Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Apr 22, 2024
Open Peer Review Period: May 21, 2024 - Jul 16, 2024
Date Accepted: Nov 11, 2024
(closed for review but you can still tweet)
Implementation of WHO SMART guidelines-Digital Adaptation Kits: Early lessons from Pathfinder Countries in Africa
ABSTRACT
Background:
The adoption of digital systems requires processes for quality assurance and uptake of standards to achieve universal health coverage. The World Health Organization (WHO) developed the Digital Adaptation Kits (DAKs) within the SMART Guidelines framework to reinforce standards and recommendations through digital systems, however, a systematic process is needed for implementing and ensuring impact of DAKs in country contexts.
Objective:
The paper details the structured process and stepwise approach used to customize the DAKs to the national program and digital context in five countries in Africa with diverse program guideline uptake and significant digital health investments: Ethiopia, Ghana, Malawi, Zambia, and Zimbabwe All these countries have existing digital systems, which have potential to be updated with the DAKs.
Methods:
A DAK assessment tool was developed and employed to assess guideline digitization readiness and opportunities for system uptake in each country. Multi-stakeholder teams were established to conduct the content review and alignment of the generic DAK to national guidelines and protocols through a series of stakeholder consultations, including stakeholder orientation, content review and alignment, content validation, and software update meetings.
Results:
Country adaptation processes identified requirements for national level contextualization and highlighted opportunities for refinement of DAKs. Quality assurance of the content during the content review and validation processes ensured alignment with national protocols. Adaptation processes also facilitated the adoption of the DAKs approach into sexual and reproductive health (SRH) national guidelines and strategic documents.
Conclusions:
Country experiences offered early insights into the opportunities and benefits of a structured approach to digitalizing primary health care services, and ultimately how this process can continuously be refined and sustained for country impact. Clinical Trial: N/A
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Copyright
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