Request for Application #2019-020

Digital Financial Services on Health Outcomes and Health Systems

An Assessment of DFS and Health Systems

Primary Author: Richard Anderson
Executive summary: 

Utilizing our expertise in Digital Financial Services (DFS), global health, and design and deployment of technologies for emerging markets, University of Washington (UW) in Seattle, Information Technology University (ITU) in Lahore, and Medic Mobile will work together to assess the financial protection means available to resource-constrained and vulnerable users of health care systems, as well as the effects of the digitization of financial protection, healthcare billing, and payments and their correlation with utilization of health services by such populations in resource-constrained environments. Our previous expertise on health system reporting, immunization logistics, medical record systems, and maternal health give us a holistic lens into the global health systems. We have also completed extensive in-depth work to understand the barriers to adoption of DFS, and produced a substantial number of papers that focus on DFS, including DFS and health payments. Our previous work also explains the nuances around technology, family, finances, and health as well as the role of culture, income, society, and gender in ownership, access, understanding, and use of technological, financial and health processes and programs. Along with an exploration of barriers and challenges to DFS adoption with regard to health services, we will articulate the impact of the aforementioned factors on DFS and health services.  Our work also shares the use of social collateral and informal savings, selling of assets to provide for financial and health emergencies. Based on our extensive work in DFS and digital health implementations and given the locations in question, we propose to emphasize a context-based approach to understand the impact of socio-cultural, religious, economic, infrastructural and gendered barriers throughout the landscaping project, particularly in the case of financial protection and implementation considerations of DFS in health care. Our work underscores the importance of the context-based approach, and we study the socio-cultural norms and their role in the financial and health service interaction. The consortium team has expertise in mixed-methods research, fieldwork, technology development and deployment in Kenya, Tanzania, Peru, Mexico, Pakistan, India, Indonesia, and the Philippines. UW will lead this landscaping project, in collaboration with ITU in Pakistan and the Medic Mobile’s team in Uganda. 

Consortium Team: 

Consortium Team

The work will be conducted at the University of Washington, Seattle, and at the Information Technology University, in Lahore, Pakistan.  Medic Mobile will offer their expertise in health payments.

University of Washington, Seattle has the leading academic research group in Information and Communication Technologies for Development (ICTD),  led by professors Richard Anderson and Kurtis Heimerl. The ICTD Lab has a 15-year history of producing top graduates, strong publications, and notable systems including Open Data Kit, Digital StudyHall, Projecting Health, and ReSpeak. The topic of this landscaping project is at the intersection of two of the lab’s focus areas: DFS and computing for global health. Under BMGF's Financial Services for the Poor program, our work examined challenges in adopting DFS and included landscaping, literature surveys, assessment of specific mobile money products, workshops, and country case studies. Among the works was the evaluation of the security of mobile money applications on both smartphones and basic phones, digitization of traditional savings products, and identification of barriers to women's financial and technological inclusion. The DFS project has a geographical focus on Sub-Saharan Africa and South Asia. The ICTD Lab has also done substantial work in computing and global health in collaboration with organizations such as the UW Department of Global Health and PATH, with on-the-ground work in India, Pakistan, Tanzania, Kenya, Laos, and other countries. Our work focused on health system reporting, immunization logistics, medical record systems, and maternal health. The lab’s work has led to involvement with multiple global goods software systems including health insurance and case tracking products. 

The ICTD Lab has partnered with Information Technology University (ITU) in Lahore, Pakistan to found the ITU FinTech Center with funding from Karandaaz. The ITU FinTech Center, directed by Lubna Razaq, has conducted collaborative research projects with UW and hosted UW fieldwork. The ITU FinTech Center developed strong ties with the Pakistan fintech industry and will be our core collaborator in the landscaping work in Pakistan. The ITU Fintech center has also led an evaluation of a program to promote women mobile money agents in Pakistan, which was completed for Women's World Banking.

Another partner is Medic Mobile, a nonprofit organization founded in 2010 to improve last-mile healthcare. Medic Mobile - which designs, builds, delivers and supports open-source software for frontline health workers and health systems -  and UW recently collaborated to study digital payments for community health workers in rural Kenya. This work characterizes the complexities of salary payments through mobile money and bank payments, as well as the relationship between digital payments and health workers’ well-being.

Final Technical Application: 
Application Status: 
Not Approved


The formal comparison to non-digital approaches could be a strong approach. This is very gender-oriented - which may be a unique value-add and is an area of policy interest, but we recommend not to sacrifice other critical components/considerations with the gender focus.

The conceptualization of the research approach is strong. We appreciate the way in which the concept delineates the various areas of inquiry of the research agenda. The proposed country case studies are well noted.

Please consider how much budget will be required for this work and determine if the amount proposed will be sufficient.