GSMA report published in June 2020, Digital Health: A Health System Strengthening Tool for Developing Countries, which uncovered the challenges facing health systems in these six countries and how these challenges have been exacerbated by the COVID-19 pandemic.
One of the lessons from our research was that progress in each country must be measured in the context of the national health system. The different organisational structures of these health systems are summarised in the first part of each country section in the report.
The following section details the state of play of digital health in each country, which varies quite considerably. Bangladesh and Rwanda treat digital health as part of a whole-of-government approach and seek to leverage government-wide infrastructure and standards. Pakistan and Nigeria, which have a strong federal tradition, have a more fragmented approach. In Myanmar and Benin, digital health is still in its early stages and relies more heavily on contributions from development partners.
Several insights were gleaned from our key informant interviews (KIIs). A common theme was that broad stakeholder involvement in digital health ecosystems is a growing trend that should be fostered, but how this is done varies from country to country. While some respondents want governments to create an enabling environment, others see start-ups and mobile operators playing a greater role. Another emerging theme was the lack of shared understanding among stakeholders of policy requirements and frameworks.
The COVID-19 pandemic is a challenge confronting all countries, and the report briefly reviews some of the digital health approaches each country has taken. While this is only a partial picture of the COVID-19 response, we discovered that the pandemic has amplified calls for digital health initiatives.
The final section features case studies from each country. While these are just snapshots, taken together they illustrate some of the progress that is being made in strengthening health systems with digital health solutions.