Co-developing a Transnational Framework Digital Health for International Health Cooperation
Voices from the South
Von Gertjan van Stam
One of the effects of the COVID-19 pandemic has been the increased use of digital technologies, also in health. Since the pandemic began, clients in health have sought to meet medical professionals using digital platforms. In Switzerland, even during the lockdown, medical doctors continued to attend to their clients, albeit ‘digitally-first’. As in education, this shift to the digital has not gone unnoticed. Professionals, governments, industries, and civil society are seeking evidence-based guidance on how to approach this shift in access to health care.
Digital Heath for Healthy Lives and Wellbeing for All, Geneva, 23-24 May 2016. Photo: ITU Pictures/flickr, CC BY 2.0
The use of digital technology in health – digital health – has grown over many years. But the pace of this change has not been uniform across the world. This diversity in the implementation of digital health and the use of technologies has created new challenges and opportunities, both internationally as well as within nations.
Towards a Framework on Digital Health in International cooperation
The board of Medicus Mundi Switzerland (MMS) has made digital health a focal topic for 2020. The task at hand is to co-develop both strategic and practical guidance on how to approach Digital Health for Switzerland’s International Health Cooperation. The aim is to empower all involved – MMS members, governments, industry, and universities – to harness digital technologies in international development. For this purpose, in 2020, the MMS secretariat has initiated various activities. Among these are research on good practices in digital health among MMS members and providing a transnational stage to develop a Framework on Digital Health in International Health Cooperation. Starting in Bern in January, a gathering of Swiss stakeholders initiated the development of this framework by listing subjects for inclusion. Subsequent developments to the framework are being continuously reviewed by experts in the North and South, guided by a steering committee of Swiss stakeholders.
Bern, January 2020: Initiation of the development of a digital health framework. Photo: © MMS
Online Workshop "Voices from the South"
In line with an increased understanding of the benefits of co-development – to include all current and future stakeholders at any stage – MMS strives to sustain an ongoing conversation with and the involvement of representatives in the global South. COVID-19 restrictions, however, have pre-empted personal meetings with stakeholders from the South due to the cancellation of global health meetings in Switzerland. Nevertheless, inputs were provided by participants from Asia, Africa, and Latin America during an online workshop, 25 May 2020. The focus of the workshop was ‘Voices from the South’. During the workshop, representatives in the South commented on the framework and actively contributed to its development. This co-development is fertilised by various narratives from real experiences and observations from the development of digital health interventions in their respective environments.
In preparation for the workshop, 30 invitations went out to content experts in the South, as suggested by MMS partners and the MMS project team. Among the invitees were directors of IT companies, representatives of community networks, digital health infrastructures at ministries of health, of various innovation hubs, professors and academics, as well as major players in the Southern health scene. Two-thirds of the invitees responded to the invitation and written responses were received and in-depth interviews held. As a result, an inspirational video was prepared that framed the workshop.
Video: Voices from the South - Swiss Framework Digital Health
Here are some of the contributions from Burkinabe, Kenyan, and Zambian participants
On digital health
“One critical area in relation to Africa […] relates to the intersection between culture and the emergence and use of digital technologies. Secondly, there is an increase in innovative products borne of local creativity and entrepreneurship. These innovations are home-grown, culturally and technologically adapted to the local conditions. They are cost effective, readily accessible and sustainable.”
“The issue of ethics is very, very important.”
“We need to talk together […] go there and ask people what they really want.”
On community enhancement
“You cannot engage communities through paperwork. First, you have to visit.”
“[Digital health must] involve the community, engage the community, include the thought leadership (by the local talent). This is ‘decentering’, where both the donor and the recipient community are participating – where there is co-development. Also, where there are ethics. Ethics is about respecting each other, being honest, being transparent.”
On workforce enhancement
“Who went to the rural areas and asked them ‘what are your problems?’.”
“Accept that local capacity can be groomed to spearhead development in the South.”
On thought leadership
“Projects must not come in, but must come out [of the community].”
“Local leadership is about embodied knowledge; what you have learnt from the time you were born and what you have observed.”
Gertjan van Stam lives in Zimbabwe and is involved with strategic developments in Information and Communication Technologies in Africa since 1987. He holds a PhD (culture) from Tilburg University, an MTech (ICT) from Nelson Mandela Metropolitan University, and an engineering degree in telecommunications. His research focuses on mechanisms of digital health development at the junctions of society and technology. Email