Success of field level eHealth health
deployments are highly dependent on energy
Electrical grid has not expanded as rapidly as
access to cell signals.*
Even if access to electricity is in place the
choice of the right hardware is critical.
* Source: World Bank 2016
While Community Health Workers may own
cell phones, they may not be aware of all of
the extended features.
Adequate training and refresher trainings are
In the end, health workers have to see a
benefit for themselves if they are to continue
using an eHealth tool.
● Female Community Health
Volunteers (FCHVs) - Nepal’s
national network of
community health volunteers
● Health workers (nurses and
mid-level physicians) at all
primary health care facilities i
● Public Health Nurses,
Statisticians at the district
health office .
Digital health initiatives often cost much more
than originally planned. ……Surprise.
Local community must be engaged and “own”
the digital health initiative.
Government and/or the community must
have a plan for uptake by end of the pilot
Lots of eHealth pilots…very little evidence of
impact AND scale. (Especially at
It’s not just about the data.. It is about health
Coordination between health verticals.
Everybody wants their data, but what does the
Building an Evidence
• Build evidence base on health outcomes
• Full cost analysis, Cost per CHW, Cost per
patient, including hardware refresh and
• Pathways to scale: MoH, Partnerships,
• Push for Digital Principles: Design for scale,
Design for Sustainability, Reuse and
• Collaborate with government to build
• Data/SMS costs
• Work much more closely with groups solving
energy infrastructure issues in communities.
* From Principles for Digital Development found at
Working together to:
• Build an evidence base
• Implement digital principles + best practices
• Scale what we know works , develop protocols
• Pathways to care for NCDs
• Ecosystem information/background in country
• MoH and MoE collaboration.