Request for Application #2019-020

Digital Financial Services on Health Outcomes and Health Systems

Realizing Global Health_SIA: Performance and Outcome Study of the Pathway for Integrating DFS and Health Systems

Executive summary: 

Our consortium team with global and local partners proposes that the landscape exercise be structured as a performance and outcome landscaping study. The study would identify and describe digital health initiatives with digital financial services (DFS) components in three countries at different stages of digital health and health system development. The study will include an in-depth analysis to identify performance success factors, barriers, and opportunities for the expansion of financial inclusion and protection in these three settings. In this way, we will provide a deeper analysis of the key takeaways set forth in USAID’s recently published Technical Brief of DFS and USAID health goals. The study will adapt the methodology set forth by WHO in its guide for evaluating digital health interventions to measure the outcomes of these interventions. We will apply the mERA core criteria (WHO 2016[1]) to DFS integrated digital health initiatives in three countries with one each from East Africa, West Africa, and Southeast Asia.

 

[1] See Monitoring and evaluating digital health interventions: a practical guide to conducting research and assessment. Geneva: World Health Organization; 2016. License: CC BY-NC-SA 3.0 IGO.

Consortium Team: 

Our consortium team combines a global health firm, Realizing Global Health, www.realizingglobalhealth.com, with the expert DFS consulting firm, Strategic Impact Advisors, www.siaedge.com and two academic institutions, The Lagos Business School, www.lbs.edu.ng and the Directorate of ICT of Muhimbili University of Health and Allied Sciences in Dar Es Salaam, Tanzania, www.muhas.ac.tz.  

RGH is a global health consulting company founded by Dr. Elvira Beracochea in 2005 to help achieve global health goals through systemic solutions that develop sustainable and self-reliant health systems. RGH helps the client achieve the health targets of the Sustainable Development Goals (SDGs) using innovative, effective and sustainable global health assistance solutions. RGH has assisted USAID, NGOs and Global Fund Grantees in over 40 countries to improve how they manage and monitor performance and use that data to make timely programmatic decisions. Dr. Beracochea recently assisted USAID Tanzania to review its health information system portfolio and in particular its contribution to the digital health platform being built by the Government of Tanzania. RGH also has conducted numerous global health project evaluations and designed a number of online training programs.

SIA is a global consulting firm that supports the creation and expanded use of financial services and digital solutions to transform a wide variety of economic activities, including access to finance, energy, health care, and information services. SIA works at the global and country level. Globally, SIA is a technical advisor to institutions such as USAID and the World Bank. At the country level, SIA has conducted assessments and created toolkits and guidance for use by private, public and development sector actors on using DFS to achieve development outcomes across a variety of sectors. This year, SIA assisted USAID in evaluating the opportunity for DFS to improve health outcomes in its programming in Nigeria.

Lagos Business School is Nigeria’s premier business school and host of the Sustainable and Inclusive Digital Financial Services (SIDFS) Initiative. Through this initiative, LBS has become a leader in studying and advocating for DFS in Nigeria. Led by Professor Yinka David-West, the team is making significant contributions towards advancing the financial inclusion discourse in Nigeria.

The ICT Directorate of Muhimbili of Health and Allied Sciences The Directorate of ICT of Muhimbili of Health and Allied Sciences in Tanzania is at the forefront of digital health developments in Tanzania. Dr. Felix Sukums, its Director, has conducted numerous studies among them a study to document the implementation of the open-source district health information system (DHIS2) and health facility digitalization in Tanzania Mainland from March 2018-September 2019. He also evaluated the implementation of the country’s national eHealth Strategy (2013-2018) and led the development of the new Digital Health Strategy (2019-2024).

Final Technical Application: 
Application Status: 
Not Approved

Comments

You propose to use this study to assess how digital platforms are being built and used to address systemic problems in the health sector focusing on the mismanagement of the resources, emphasizing a decentralized workforce. Meanwhile the purpose of the RFA is to focus on the impact of DFS on financial protection among users and performance enhancements (or lack thereof) at health facilities which incorporate DFS, among other digital solutions.

Although this application aims to assess the health outcomes in terms of increased access, coverage, financial resilience to shocks, it is not clear how the focus on digital platform design and resource management will provide the insights the research seeks.

Dear Celia: We are writing to seek clarficiation on your comment on our application regarding our approachto the assessment.  We are not following your desciption of our proposed approach.  Specifically, could you point us to how you think we indicatewe will be looking at "how digital plaform are being builtandusedtoaddress systemic problems in the health sector focusing on mismangement of resources and a decentralized workforce?" 

Thank you in advance for a clarification. 


Shelley

 

Dear Shelley, 

Thank you for your clarifying question. I am following up with the technical reviewer who shared this feedback and will follow up with clarification if possible as soon as I can. 

Best,

Celia

Hi Shelley, 

Apologies for the delayed response. I have followed up with the technical reviewer, and they indicated that their feedback was based upon the following section in your concept note, rather than your preliminary technical application:

https://applications.digitalsquare.io/sites/default/files/rfa-2019-020/1571418709/sia_rgh_lbs_muhas_concept_note_-_dfs_and_health_outcomes_study_final.pdf   

Section: Project Description (last paragraph)

"Therefore, this study will assess how digital platforms are being built and used to address systemic problems in the health sector, specifically around the mismanagement of critical human resources: shortages, maldistribution, lack of supervision and career paths, absenteeism, low productivity and burnout of frontline health care workers"

 

Can you describe your apporach in narrative form to help reviewers better understand the thinking underpinning the workplan?