How digital transformation can accelerate data use in health systems.

Introduction: We are in an era of rapid technological advance and digitalization. Countries around the world want to leverage technology to improve health outcomes by accelerating data use and increasing evidence-based decision-making to inform action in the health sector. Yet, there is no "one size fits all" approach to achieving this. To understand more, PATH and Cooper/Smith conducted a study documenting and analyzing the experiences of five African countries (Burkina Faso, Ethiopia, Malawi, South Africa, and Tanzania) that are on this digitalization journey. The goal was to examine their different approaches and develop a holistic model of digital transformation for data use that identifies what the essential components for digitalization success are and how they interact with each other. Methods: Our research had two phases: first, we analyzed documentation from the five countries to identify core components and enabling factors for successful digital transformation, as well as barriers encountered; and second, we held interviews with key informants and focus groups within the countries to fill gaps and validate findings. Findings: Our findings show that the core components of digital transformation success are highly interrelated. We found that the more successful digitalization efforts address issues that cut across components-such as stakeholder engagement, health workforce capacity, and governance structures-and consider more than just systems and tools. Specifically, we found two critical components of digital transformation that have not been addressed in previous models like the eHealth strategy building blocks developed by the World Health Organization and the International Telecommunication Union: (a) cultivating a culture of data use throughout the health sector and (b) managing the process of system-wide behavior change required to move from manual or paper-based to digital systems. Conclusion: The resulting model is based on the study's findings and is intended to inform low- and middle-income (LMIC) country governments, global policymakers (such as WHO), implementers, and funders. It provides specific, concrete, evidence-based strategies these key stakeholders can implement to improve digital transformation for data use in health systems, planning, and service delivery.