Strengthening Capacity and Accelerating Enterprise-Driven Digital Health Support

For over a decade, the Government of Ethiopia has invested in building an effective health information system (HIS) in collaboration with development partners. Following the reformation of Ethiopia’s traditional information system in 2008, a new model was adopted that aligns with the principles of integration, standardization, and simplification. The information revolution (IR) has seen significant achievements, such as standardizing the systematic collection, organization, analysis, and use of information for decision-making. As part of Ethiopia’s IR agenda, various efforts have been made to address HIS human resource and technology challenges. During the IR period, partners have supported digitizing and scaling up the HIS, with USAID devoting significant resources to HIS strengthening, and the Bill and Melinda Gates Foundation, global health initiatives, and global public-private partnerships, such as the Global Fund and Gavi, featuring HIS as a mainstay of their support to the health system. These technical and financial supports have been critical to the performance and success of the HIS to date.

However, the approaches of several implementing partners have also depleted the government’s capacities, leading to a detrimental dependence on external support. Most of the projects implemented through global initiatives are not fully owned by the government, raising questions about the sustainability of the results. Thus, our USAID-funded Digital Health Activity has intentionally integrated the goal of self-reliance into its planning, programming, and implementation processes to advance the capacity of the Government of Ethiopia to sustain the achievements of its collaboration with DHA.

To support progress on the Journey to Self-Reliance, DHA implements the following two main strategies:

Build the Capacity of Local Universities to Be HIS Centers of Excellence in Various Components of the Ethiopian Health Information System

DHA provides technical and financial support to Jimma and Mekelle universities to become centers of excellence in community HIS and eHealth architecture and interoperability, respectively. DHA strengthens the ability of the universities to implement capacity building, innovation, and research activities. DHA’s approach includes developing partnerships that link academia to program implementation, supporting operational research, and creating university-run HIS Centers of Excellence and demonstration sites. The broader goal is to improve collaboration between the health sector and universities, thereby helping to ensure the sustainability of results.

Private Sector Engagement in Digital Health

Given the vital role of the private sector in innovation and technology development, engaging this sector is essential to building a resilient digital HIS. DHA collaborates with the private sector to develop, implement, and support digital health tools and services in a cost-effective manner. To create and sustain small businesses that support grassroots technology and HIS implementation, DHA collaborates with local IT firms and supports the creation and evolution of social enterprises. DHA also has sub-contracts with two private IT firms to implement the electronic medical records system and maintain and support the HealthNet infrastructure.

DHA supports the establishment of ten youth groups as social enterprises; four are women-led. In addition, the Activity provided initial capital and market opportunities by outsourcing some HIS support at the woreda and health-facility level. DHA plans to engage additional firms in supporting the national HIS and to establish 40 social enterprises throughout the life of the Activity.

DHA prioritizes enduring partnerships with the Government of Ethiopia, local universities, and the private sector and believes its approach will foster a stable, self-reliant Ethiopian HIS.