How to design digital health tools for impact

There’s no shortage of digital health tools being developed and implemented globally. But to make an impact, developers need to consider the needs of community health workers — and ensure they have a seat at the table when such tools are being designed — while satisfying the requirements of decision-makers. That’s according to Dr. Ruchit Nagar, co-founder and CEO of Khushi Baby, a nonprofit based in Rajasthan, India, during a Devex event on the sidelines of the United Nations General Assembly. Khushi Baby started with a digital health application targeted at improving child immunization. Health workers access a child’s health record by using a tablet to scan the necklace that the child is wearing, which the Khushi Baby team uses to house the child’s medical record. This, among other things, helped health workers keep track of a child’s immunization record. After years of working on its digital health tool, the organization reached out to the state government of Rajasthan in India to see if they could scale across the state. That’s when they learned that there were numerous digital health apps, and that community health workers are dealing with several different programs. “We need to figure out how to fix the plumbing of the public health system, and that became our kind of refined vision and changed our approach to not just thinking about immunization or maternal and child health, but really thinking about the whole scale of the problem and how the community health worker needed to be centered around that problem,” Nagar said. In India, where they work, community health workers have to submit reports every month on about 50 activities across different health programs to get paid. And that takes them over 50 hours a month, just for paperwork, he said. The burden is so huge that data quality can suffer, and in turn, can have an impact on improvements that can be made on the ground. “What is needed, I think, is to have both that tree level view and forest level view, and better coordination and collaboration, both with policymakers [and] with development agencies, and having community health workers have a seat at the table,” he said. “Digital health tools can be enabling. They have tremendous potential to make impact. But that impact can only be unlocked if [health workers] don't also have to work on paper, if the data is integrated, and if they're properly incentivized,” he added.