ICTs and the challenge of health system transition in low and middle-income countries
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ICTs and the challenge of health system transition in low and middle-income countries Gerald Bloom1* , Evangelia Berdou4, Hilary Standing1, Zhilei Guo2 and Alain Labrique3
Abstract The aim of this paper is to contribute to debates about how governments and other stakeholders can influence the application of ICTs to increase access to safe, effective and affordable treatment of common illnesses, especially by the poor. First, it argues that the health sector is best conceptualized as a ‘knowledge economy’. This supports a broadened view of health service provision that includes formal and informal arrangements for the provision of medical advice and drugs. This is particularly important in countries with a pluralistic health system, with relatively underdeveloped institutional arrangements. It then argues that reframing the health sector as a knowledge economy allows us to circumvent the blind spots associated with donor-driven ICT-interventions and consider more broadly the forces that are driving e-health innovations. It draws on small case studies in Bangladesh and China to illustrate new types of organization and new kinds of relationship between organizations that are emerging. It argues that several factors have impeded the rapid diffusion of ICT innovations at scale including: the limited capacity of innovations to meet health service needs, the time it takes to build new kinds of partnership between public and private actors and participants in the health and communications sectors and the lack of a supportive regulatory environment. It emphasises the need to understand the political economy of the digital health knowledge economy and the new regulatory challenges likely to emerge. It concludes that governments will need to play a more active role to facilitate the diffusion of beneficial ICT innovations at scale and ensure that the overall pattern of health system development meets the needs of the population, including the poor. Keywords: E-Health, Digital health, Health knowledge economy, Universal health coverage
Background The rapid pace of mobile phone adoption, with its promise of universal connectivity, lends credence to beliefs that the latest generation of information and communication technologies (ICTs) will support substantial beneficial changes in the organisation of the health sector [1–3]. This has led donor agencies and foundations to invest in many digital health interventions in low and middle-income countries, in the hope that they will provide a way to address major deficiencies in access to safe, effective and affordable health services, especially by the poor [4]. It has also stimulated large private sector investments in pursuit of niches in rapidly changing markets. * Correspondence: [email protected] 1 Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK Full list of author information is available at the end of the article
The aim of this paper is to contribute to debates about how governments and other stakeholders can influence the
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