Resilient Health Systems: So What, Now What?

During the development of the COVIDaction Resilient Health Systems (RHS) workstream and the selection of its nine awardees, health systems and innovation experts illuminated the opportunity offered by this work to investigate a critical learning question: what is the role of technology in building resilient health systems? Here are some of our reflections on this work.

The COVIDaction RHS theme is working with its portfolio of innovators to explore how their technologies will contribute to health system resilience. Understanding implementation challenges and testing assumptions is key to understanding this contribution to health systems. As a result, we started a learning journey together, one where innovators benefit from expert technical assistance and coaching support, learn from one another, and document practical lessons and evidence along the way.

So What? Developing an Overarching Learning Agenda

To start the process we had a kickoff session with each RHS awardee where we collaboratively articulated their long-term vision, near-term outcomes, and the steps along a causal chain that would yield these results. Then, we did a deep dive into the innovators’ key assumptions, priorities, and areas of uncertainty to draft key learning questions for each awardee.

A portfolio-level learning agenda was created by aggregating the innovators’ learning questions and identifying commonalities. By working together with the awardees and other technical experts to answer these questions, we hope to both provide them with support and guidance that is directly relevant to their scaling journey, as well as collect and share cross-cutting evidence and practical lessons that are relevant and helpful to the global innovation and health systems community.

The RHS Learning Agenda both unpacks the broader theme question around the role of technology in building health system resilience, and delves into the practical implementation questions these innovators face when seeking to scale their innovations and integrate them into the wider health system. Here are some of the questions we ask -

• How can innovative technologies be sustainably integrated into health systems at scale to improve health system resilience?
• What are the most important considerations and effective ways for innovators to develop a sustainable business model?
• How can innovators ascertain demand and increase the likelihood of uptake of their technology by end users?
• How can innovators identify and operationalise opportunities for sustainable integration within the broader health system?
• How can innovators ensure adequate data privacy and security for their end users and in accordance with local laws and regulations?
• How should innovators adapt to COVID-19 within their local contexts?
• How can technologies/platforms/apps be further developed and adapted to meet the needs of end users and other key stakeholders (e.g., for DHIS2 integration)?

Now What? Tackling the RHS Learning Agenda

The questions in the RHS Learning Agenda are complex, so we took a multi-pronged approach to seeking the answers.

We identified technical assistance providers across our network to help answer the thorniest learning questions. Our networks include experts in many facets of development across a diverse consortium, including University College London, Results for Development, Brink, AfriLabs, IMC Worldwide. For example, one of our awardees received technical assistance (TA) support to strengthen their level of engagement with the Ministry of Health in Mozambique, while another explored machine learning conversation design with a COVIDaction expert.

We then leveraged tacit knowledge of fellow practitioners through a series of peer-learning events. These events quickly grew to include not just the nine RHS awardees, but those from across the Frontier Technologies Hub too. Through peer learning activities that bring innovators together, COVIDaction can efficiently provide technical guidance and facilitate the sharing of knowledge and experience. During our first peer learning session, RHS innovators prioritised sustainable business models, end-user uptake, and health system integration as their priority topics to explore together. These topics aligned well with the portfolio-level questions in our learning agenda.

Finally, our COVIDaction RHS coaches documented practical and actionable lessons along this learning journey, and provided networking opportunities throughout. We recognised that several of the questions in our Learning Agenda would benefit from deeper expert consultation and a review of the existing evidence base to help inform the support that COVIDaction provides. To that end, our rapid research cycles filtering through resources already published about health systems resilience, uptake, and integration to situate the work of RHS awardees within the global landscape and develop practical tools that innovators and their partners can use.

We’ve got much more to share with you about our Rapid Research journey and we’re looking forward to sharing it with you so check back with our Medium page as we look to publish more findings and don’t forget that you can subscribe to our COVIDaction Friday Download newsletter or follow us on Twitter for more news.