Evidence map›Paper›PMID 41035560›Full record

ArticleBulletin of the World Health Organization2025

Associations between digital maturity in health and primary health care performance, 109 countries.

Lena Kan, Yoko Shimada, Abdulaziz Mohammed Hussen, Arisa Shichijo Kiyomoto, Shivani Pandya, Patricia Mechael, Binyam Tilahun, Meredith Kimball, Marelize Gorgens, Malarvizhi Veerappan and 2 more

Abstract read
In one paragraph

Article in Bulletin of the World Health Organization, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lena KanCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).
Yoko ShimadaCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).
Abdulaziz Mohammed HussenCenter for Digital Health and Implementation Sciences, University of Gondar, Gondar, Ethiopia.
Arisa Shichijo KiyomotoCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).
Shivani PandyaCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).
Patricia MechaelCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).
Binyam TilahunCenter for Digital Health and Implementation Sciences, University of Gondar, Gondar, Ethiopia.
Meredith KimballGates Foundation, Seattle, USA.
Marelize GorgensWorld Bank, Washington, DC, USA.
Malarvizhi VeerappanWorld Bank, Washington, DC, USA.
Ethan WongGates Foundation, Seattle, USA.
Smisha AgarwalCenter for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe St, Baltimore, Maryland, MD 21205, United States of America (USA).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To investigate associations between digital maturity in health and primary health care performance globally. Methods: We conducted a search of publicly available data on digital maturity in health and primary health care performance for the 194 World Health Organization Member States. We identified 14 indicators of digital maturity in health, covering seven core subcomponents. A digital maturity in health index was derived from these indicators. Primary health care performance was assessed using the universal health coverage effective coverage index. Findings: Digital maturity in health data were missing for 85 of the 194 countries, with considerable variation across subcomponents. The remaining 109 countries were divided into four types by digital maturity in health index. We identified countries leading or lagging in digital maturity and highlighted the strongest and weakest subcomponents. Overall, there was a strong, nonlinear, positive correlation between digital maturity in health and primary health care performance (Spearman correlation: 0.85). However, there were notable exceptions, which indicates digital maturity can enhance primary health care but is not necessary for its improvement. The relationship between health-care expenditure and digital maturity in health and primary health care performance varied among countries with similar spending and digital maturity. Conclusion: Overall, primary health care performance was positively associated with digital maturity in health and health-care expenditure. However, some countries had a strong primary health care system despite low digital maturity, and some had high digital maturity but a weak primary health care system. The study's findings could help policy-makers prioritize investment in digital health.

Indexed as

Digital TechnologyGlobal HealthPrimary Health CareHumansWorld Health Organization

Identifiers

PMID41035560
PMCPMC12477510

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.