Seven years after world leaders met to decide on the 17 Global Goals for Sustainable Development, countries around the world have been implementing digital technologies to both transform their economies and deliver on the goals. Digital Identity (ID) is one such technology. The ability to uniquely identify patients and community members is an indispensable part of providing quality and equitable health care services and ultimately, a critical part of achieving universal health coverage.

As the annual Global Digital Health Forum approaches, Palladium’s Director of Information Systems, Teddy Berihun, is keen to discuss how better health outcomes can be achieved through digital public infrastructure investments like digital ID.

Growing up in Ethiopia and then returning there to work at the United States Agency for International Development (USAID), Berihun was struck by the challenges associated with providing healthcare services without patient identification systems or national IDs. Patient records at health facilities were often paper based and attempts for digitisation lead to more stand-alone information systems that were unable to exchange data between or within the health facilities.

Berihun offers two recommendations for countries to drive interoperability between this digital public infrastructure and the health information systems that support universal health coverage.

1. Follow the money

“The biggest issue we have is that the funders have to recognise that these are not siloed investments,” Berihun says. “Funding for the health sector and for digital investments have to go hand in hand.” He explains that donors must understand the nexus of how the resources are allocated and prioritised and should not assume they are two separate investments.

2. Prioritise health in the digital transformation strategy

Social sectors, especially the health sector, often take a back seat when it comes to investments. When countries are drafting their digital transformation strategies, they must elevate the health sector to take advantage of that investment. “Right now, there is no one funding that space. The World Bank is usually funding digital IDs and USAID is funding digital health. How do we take advantage of the investment by the World Bank in this digital space to improve the digital ecosystem in health?”

But we already know that digitising national IDs doesn’t need to take decades to achieve.

Just three years ago, the digital infrastructure of the Ukrainian government was composed of dozens of registries and interfaces that did not work together. The Ministry of Digital Transformation was formed and focused on the building blocks that would become the foundation for the rest of the digital transformation: digital ID, eSignature, and data exchange.

They developed the Diia app, which has been especially vital in the past year to keeping citizens connected and enabling displaced persons to receive payments and assistance. By investing in this feature, digital transformation has enabled citizens to access healthcare needs in real-time. Although not intended for a wartime scenario, the app has proven crucial as millions of Ukrainians have fled their homes and have been unable to easily access government services due to location, physical handicaps, or poverty.

Other forms of biometric and algorithmic IDs are helping deliver better health outcomes. In Burundi, Data.FI, a USAID-funded project implemented by Palladium, in collaboration with a government-led technical working group, is scaling a biometric unique ID approach. This enables individual clients to have a unified record across all HIV service provision sites, improving the quality of data and services delivered. The biometric system will ensure more accurate counting of clients currently in treatment and clients experiencing an interruption in treatment.

With this information, government and partners can maximise available client tracing resources. Prior to deploying this digital solution, Data.FI undertook a risk assessment and actioned a series of risk mitigation strategies to ensure that the solution was ethically sound and would not compromise the information of people living with HIV in Burundi.

Ethiopia is now one of the latest countries to launch its digital ID system, and is preparing for a national rollout, aiming to reach 70 million Ethiopians with a digital ID by 2025. There’s strong governmental support for the program – Minister of Health Lia Tadesse noted in a keynote address at the National ID forum “We believe strongly that by working alongside the government stakeholder, development partners, higher education institutions, and the private sector, we will go faster in the implementation of digital health solutions and do so in a more sustainable way.”

At a minimum, healthcare providers and health system administrations need to know a patient's identity to access relevant medical and treatment histories to ensure that they are giving consistent and appropriate care, to track patients across different healthcare experiences to provide comprehensive care (including referrals). Patients also need documentation to prove enrolment in insurance programs or other safety nets that cover medical expenses.

As countries continue to rebuild their economies after the COVID-19 pandemic or, in Ukraine’s case, after the war, they will have a unique opportunity to introduce innovative digital solutions and improve health outcomes for their populations.

Eager to learn more? Join Teddy Berihun and other Data.FI colleagues at the Global Digital Health Forum, in Washington, D.C., and online December 5-7, 2022. Contact info@thepalladiumgroup.com for more information.