May 21, 2024


The COVID-19 pandemic has been a sharp reminder that health information systems and the data they generate are critical to identifying disease outbreaks and to allocation of prevention and treatment resources. Yet these data systems are often poorly funded and need strengthening. What has work at the country level taught us?

Since 2022, I’ve been part of a collaborative group of organizations that, together with the United States Agency for International Development, studied global COVID-19 vaccine delivery digital health investments made across 11 countries during the emergency phase of the pandemic.

We asked three questions:

  1. Are there indications that digital health investments made to address emergency needs can contribute beyond the crisis response to strengthen health systems?
  2. What factors can support or inhibit this system-strengthening effect?
  3. How can such investments contribute toward global health security, bolstering country health emergency preparedness and response capabilities?

As my colleague from USAID Amarynth Sichel says, in a commentary published this week in a special issue of Oxford Open Digital Health, “The answers to these questions provide insight into how to strengthen global health security and how to ensure that investments in country digital and data systems can yield the broadest possible value, recognizing that health systems may be under increasing strain as pandemics become more likely and as climate change increases zoonotic disease risks.”

Taken together, the findings of these multicountry studies point to the importance of the presence or absence of conditions that allow digital health investments to thrive. We found that this “enabling environment” not only contributes to an effective emergency response, it also influences the extent to which digital investments deployed during an emergency contribute to stronger health systems that are better prepared for future health shocks.

One study, which analyzed USAID’s COVID-19 vaccine digital investments in Burkina Faso, Indonesia, Mali and Suriname, suggested that connecting investments in digital system development, governance and infrastructure can improve country data management processes and data use for decision making in routine health and emergency responses.

Another study, conducted in Honduras, confirmed the value of using a “situation room” method to build local capacity in data analysis, visualization and use — in short, the institutionalization of processes and systems for continuous data review and staff training. Governments and health program managers require data to measure progress against targets, allocate limited resources to reach the populations most in need, rapidly course-correct underperforming programs and determine whether they are addressing the most urgent needs.

As the World Health Organization said in its 2023 “Call to Action” to improve pandemic preparedness, effective preparedness relies on coordinated action, including to maintain, sustain and build on routine systems. The studies in the journal’s special issue share insights and offer recommendations to translate insights from the ground level — from projects examining the effect of investments in digital data systems — into actions that can improve future health emergency responses and strengthen health systems.

The full issue is available online, where you can also find a related commentary on the studies by USAID.


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