Professional Documents
Culture Documents
Digital REACH Strategic Plan 2019-2028
Digital REACH Strategic Plan 2019-2028
INITIATIVE
STRATEGIC
PLAN
ϮϬϭϵͳϮϬϮϴ
© October 2018
Table of Contents
"Ɯ+&1&,+,#"/*0 Ǚ
/"3&1&,+0 Ǜ
(+,4)"!$"*"+10 ǜ
5" 21&3"2**/6 ǖǕ
+1/,!2 1&,+ ǖǞ
%"&$&1) +&1&1&3" Ǘǘ
&$&1) +!/1+"/11"0 ǗǛ
1/1"$& )&$+*"+14&1%+!/1+"/11"0 2ǜ
,/(01/"*ǖǿ +&1&1&3"+$"*"+1 ǘ5
,/(01/"*Ǘǿ ")1%/,$/**"0 Ǚǖ
,/(01/"*ǚǿ"!"/0%&-+!!3, 6 ǛǛ
,/(01/"*Ǜǿ1/1"$6+! +3"01*"+1 ǛǞ
,/(01/"*ǝǿ,/(#,/ " ǜǚ
,/(01/"*Ǟǿ1+!/!0+! +1"/,-"/&)&16 ǜǝ
%"1% ,/4/! 81
--"+!&5ǿ/1+"/11"&121&,++)60&0 ǖǕǗ
eLEARNING
Learning using electronic technologies to access educational curriculum outside of a traditional classroom.
ENVIRONMENTAL ENABLERS
Components of the ecosystem that support digital health, namely leadership and governance, strategy and
investment, the workforce, harmonisation of standards and technical interoperability, and legislation, policy,
and compliance.
FRAMEWORK
Conceptual structure guiding the Digital REACH Initiative components.
HEALTH PROVIDER/WORKER
The health professional whose key responsibility is the provision of healthcare services irrespective of their
organisations.
HEALTHCARE SERVICES
Prevention and management of disease, illness, injury, and other physical and mental impairments delivered
by healthcare provider to individuals through the healthcare system.
HEALTH SYSTEMS
All the activities whose primary purpose is to promote, restore, and maintain health, including the people,
institutions, resources, and policies that governments put in place to improve public health.
INITIATIVE
%"&$&1)"$&,+)01#/& +,**2+&16 ")1%ț Ȝ +&1&1&3"Ǿ+"401+!&+$,!64&1%!"Ɯ+"!
governance structure set up to oversee the creation of an enabling environment for digital health across the
EAC region and to implement digital health programmes to improve regional health in the EAC.
4
INTEROPERABILITY
%"&)&16,#!&ƛ"/"+1&+#,/*1&,+1" %+,),$60601"*0+!0,ƞ4/"--)& 1&,+01, ,**2+& 1"Ǿ"5 %+$"
!1Ǿ+!20"1%"&+#,/*1&,+1%1%0""+"5 %+$"!ǽ +1"$/1&,+)),4014,--)& 1&,+01,"5 %+$"
information, interoperability allows many.
mHEALTH
The delivery of healthcare services through mobile networks and devices.
STANDARDS
2)"0,/$2&!")&+"01%1"+02/" ,+0&01"+ 6&+1%" ,+1"51&+4%& %1%"6/"--)&"!ǽ2)"0,/$2&!")&+"01%1
"+02/" ,+0&01"+ 6&+1%" ,+1"51&+4%& %1%"6/"--)&"!ǽ
TRANSFORMATIONAL TECHNOLOGIES
A new technology that replaces an established technology, or an innovative technology that creates a
completely new industry.
TELEMEDICINE
%"20",#*,!"/+1" %+,),$&"01,!")&3"/%")1%0"/3& "01,-1&"+10+!1,# &)&11"/"*,1""5 %+$"+!
sharing of health information with healthcare providers within accepted jurisdiction.
5
Abbreviations
AMR Antimicrobial resistance LMICs Low and middle-income countries
EAACH East African Academy for NEAT [Telemedicine] Networks for East
Community Health African Tertiary [Healthcare
Services]
EAHRC East African Health Research
Commission NGO ,+Ȓ$,3"/+*"+1)/$+&01&,+
EAIDSNet East African Integrated Disease OpenHIE -"+ ")1% +#,/*1&,+5 %+$"
Surveillance Network
OpenMRS -"+"!& )" ,/!601"*
EAHC East African Health
Cloud PMO /,'" 1+$"*"+1ƛ& "
6
Acknowledgments
The concept for Digital REACH Initiative was created and commissioned by the East African Community (EAC)
through the East African Health Research Commission (EAHRC). In developing the Strategic Plan, EAHRC
/" "&3"!Ɯ++ &)02--,/1+!1" %+& )00&01+ "#/,*1%"Ǿ1%"+&1"!11"0$"+ 6#,/ +1"/+1&,+)
"3"),-*"+1ț ȜǾ1%"&))ǔ")&+! 1"0 ,2+!1&,+Ǿ&$&1).2/"Ǿ01&)" ")1%Ǿ1%", ("#"))"/
,2+!1&,+Ǿ+!1%"&1,) ,2+!1&,+ǽ%"!, 2*"+1404/&11"++!"!&1"!6&1)3"Ǿ + ǽ
The EAHRC would like to thank the multiple stakeholders who have been engaged throughout the process of
!"3"),-&+$1%" ,01"!&$&1) 1/1"$& )+ǽ-" &)1%+(0/""51"+!"!1,1%"#,)),4&+$ ,+1/&21,/0
for their contribution to the development of the costed Strategic Plan:
7
Foreword by Hon Amb Liberat
Mfumukeko EAC Secretary
General
Health is a central pillar for the prosperity of the citizens of the
East African Community (EAC). East African countries have been
cooperating on matters of health for over a hundred years,
denoting the value that health brings to socioeconomic prosperity.
In its determination for regional integration, the EAC has opened
borders to facilitate the free movement of people, services, and
20&+"00ǽ%&0#/""*,3"*"+101+!01, ,+1/&21"0&$+&Ɯ +1)61,
the socioeconomic agenda, but it requires robust health systems
and collaboration across the region. This millennium the world Hon Amb Liberat Mfumukeko
has witnessed how Information and Communication Technology EAC Secretary General
ț Ȝ +/"3,)21&,+&0"0, &," ,+,*& 0Ȁ1%"!")&3"/6,#Ɯ++ &)
0"/3& "0&+01#/& %00&$+&Ɯ +1)6&*-/,3"!1%/,2$%1%"20",#!&$&1)1" %+,),$6ǽ &3"+1%"-,4"/,#
the technology, the EAC has taken another step, to integrate technology into the health sector using digital
health, as a way of strengthening regional healthcare services. In realising the value of digital health, the East
African Health Research Commission (EAHRC), an institution of the EAC, established to guide the provision of
"3&!"+ "Ȓ0"!%")1%0"/3& "0Ǿ ,+ "-12)&0"!+! ,,/!&+1"!1%""ƛ,/11,!"3"),-1%"&$&1)"$&,+)
East African Community Health (Digital REACH) Initiative.
Digital REACH is an implementation science-led initiative. The Initiative will develop and implement regional
health programmes that require economies of scale and regional capabilities which the EAC is uniquely
-,0&1&,+"!1,!!/"00ǽ%" +&1&1&3"&0!"0&$+"!1, ,*-)"*"+1Ǿ&*-/,3"Ǿ+!01/"+$1%"+ ,2+1/6Ȓ0-" &Ɯ
work in digital health and has been developed in collaboration with Partner States to ensure alignment with
national strategies and priorities. The EAHRC will coordinate all stakeholders to bring about the digital health
best practices into the mainstream of the regional health system.
This initiative has come at the right time. A time when the EAC is grappling with multiple health challenges
including the threat of disease outbreaks, the increasing impact of non-communicable diseases, and emerging
infectious diseases. Through the Digital REACH Initiative, we are optimistic that health professional training will
improve, continuity of care for EAC citizens will not be hampered by the movements of people across borders,
and that communities in remote areas will be able to access specialised health services. In addition to this, the
generation and use of data by the region will empower the EAC to establish a health system that is evidence-
based and that allows citizens to take greater ownership of their own health.
The completion of this costed Digital REACH Initiative’s Strategic Plan is an implementation of the priorities for
health investment that were approved by the Heads of all the EAC Partner States. The Digital REACH Initiative
marks a new era in health for EAC, and the world at large.
Sincerely,
8
Foreword by Professor Gibson
Kibiki, Executive Secretary
of the EAHRC
A healthy population is essential for the prosperity of the East
African Community (EAC). Sustainable development is built on a
productive society that is able to thrive in a healthy region, free
,#%")1%1%/"10Ǿ4&1%".2&1)"+!"ƛ" 1&3" /"ǽ01#/& +
leaders and citizens have shown determination to construct a
powerful and sustainable East African regional economic and
political bloc that allows free movement of people, services, and
Professor Gibson Kibiki, MD, MMed, PhD goods. Strengthening healthcare provision at all levels of the
Executive Secretary – East African health system, from national all the way to the regional level,
Health Research Commission is critical to regional health security and to facilitate access to
quality healthcare across the region.
Technology is an important part of this vision. There is a clear opportunity for East Africa to utilise digital
1" %+,),$&"01,!3+ "1%"%")1%+!-/,0-"/&16,#1%"/"$&,++!&10 &1&7"+0&+4601%1/"*,/""ƛ" 1&3"
+!"ƛ& &"+1ǽ%&)"/1+"/11"0%3"" %*!"-/,$/"00&+&+ ,/-,/1&+$1" %+,),$6&+1%"&/-/,3&0&,+
of healthcare, there is work to be done so that all EAC countries can reap the rewards.
ƞ"/0"/&"0,#01/1"$& -)++&+$!&0 200&,+0 ,,/!&+1"!61%"01#/& + ")1%"0"/ %,**&00&,+
ț ȜǾ1%"/1+"/11"0,ƛ& &))6/" ,**"+!"!,+ǗǗ+! "/2/6ǗǕǖǝ&+*-)Ǿ$+!1%11%"
region harness the potential of digital technology by scaling uptake and utilisation of digital technologies and
solutions for improved health service delivery and health outcomes. The recommendation was approved as
%")1%-/&,/&16#,/&+3"01*"+161%" "!0,#1%"0&5/1+"/11"0!2/&+$1%" ,&+1 "!0,#1%"
11""1/"1,+ +#/01/2 12/"+! ")1%"3"),-*"+1,+Ǘǘ/! "/2/6ǗǕǖǝ&+*-)Ǿ$+!ǽ
The Digital Regional East African Community Health Initiative (Digital REACH Initiative) is the vision for
realising the recommended priority. This strategic plan builds on the Digital REACH Initiative roadmap, which
40--/,3"!61%"*&+&01"/0,#%")1%,#1%"0&5/1+"/11"0!2/&+$1%"ǖǚ1%/!&+/6""1&+$,#
1%"" 1,/),2+ &),#&+&01"/0,# ")1%#/,*ǖǘ1%1,ǖǜ1%,3"*"/ǗǕǖǜ&+*-)Ǿ$+!ǽ%"
document details the approach to take this Initiative forward, along with further detail on the activities and
implementations that will realise its mission of a strong digital health ecosystem in East Africa.
I would like to thank the representatives of the EAC Partner States, EAHRC Commissioners, EAHRC National
, ),&+10ȉ"5-"/10Ǿ%")1%"5-"/10Ǿ +!" ")1%$,3"/+*"+1,ƛ& &)0#/,*/1+"/11"0Ǿ+,+Ȓ
governmental organisations, and development partners for their valuable inputs and support to the EAHRC
1%/,2$%,211%&0-/, "00ǽ%"6%3"""+"00"+1&)1,!"3"),-&+$1%&0&++,31&3"ǾƜ/01Ȓ,#Ȓ&10Ȓ(&+!01/1"$61%1
02--,/101%" +1"$/1&,+$"+!1,4/!0Ȋ+"",-)"Ǿ+" ")1%601"*ȋ1(&+$/"$&,+)-"/0-" 1&3"
in advancing technology for health.
Sincerely,
Professor Gibson Kibiki, MD, MMed, PhD
5" 21&3"" /"1/6Ȕ01#/& + ")1%"0"/ %,**&00&,+
9
A prosperous and healthy
region is one in which
Executive Summary each EAC Partner State
THE DIGITAL REGIONAL EAST AFRICAN can participate fully in
COMMUNITY HEALTH INITIATIVE trade and industry within
A prosperous and healthy region is one in which each EAC an environment that
Partner State can participate fully in trade and industry within an sustains and nourishes
environment that sustains and nourishes its people, free of health its people, free of health
1%/"10+! -)",#-/,3&!&+$2+&3"/0) /"1,))ǽ-"+,/!"/0
and the continuous movement of people underscore the need for a
threats and capable of
regional approach to track and respond to regional health priority providing universal care
needs, while laying the groundwork for a robust and sustainable to all.
regional economy. Technology can help to strengthen regional
health systems by bolstering the access, use, and performance of
health services.
The Digital Regional East African Community Health (Digital REACH) Initiative will be a new, ground-breaking
Initiative within the East African Community (EAC) that will implement regionally-focused, interoperable
information and communications technology (ICT) across all dimensions of the health sector in East Africa,
4%&)")"3"/$&+$"5&01&+$ ,2+1/6!&$&1)%")1%&+3"01*"+10ǽ 1%01%"-,4"/1,02--,/12+&3"/0)%")1%
,3"/$"6&*-/,3&+$%")1% /"!")&3"/6 /,001%"/"$&,+Ǿ1/+0#,/*&+$1%")&3"0,#,3"/ǖǛǕ*&))&,+-",-)"ǽ
The Initiative has been developed based on collaboration and inputs from representatives of the EAC Partner
11"0+!&002--,/1"!6))/"0&!"+10,#1%"Ǿ0-" &Ɯ ))61%""-2)& ,#2/2+!&Ǿ1%""-2)& ,#"+6Ǿ1%"
Republic of Rwanda, the Republic of South Sudan, the United Republic of Tanzania, and the Republic of Uganda.
Each of the Digital REACH workstreams described in this document support the EAC’s integration agenda
,#Ȋ+"",-)"Ǿ+" ")1%601"*ȋǽ%&002--,/1,#/"$&,+)&+1"$/1&,+&04%1*("01%"&$&1)
Initiative unique and is why it has received the highest levels of political support in the EAC region.
10
VISION AND MISSION
The Digital REACH Initiative is guided by the following vision and mission:
&0&,+ǗǕǗǝ
Interconnected health systems
for a healthy and prosperous East Africa
&00&,+11"*"+1
Maximise the power of digital health in East Africa by ensuring an
enabling environment and by implementing scaled, coordinated,
transformational, and innovative approaches.
-1&*&0"1%"/"3"+1&,+Ǿ&$+,0&0Ǿ+!/"1*"+1,#/&,/&16 ")1%,+!&1&,+0
Improve quality, access, and continuity of care across EAC countries for communicable and non-
communicable diseases.
*-/,3" ")1%,/("/!2 1&,++!/&+&+$
Provide standardised and recognised healthcare training and capacity building for pre and in-service
health workers.
*-/,3"2--)6%&+ƛ& &"+ 6
Take advantage of economies of scale for dealing with suppliers and vendors that impact the region.
+ +%+ "2)& ")1%!2 1&,++!4/"+"00
Improve and support community health-related knowledge and provide patient education for
preventive care, and behavior change.
2--,/1+&3"/0) "001, ")1% /"
Enhance social health protection in the region and the portability of health insurance.
*-/,3"&0"0"2/3"&))+ "+!"0-,+0"
Build capacity and improve regional disease surveillance to prevent, detect, and respond to infectious
diseases, emergencies, and outbreaks.
-1&*&0" 2*+"0,2/ ")), 1&,++!+$"*"+1
-1&*&0"%")1%4,/("/*,&)&01&,++!# &)&11"%")1%4,/("/(+,4)"!$"0%/&+$ /,001%"/"$&,+0ǽ
,+&1,/,-2)1&,+ ")1%1120
Track regional priority health indicators and promote use of health research to support health policies
and further the regional health agenda.
The Initiative has been structured into nine workstreams. They will run in parallel and support one another,
01/1&+$4&1%0")" 1-/&,/&16 1&3&1&"0+!"5-+!&+$&+1,,1%"//"0,#4,/(0$&+0/"*!"+!/"0,2/ "0
become available. Implementation of workstreams will be staggered in line with these priorities. The Health
/,$/**"0,/(01/"*4&))#, 20,+1%"&*-)"*"+11&,+,#0-" &Ɯ Ǿ01/1"$& %")1%-/,$/**"0Ǿ4%&)"
the seven Enabling Environment Workstreams will focus on the creation of an enabling environment for digital
health that can be shared across Partner States and that supports health programme implementations. An
,3"// %&+$4,/(01/"*#,/ +&1&1&3"+$"*"+14&)))"!+!*+$"1%" +&1&1&3"ǽ02**/6,#1%"!&ƛ"/"+1
workstreams can be found below.
11
INITIATIVE MANAGEMENT
HEALTH PROGRAMMES
Regional, on-the-ground, health service delivery
programmes driven by digital technology
INFRASTRUCTURE SERVICES AND LEADERSHIP STRATEGY AND Ǿ STANDARDS
APPLICATIONS AND INVESTMENT Ǿ AND INTER-
Create the ADVOCACY COMPLIANCE Build health
technical global Identify and Negotiate with worker
goods that support the Advocate, "51"/+) 1,/0 Develop the professional
support all other development socialise, lay the on behalf of the policies and capacity across Identify and
workstreams of reusable and groundwork, region to realise guidelines the region to develop
and provide interoperable remove political economies needed, and facilitate human common
regional tech 0,ƞ4/" obstacles, and of scale work to gain their resource sharing guidelines,
support services and garner political and greater adoption across and improve standards, and
applications support for "ƛ& &"+ &"0 Partner States care protocols to lay
built for regional implementations the foundation
and national #,/+"ƛ" 1&3"
use regional
digital health
ecosystem
Much investment has already been made across a number of these workstreams by Partner States and
!"3"),-*"+1-/1+"/0ǽ+"/)60 +,#4%1)/"!6"5&010 /,001%"/"$&,+4&))" //&"!,21,+ "" %
4,/(01/"*&00"12-Ǿ1,2&)!,++!02--,/1"5&01&+$&+&1&1&3"0+!)"/+#/,*-/"3&,20&*-)"*"+11&,+0ǽ
IMPLEMENTATION APPROACH
("6!&ƛ"/"+1&1,/,#1%"&$&1) +&1&1&3"&01%1&11("0+"3&!"+ "Ȓ0"!--/, %Ǿ&*-)"*"+1&+$
targeted regional digital health programmes while also creating the supportive foundations that will make
those programmes successful. This is a ground-breaking dimension of this Initiative. It makes it possible to not
only identify evidence of impact, but also to apply that evidence in a way that structures and drives work on
the enabling environment and subsequent health programme implementations.
%"0" 1&,+"),4-/,3&!"0+,3"/3&"4,#1%"!&ƛ"/"+14,/(01/"*0+!1%"&!"+1&Ɯ"!-/&,/&16 1&3&1&"0
for each, selected based on input from EAC and Partner States, the feasibility and potential impact of
implementation, the critical dependencies of these activities to other areas of works, and the importance of
striking a balance between building foundations and establishing quick-wins towards progress and impact.
12
ǖǿ
,/(01/"*ǖǾ1%" +&1&1&3"+$"*"+14,/(01/"*Ǿ4&))%,)&01& ))6$2&!"Ǿ ,,/!&+1"Ǿ+!*5&*&0"1%"
impact of the other eight Initiative workstreams. It aims to -/,3&!"01/1"$& ,/$+&01&,+)!&/" 1&,+ /,00
1%""+1&/" +&1&1&3"Ǿ /"1",-"/1&,+)"ƛ& &"+ &"0Ǿ!/&3"4/"+"00,#1%" +&1&1&3"1%/,2$%2+&Ɯ"!
*"00$&+$+!-2)& /")1&,+0, and "+02/" ,*-)&+ "4&1%/"$2)1&,+0+!$/+1/".2&/"*"+10. It will
coordinate across all other workstreams, making sure all are working towards the achievement of the vision
and mission of the Initiative.
%"/,'" 1+$"*"+1ƛ& "țȜ4&))/"0&!"&+1%&04,/(01/"*+!4&))"1%" "+1/)&0"!*+$"*"+1
organisation of the Digital REACH Initiative, providing leadership and coordination across all other
4,/(01/"*0ǽ%"#2))1/1"$& )+"5-)&+0&+#2/1%"/!"1&)%,41%&04&))"0"12-+!*+$"!ǽ5*-)"
priority activities include:
1.1 Set up the appropriate entity and structures to lead and manage the Initiative and provide ongoing
1.8 Share and duplicate best practices among Partner States and other regional organisations
{
PARTNERS’ FORUM
(Partner States, EAC Organs and
Board of Directors Institutions, development partners, and
the private sector)
(Partner States, EAC Organs and Institutions,
development partners, and the private sector)
Digital REACH Initiative PMO TECHNICAL ADVISORY GROUP
(Executive Director and the Digital REACH Directorate) (Local and international health and
technology experts)
3"/0&$%1 /,00))1%"/,/(01/"*0
Workstreams will have their own Workstream Lead, teams, management structure, and budget and report to the
ǽ,/(01/"*Ȓ0-" &Ɯ -/1+"/0%&-04&))"*+$"!11%"4,/(01/"*)"3")
HEALTH PROGRAMMES
INFRASTRUCTURE SERVICES AND LEADERSHIP STRATEGY AND Ǿ STANDARDS
APPLICATIONS AND INVESTMENT Ǿ AND INTER-
ADVOCACY COMPLIANCE
13
Ǘǿ
%" ")1%/,$/**"0,/(01/"*4&))#, 20,+&*-/,3&+$%")1% /"&+1%"1%/,2$%0-" &Ɯ /"$&,+)
!&$&1)%")1%&*-)"*"+11&,+0ǽ3"/1%" ,2/0",#1%" +&1&1&3"1%&04,/(01/"*4&)),3"/0""+!&*-)"*"+1
+&+"%")1%-/,$/**"0, as detailed below. Not all implementations will start at once; some have been
&!"+1&Ɯ"!0-/&,/&1&"061%"Ǿ4%&)",1%"/04&))"01/1"!,+ "1%" +&1&1&3"&+2+!"/46+!/"0,2/ "0
are available.
The Health Programmes workstream provides implementation oversight, M&E, and coordination across all
Health Programmes implemented in this workstream.
TELEMEDICINE REGIONAL EAST AFRICAN ACADEMY EAC REGIONAL THE EAST AFRICAN
EAST AFRICA DISEASE FOR COMMUNITY HEALTH CLOUD (EAHC)
AFRICAN TERTIARY Ǿ HEALTH (EAACH) (RHO)
(NEAT) HEALTHCARE CONTROL AND Set up the EAHC to
SERVICES RESPONSE Establish a community Create a Regional support other health
(READSC,R) training and learning ")1%0"/31,/6 programmes, inform
Implement platform to improve to facilitate access health research, and to
telemedicine to link Design a health alert health education and to data, information, better understand health
East African Centres and early warning awareness, and train analyses, and trends and outcomes in
,#5 "))"+ "+! system for disease frontline workforce in the empirical evidence the region.
specialised health care outbreaks and community leveraging for monitoring and
facilities across the epidemics in the digital technology. evaluating regional
region. region. health.
Key
REGIONAL HEALTH REGIONAL TECHNICAL INNOVATIONS IN
SERVICES MANAGEMENT AND ASSISTANCE FOR HEALTH OPTIMISE THE PREVENTION,
DIAGNOSIS, AND TREATMENT OF
PEER LEARNING DIGITAL HEALTH PRIORITY HEALTH CONDITIONS
by sharing data in priority reusable assets in States in areas &*-/,3"!"ƛ& &"+ &"0+! OPTIMISE HUMAN RESOURCE
cross-border communities the region through that support the "ƛ" 1&3"+"00&+-2)& ALLOCATION AND MANAGEMENT
and supporting portability the implementation implementation health. IMPROVE DISEASE SURVEILLANCE
AND RESPONSE
of health insurance. of knowledge of Digital REACH IMPROVE SUPPLY CHAIN
management Initiative. EFFICIENCY
+ + +
,/(01/"*ǘȒǞǿ/"1&+$++)&+$+3&/,+*"+1
+",#1%"*',//,)"01%"&$&1) +&1&1&3"4&))-)6&+1%"/"$&,+&01, /"1"+!02--,/11%""+)&+$
environment for digital health, to ensure sustainability and scale. An enabling environment can also facilitate
entry of the private sector and development partners for the provision of sustainable digital health systems
and services. Part of the Digital REACH Initiative strategy is to create an ecosystem that is attractive to large
companies as well as small, local entrepreneurs so that digital health can grow as an industry. It will do this by:
• Directly engaging and partnering with the private sector to implement workstream activities (e.g., through
PPPs)
• Creating an enabling environment that will attract and stimulate investment in the region (e.g., through
supportive regulatory framework and policies)
,/(01/"*0ǘȔǞ4&))4,/(1, /"1"1%&0"+)&+$"+3&/,+*"+1ǽ %4,/(01/"*4&))-)6("6/,)"
in stimulating private sector investment. The Strategy and Investment workstream will lead the overall
14
engagement of the private sector but it will be the responsibility of each workstream to identify areas where
the private sector can be brought in and engaged to support their activities.
ǘǿ
3.1 Build the East African Health Cloud (EAHC) and set up a regional support team to maintain it over time
ACTIVITIES
to enable real-time storing, capturing, analysing, and retrieving of health data on priority diseases and
PRIORITY
4.1"3"),-!" &0&,+Ȓ02--,/11,,)02&)1&+1,+"4,/"5&01&+$0601"*01,02--,/1%")1%4,/("/0!")&+$4&1%
cases of outbreaks and health emergencies (e.g., outbreak alerts, an alert to notify the regional body, care
PRIORITY ACTIVITIES
Digital REACH Initiative and work with Strategy and Investment team for potential group pricing discounts
ǚǿ
15
5.1 Advocate for agreement on data sharing and storage in a regional cloud
PRIORITY ACTIVITIES 5.2 Advocate for regional agreement on health insurance portability for all EAC citizens
across all EAC Partner States to reduce data collection and reporting burden for health workers
5.5 Advocate for a holistic approach to use of digital technologies and solutions in the health sector within the
EAC region
This workstream will make use of skilled business analysts and negotiators to !"3"),-1%"20&+"00 0"0
that will be used to engage with the private sector and the development community on behalf of the EAC in
order 1,/")&0"" ,+,*&"0,#0 )"+!$/"1"/"ƛ& &"+ &"0.
This workstream will also work to engage with the private sector to develop an investment mechanism to
"5-+! ,**2+& 1&,+&+#/01/2 12/"&+/"04&1%),4 ,++" 1&3&16+!1,+"$,1&1"+!01/2 12/"-2)& Ȓ
private partnerships (PPPs) that can be utilised across the Initiative. Priority activities are:
6.1 Conduct feasibility assessment, develop business case, and identify opportunity for public private
PRIORITY ACTIVITIES
partnerships (PPPs) for the build and maintenance of the EAHC and NEAT
6.2 Conduct business case assessments and use for negotiating agreements with mobile network operators
negotiation for reduced pricing with suppliers to reduce cost of healthcare for providers and patients
7.1 "0&$+-,)&
6+!)"$&0)1&,+/,2+!/"*,1"!1%,01&+$ț&+ )2!&+$!1-/&3 6+! ,+Ɯ!"+1&)&16
PRIORITY ACTIVITIES
16
ǝǿ
The overall goal of this workstream is to 2&)!1%" - &16,#%")1%4,/("/0&+1%"/"$&,+ to facilitate
human resource sharing across countries, strengthen patient care and outcomes, and overcome shortages of
skilled health workers. The workstream will work in close collaboration with professional bodies and academic
&+01&121&,+0+!4,/(4&1%&+"5&01&+$/"$&,+)#/*"4,/(0ț"ǽ$ǽǾ01#/& +2)&Ɯ 1&,+0 /*"4,/(#,/
Higher Education) and forums. The workstream will promote eLearning and support training institutions in
01#/& ǽ 104,/(4&))&+ )2!" ,,/!&+1"!/"3&"4,#"5&01&+$!&$&1)%")1%1/&+&+$&+1%"/"$&,++!1%"
harmonisation across Partner States of minimum standards in teaching curricula, which include the use of
digital tools and ICT as well as data sharing and security. Priority activities are:
8.1 Work with universities and training institutions to harmonise and make available eLearning course content
PRIORITY ACTIVITIES
digital health and telemedicine for healthcare professionals and health IT professionals
8.3 Work with universities to embed digital learning methods in medical and healthcare worker training
emergencies)
9.1 Develop data sharing, security, and management guidelines, protocols, and standards
9.2 Create a regional data dictionary, mapped to international standards, and supporting governance process,
PRIORITY ACTIVITIES
17
THE PATH FORWARD
%"-2/-,0",#1%"01/1"$& -)+&01,ǖȜ&+#,/*&*-)"*"+11&,+-)+0#,/" %4,/(01/"*+!02--,/1
foundational decisions that need to be made for each one, including the selection of appropriate partners,
and 2) support resource mobilisation with potential partners and funders. The long-term success of the Digital
+&1&1&3"4&))/")6,+1%"3&)&)&16+!02--,/1,#3/&"!/"0,2/ "0ǽ &3"+1%"0 ,-"+!1&*")&+",#
this initiative it is understood that mobilising the necessary resources for implementation will be an ongoing
+! ,)),/1&3"-/, "00ǽ ,,!-/1+"/0%&-/".2&/"0+,-"+*&+!*,+$$,3"/+*"+10Ǿ!"3"),-*"+1
partners, and the private sector alike, and it is in this spirit that resource mobilisation for the Digital REACH
+&1&1&3"4&))" ,+!2 1"!ǽ 1&0"5-" 1"!1,"+&1"/1&3"-/, "00Ǿ1%14&))/".2&/"1%"&!"+1&Ɯ 1&,+,#
complementary priorities with potential partners. These materials provide the EAC and Partner States with
1%"*1"/&)01,*,&)&0"1%"/"0,2/ "0+" "00/61,)2+ %1%"&$&1) +&1&1&3"&+"/)6ǗǕǖǞǽ
LOCAL SERVICE PROVIDERS AND CIVIL SOCIETY
GROUPS 2--,/1&+/"01%102--,/1(+,4)"!$""5 %+$"1%/,2$%
Support in the areas that align with their own agenda in-kind support (e.g., research support, participation in
and goals through in-kind support (e.g., technical !3&0,/6,!&"0Ǿ02--,/14&1%!3, 6"ƛ,/10Ȝ
assistance, participation in advisory bodies, support
4&1%!3, 6"ƛ,/10Ȝ
CONCLUSION
/"1"!+!,4+"!61%"Ǿ1%&0&01%"Ɯ/011&*"+#/& ++&,+"$&,+) ,+,*& ,**2+&16țȜ
has come together to create an ambitious and coordinated approach to digital health that is priori-tised for
investment by all Presidents of the Partner States. A successful implementation of the Digital REACH Initiative
4&))#2))602--,/11%"ȉ0&+1"$/1&,+$"+!,#Ȋ+"",-)"Ǿ+" ")1%601"*ȋǽ
18
Introduction
D igital health is a way of augmenting health services with digital technologies. Technology can strengthen
healthcare services by bolstering the access, use, and performance of health services in pursuit of improved
%")1%,21 ,*"0ǽ 1 +02--,/1"11"/%")1% /"6&*-/,3&+$1%""ƛ& &"+ 6+!"ƛ" 1&3"+"00,#%")1% /"
delivery services, creating a more skilled health workforce through targeted and relevant training and capacity
building, supporting research through the availability and access to better and higher quality evidence, and
improving governance using data to support policies and decision making. Digital technologies can also support
health security by helping authorities prevent, track, and respond to health threats, such as infectious diseases
and epidemics that can rapidly spread across borders.
Currently, the EAC region has a variety of digital health implementations amongst Partner States (Burundi,
Kenya, Rwanda, South Sudan, Tanzania, and Uganda) addressing access to health services and improving health
,21 ,*"0#,/ &1&7"+0ǽ /"1!3+ "0/""&+$*!"Ǿ6"11%"/"/"*+6,--,/12+&1&"01, 1/"$&,+))6Ǿ+!#,/
the EAC to lead and coordinate across Partner States, development partners, and private companies to improve
%")1%,21 ,*"06&*-)"*"+1&+$0201&+)"!&$&1)1" %+,),$&"01%1"5-+!1%"460-1&"+100""(.2)&16
care wherever they are in the EAC
The Digital Regional East African Community Health (REACH) Initiative is seizing that opportunity. The Initiative
provides a foundation for coordinated action. It builds upon collective momentum and understanding to create a
regional strategy for digital health which allows the EAC Partner States to:
• --)6 /,001%""+1&/"%")1%0" 1,/#,/1%"&*-/,3"*"+1,#%")1%,21 ,*"0+!1%""+"Ɯ1,#-1&"+10
and the general population, across East Africa
• "3"/$""5&01&+$00"10+!01/"+$1%0 /,00 ,2+1/&"0Ǿ)),4&+$/1+"/11"01,1("!3+1$",#
advances in other countries for sustainable development
• Harmonise standards and policies to support the free movement of services and people, allowing access to
and continuity of care across the region
• "+"Ɯ1#/,*" ,+,*&"0,#0 )"4&1%/"$/!01,1%"&+3"01*"+1&++!*&+1"++ ",#0%/"!&+#/01/2 12/"Ǿ
resources, and applications
• Increase bargaining power with third parties like private companies and development partner organisations
by negotiating as one and speaking with one regional voice on strategic digital health issues
• 5&*&0"!"3"),-*"+1-/1+"/+!-/&31"Ȓ0" 1,/ ,,/!&+1&,++!&+3"01*"+1Ǿ/"!2 &+$2++" "00/6
!2-)& 1&,++!#/$*"+1"!&*-)"*"+11&,+0Ǿ+!*5&*&0&+$1%"&*- 1,#"51"/+)&+3"01*"+1
• Enhance sustainability of health programmes and reduce dependence on development partner funding
This strategic plan builds on the &$&1) +&1&1&3",!*-Ǿ4%& %40--/,3"!61%"0&5%"!0,#011"
!2/&+$1%"ǖǚ1%/!&+/6""1&+$,#1%"" 1,/),2+ &),#&+&01"/0,# ")1%#/,*ǖǘ1%1,ǖǜ1%,3"*"/
ǗǕǖǜ&+*-)Ǿ$+!ț0""--"+!&5Ȝǽ 1-/"0"+101%"1"+Ȓ6"/1/1"$& )+#,/&*-)"*"+1&+$1%"&$&1)
REACH Initiative and will allow the EAC to pursue the resources necessary to launch the Initiative and plan for
#2))Ȓ0 )",-"/1&,+06"/)6ǗǕǖǞǽ 1&0#,/4/!Ȓ# &+$!, 2*"+11%1!"0 /&"0$,)0Ǿ("6*&)"01,+"0Ǿ01/1"$&
approaches, considerations for implementation, and organising principles for advancing digital health in the EAC.
To realise the EAC’s goal of becoming a globally competitive, upper-middle-income region with well-educated
+!%")1%6%2*+/"0,2/ "01%1-/,3&!" "001,%")1%0"/3& "0#,/"3"/6 &1&7"+6ǗǕǚǕǾ01#/& +
governments and their partners must continue to promote and invest in resilient health systems and coordinated
digital health programmes. The Digital REACH Initiative Strategic Plan will serve as a blueprint to that future.
19
&++,31&,+0)&("1%"*"0*,&)"*,+"60601"* %&"3&+$02 "00&+&+ /"0&+$-",-)"ȉ0 "001,Ɯ++ &)
0"/3& "0ǽ ,3"/+*"+10&+1%"/"$&,++!,/$+&01&,+002 %01%" /"0""(&+$1,)"3"/$"1%"-,4"/,#
digital technology through initiatives like Transform Africa.
)1%,2$%1%"/"/"&+%"/"+1!&ƛ"/"+ "0&+1%"%")1%0" 1,/Ǿ"0-" &))60&1/")1"01,1%" ,*-)"5&16,#1%"
" ,0601"*+!&002"0/")1"!1,!1-/&3 6+! ,+Ɯ!"+1&)&16Ǿ!&$&1)%")1%0,)21&,+0+,+"1%")"00%3"
the potential to revolutionise service delivery and access to information. In Africa and other developing
regions, digital health solutions deployed over the last decade have demonstrated promising results in patient
"%3&,/+!%")1%0601"*#2+ 1&,+&+$ǽ ,/"5*-)"Ǿ+1&,+4&!"-/,$/**" ))"!,*,++" 1&+,21%
#/& 1%10"+!0&+#,/*1&,+1,"5-" 1&+$*,1%"/0%0/" %"!,3"/*&))&,+4,*"+Ǿ4&1%"/)6/"02)10
0%,4&+$1%1"+/,))"!*,1%"/04%,/" -,0&1&3"%3"%&$%"//1"0,#+1"+1)3&0&111"+!+ "1%+1%,0"
who do not.21%"/0,)21&,+0%3"&*-/,3"!-1&"+1 "001,1")"*"!& &+"Ȓ0"!0"/3& "0ț0&+"+63 ) and
%")1%4,/("/0ȉ&)&161,1/ (02--)&"0,#*"!& 1&,++!,1%"/ ,**,!&1&"0ț#,/"5*-)"Ǿ&++7+&4 ). In
*+6 0"0Ǿ0,)21&,+0 +!!/"00!"Ɯ &10&+),4+!*&!!)"Ȓ&+ ,*" ,2+1/6ț Ȝ%")1%0601"*0Ǿ&+ )2!&+$
shortages of trained workforces and poor health infrastructure.
Although a stronger evidence base for the long-term impact of digital health is needed, these initial indicators
2&)!1%" 0"#,/&+3"01*"+16$,3"/+*"+10Ǿ!"3"),-*"+1-/1+"/0Ǿ+!,1%"/" ,0601"* 1,/0ǽ"1)"00,+0
from these implementations underscore the fact that obtaining a return on these investments requires
strengthening the ecosystem in which solutions operate. Digital solutions that provide real-time decision
02--,/10"/3& "0#,/%")1%4,/("/011%"-,&+1,# /"Ǿ#,/"5*-)"Ǿ*6")"00"ƛ" 1&3"&#!1+"14,/(0
/"+,1#2+ 1&,+&+$ǽ%"0"3"+ ,*-,+"+10,#1%" Ȓ " ")1%,,)(&1ǚ , which include areas such as a
country’s policy environment and physical infrastructure, provide a blueprint for political and digital health
leaders to create an enabling environment in which digital health can thrive.
&3"+1%"&*-,/1+ ",#1%"0"")"*"+10+!1%"0 )",#1%"&+3"01*"+1+""!"!&+1%"*Ǿ1%" +-)6
-,0&1&3"/,)"&+!3+ &+$!&$&1)%")1%&+1%"/"$&,+ǽ /,*"+ ,2/$&+$%/*,+&01&,+,#01+!/!01,1%"
development of shared infrastructure and the deployment of regional solutions, cooperation by Partner States
&+1%"&$&1) +&1&1&3" +%")--/,*&0&+$0,)21&,+03,&!1%"-&1#))0"5-"/&"+ "!")0"4%"/"Ȕ4%&)"
%/+"00&+$1%"/"0,2/ "0+!"5-"/&"+ "+" "00/6#,/0 )"ǽ
1
KWWSVZZZJVPDLQWHOOLJHQFHFRPUHVHDUFK"¿OH FHIEGIGFHE GRZQORDG
http://www.health.gov.za/index.php/mom-connect
KWWSVZZZLWXLQWQHWZVLVVWRFNWDNLQJSURMHFWV3URMHFW'HWDLOV"SURMHFW,G
KWWSVZZZMVLFRP-6,,QWHUQHW5HVXOWVDUWLFOHGLVSOD\FIP"W[W*HR$UHD ,17/ LG WKLV6HFWLRQ 5HVXOWV F-
WLG QD FLG QD WLG
KWWSVZZZLWXLQWGPVBSXELWXGRSEVWU'675(B+($/7+3')(SGI
20
Ȓ
+&*-,/1+1!&*"+0&,++!"+"Ɯ1,# /"1&+$+"+)&+$"+3&/,+*"+1#,/!&$&1)%")1%&+1%"&0
01&*2)1&+$-/&31"Ȓ0" 1,/&+3"01*"+1ǽ%"-/&31"0" 1,/ +-)6+&*-,/1+1/,)"&+!!/"00&+$ ,*-)"5Ǿ
systemic challenges that the public sector may be ill-suited to solve. It can also support the move towards the
Ɯ++ &)Ǿ,-"/1&,+)Ǿ+!1" %+& )0201&+&)&16,#1%"&$&1) +&1&1&3"+!&10-/,$/**"0ǽ
Tackling issues such as policies and infrastructure and making a clear business case for partnerships and
&+3"01*"+1 +%")-/&+$1%"&+Ɲ2"+ "+!01/"+$1%,#1%"-/&31"0" 1,/1,"/,+!&$&1)%")1%ǽ/1,#1%"
Digital REACH Initiative strategy is to create an ecosystem that is attractive to large companies as well as small,
local entrepreneurs so that digital health can grow as an industry. The Digital REACH Initiative will stimulate
private sector investment in two ways:
• By directly engaging and partnering with the private sector to implement key workstream activities
• By creating an enabling environment that will attract and stimulate more investment in the region
21
A Call to Action: Supporting Digital REACH and Why It Matters Now
The distinction between digital health and the broader health system is
growing smaller by the year.
I CT adoption amongst all health stakeholders from patients to health ministers — has occurred so quickly
and thoroughly that the term digital health is losing its novelty. This signals its maturity and the need
for coordination across the ecosystem, moving away from a fragmented approach to digital health —
characterised by siloed applications, waste, and variable data — to a holistic digital health model with
coordinated investments and common assets leveraged across multiple health programmes. Strong
)"!"/0%&-+!$,3"/++ " +-/,-")1%&0*,!")1,/")&16Ǿ-/"3"+1&+$!2-)& 1&,+,#"ƛ,/1 /,001%"
/"$&,++!$"+"/1&+$)/$"Ȓ0 )" ,01"ƛ& &"+ &"0Ǿ&*-/,3"!%")1%,21 ,*"0Ǿ+!#01"/+!"11"/%")1%
programme implementations. The purpose of the Digital REACH Initiative is to harness this opportunity for
digital health technologies through coordinated regional action.
/"1"!+!,4+"!61%"1%/,2$%1%" Ǿ1%&0&01%"Ɯ/011&*"+#/& ++&,+/"$&,+%0 ,*"
together to create an ambitious and coordinated approach to digital health that is prioritised for investment
by all Presidents of the EAC Partner States.
PATH TO IMPLEMENTATION
This Strategic Plan is an important step towards coordinated regional action in digital health. The Digital REACH
Initiative Strategic Plan provides a common regional vision and strategic approach that is aligned with country
-)+0ǽ 1)0, /"1"0-)1#,/*#,/1%"*,&)&01&,+,#/"0,2/ "0#,/1%"0-" &Ɯ &*-)"*"+11&,+ 1&3&1&"0,21)&+"!
in this document.
%"Ɯ$2/""),40%,401%"1&*")&+"#,/1%"!"3"),-*"+1,#1%&01/1"$& )++! ,01&+$-)+4%& %4&))-,0&1&,+
the EAC and Partner States to mobilise funding necessary to launch the Digital REACH Initiative, plan for full-scale
,-"/1&,+0Ǿ+!*,3".2& ()6&+1,&*-)"*"+11&,+*,!"01/1&+$&+"/)6ǗǕǖǞǽ
22
The Digital REACH Initiative
T he free movement of people, services, and goods across the EAC relies on a healthy population. Through
digital technologies and political will, the region can realise seamless access to improved healthcare
services for all EAC citizens, enhanced surveillance of diseases, real-time response to health security threats
such as disease outbreaks, and market-driven distribution of the health workforce to achieve a healthy
and wealthy East Africa. Additionally, the regional implementation of digital health infrastructure and other
enabling components that can be shared by Partner States in their country-level strategies will create
"ƛ& &"+ &"0+! -&)&1&"01%14,2)!+,1" %&"3"!,1%"/4&0"ǽ
This section lays out the goals, key milestones, strategic approaches, considerations for implementation,
+!,/$+&0&+$-/&+ &-)"0#,/!3+ &+$!&$&1)%")1%&+1%"ǽ 1,ƛ"/0*2)1&!&*"+0&,+)Ǿ%,)&01& 3&"4,#
how the region can move forward with digital health by laying out key roles and responsibilities for the region
and for EAC Partner States. It also describes key approaches for how this Strategic Plan can be implemented
through the Digital REACH Initiative. The Digital REACH Initiative is guided by the following vision and mission:
&$2/"Ǘǿ&$&1) +&1&1&3"&0&,++!&00&,+
&0&,+ǗǕǗǝ
Interconnected health systems
for a healthy and prosperous East Africa
&00&,+11"*"+1
Maximise the power of digital health in East Africa by ensuring an
enabling environment and by implementing scaled, coordinated,
transformational, and innovative approaches.
U0"/0,#1%&01/1"$& )+
1ƛ+!)++&+$/1+"/0
4&))20"1%&01/1"$& )+1,#2/1%"/!"Ɯ+",3"/))/"$&,+)+""!0+! - &1&"0Ǿ*("!" &0&,+0,+/"$&,+)-/&,/&1&"0Ǿ
+!!"3"),- 1&,+)"&*-)"*"+11&,+-)+0ǽ%"64&)))0,20"1%&01/1"$& )+1,0" 2/"Ɯ++ &)02--,/1#,/1%"
set up and implementation of the Digital REACH Initiative.
/1+"/11"0
will use this Strategic Plan to identify their role in supporting the Digital REACH Initiative, including any human resources
and other assets that can support the Initiative.
"3"),-*"+1/1+"/0
will use this Strategic Plan and costing plan to identify opportunities to mobilise and provide support.
/&31"" 1,/
will use this Strategic Plan and costing plan to identify opportunities for investment and partnerships.
+&1&1&3"1ƛ
will use this Strategic Plan as a reference guide to set up and manage the Initiative and its workstreams and to develop
implementations plans that work in concert towards common goals.
23
DIGITAL REACH INITIATIVE OUTCOME GOALS
%"0-" &Ɯ ,21 ,*"$,)0,#1%"&$&1) +&1&1&3"/")&01"!"),4ǽ%"0"%3"""+&!"+1&Ɯ"!6
/1+"/11"/"-/"0"+11&3"01%/,2$%0"/&"0,#/"$&,+)4,/(0%,-0&+ǗǕǖǜ+!ǗǕǖǝǽ
Success against these goals will be measured by the regional nature of the outcomes. The illustration on the
+"51-$"!"-& 101%"*&1&,203&0&,+1%"&$&1) +&1&1&3"4&))01/&3"1, %&"3"1,&*-/,3"1%"-1&"+1
"5-"/&"+ " /,001%"1%/,2$%1%",3",21 ,*"$,)0ǽ
24
IMPROVING HEALTHCARE THROUGH THE DIGITAL REACH INITIATIVE
ONSET OF SYMPTOMS: Mary feels unwell while traveling in Kenya. She decides to visit a She visits a local health facility and is registered.
local health facility...
Patient is able to
access treatment in
another Partner State
Patient remembers SMS and is able to pay
campaign explaining for it because of a
similar and encouraging region EAC insurance
presentation at clinic. product.
Mary is diagnosed with a regional priority disease that cannot be treated at this facility. She is referred to a hospital that can treat her.
Health worker shares necessary
data with referral hospital in a
different Partner State;
Health workers in the other
Health workers access treatment
Partner State have received the
and diagnosis tools to support
same training and are aware of
diagnosis and confirms
necessary protocols.
regional treatment protocols
electronically;
If diagnosis is a priority disease
area health worker follows
regional protocols and guidelines
to share information with other
Partner States.
She is treated and discharged with medication or a prescription Mary goes back home to Tanzania and follows the instructed treatment regimen
She travels to her local health facility for follow up actions related to her treatment Mary is cured and goes home. Outcomes of her treatment are documented.
OPTIMISE THE DIAGNOSIS AND TREATMENT OF PRIORITY IMPROVE HEALTH WORKER EDUCATION AND TRAINING INCREASE SURVEILLANCE AND IMPROVE RESPONSE ENHANCE PUBLIC HEALTH EDUCATION AND AWARENESS
HEALTH CONDITIONS
KEY GUARANTEE UNIVERSAL ACCESS TO QUALITY HEALTH CARE OPTIMISE RESOURCE ALLOCATION AND MANAGEMENT IMPROVE SUPPLY CHAIN MANAGEMENT IMPROVE POPULATION HEALTH STATUS
25
Digital REACH and Partner States
A cross the EAC region the health strategic plans of Partner States demonstrate commitment to universal
health coverage as a cornerstone of national and regional development. An overview of the current status
,#!&$&1)%")1%&+1%"/"$&,+&+!& 1"04")1%,#"5&01&+$00"101%102--,/1 ,,/!&+1"!--/, %ǽ
%"/"/"0"3"/)!&$&1)%")1%00"10 /,00/1+"/11"01%1 +")"3"/$"!1,"5-+!!&$&1)%")1%
1%/,2$%,211%"/"$&,+02 %0/"$&,+)02/3"&))+ "&+&1&1&3"0ț"ǽ$ǽǾ "1ȜǾ0601"*0ț ǗǾ-"+Ǿ
1&,+)0"/31,/&"0ȜǾ/1+"/11" ,**&1*"+10ț"ǽ$ǽǾ +!+"Ȓ ")1%Ȝ+!+1&,+)00"10ț"ǽ$ǽǾ
developed policies, insurance products). Partner States have also reported similar challenges, such as the
) (,#!&$&1)%")1%"5-"/1&0"Ǿ)&*&1"!&+#/01/2 12/"Ǿ2+/")&)" ,++" 1&3&16Ǿ+!#/$*"+1"!" ")1%
initiatives with multiple development partners and misaligned time frames, which all present opportunities for
coordinated regional action.
There are, however, distinctions between EAC Partner States which could pose a challenge to regional
,)),/1&,+ǽ/1+"/11"0/"1!&ƛ"/"+101$"0,#!"3"),-*"+14&1%/"$/!01,1%"&/!&$&1)%")1%
strategy and implementation, and clear governance structures for coordinating digital health have not been
established in all countries. These distinctions create an opportunity for Partner States to share lessons,
information, and reusable assets to close gaps across the region.
%" 2//"+101120,#!&$&1)%")1%#,/" %/1+"/11" +"#,2+!&+--"+!&5ǽ+ ")2+ %"!Ǿ
" %4,/(01/"*4&)) ,+!2 10")&+"00"00*"+1,#"5&01&+$00"10&+" %/1+"/11"ǽ,/(&+$4&1%
Ministries responsible for health and ICT, national research institutes, and other relevant national bodies, the
Digital REACH Initiative will identify key assets to be leveraged for each workstream.
26
Strategic Alignment with EAC and Partner States
This strategic plan builds on the Digital REACH Initiative Roadmap, which
40--/,3"!61%"0&5%"!0,#011"!2/&+$1%",2+ &),#&+&01"/0&+
,3"*"/ǗǕǖǜǽ 1&0#2))6)&$+"!4&1%1%"01#/& +%")1%&+3"01*"+1
priorities and serves as a complement to individual Partner State health
strategies.
Ǟǽ1/"+$1%"+&+$,#%")1%/"0"/ %+!!"3"),-*"+1
ǽ2-/&,/&16Ǟǽǖǿ01)&0%+"$&,+) ")1%"0"/ %+!"3"),-*"+1 &)&11&,+
Mechanism
ǽ2-/&,/&16ǞǽǗǿ01)&0%+"$&,+)0"/31,/6,+%")1%/"0"/ %+!!"3"),-*"+1
c. 2-/&,/&16Ǟǽǘǿ +3"01*"+1&+!&$&1)%")1%1" %+,),$6#,/"11"//"0"/ %#,/%")1%Ǿ
%")1%0"/3& "0!")&3"/6Ǿ+!%")1%,21 ,*"0
27
ALIGNMENT WITH PARTNER STATE PRIORITIES
28
ǚǽ"-1&"+1Ȓ "+1/& +!"3&!"+ "Ȓ!/&3"+ Ǜǽ2/02"-/1+"/0%&-0+!Ɯ++ &+$
Adopt an implementation-science approach by using +$"+!-2/02"01/1"$& -/1+"/0%&-0+!Ɯ++ &+$
evidence generated by the Initiative to drive decision throughout the life of the Initiative through involvement
making and the health implementation agenda in ways of government, development partners, and the private
that improve on-the-ground health-service delivery. sector.
,1",+1" 2/&16+!/&3 6
&$&1)%")1%!1&0"5-,0"!1,%&$%0" 2/&16/&0(+!&10-/,1" 1&,+&0%&$%-/&,/&16#,/1%"&$&1)
Initiative. It is of the utmost importance that data that is generated by or shared with Digital REACH
"01,/"!0#")6+!0" 2/")6ǽ%&04&))/".2&/"%/!4/"Ǿ0,ƞ4/"Ǿ+!/"$2)1,/6*" %+&0*01%1
protect against unauthorised access, use, or disclosure of sensitive health data. The following are a list of
considerations that the Digital REACH Initiative will integrate into all of its activities, through the creation
of associated policies, data standards, and the design and build of infrastructure and digital solutions, to
safeguard health data privacy and security.
ǖǽ/,3&!"0" 2/"&!"+1&16*+$"*"+10"/3& "0+!21%"+1& 1&,+*" %+&0*0&+ )2!&+$20",#*2)1&Ȓ
factor authentication and secure web portals
2. Provide variable user access roles for sensitive data (e.g., user roles, location, sensitivity of data, consent
-,)& &"0Ǿ"5-&/1&,+-"/&,!0#,/ "00Ȝ
ǘǽ0"&+!201/601+!/!"+ /6-1&,+)$,/&1%*0țȒǗǚǛȜǾ1/"01+!&+*,1&,+
4. Protect privacy of sensitive personal data through anonymisation, aggregation, and other statistical
*"1%,!0#,/,0 2/&+$&!"+1&Ɯ)"&+#,/*1&,+
ǚǽ+02/" ,*-)&+ "1,&+#,/*"! ,+0"+1-,)& &"0#,/1%" ,))" 1&,++!0%/&+$,#0"+0&1&3"!1
Ǜǽ/,3&!" ,*-/"%"+0&3"2!&11/&)#,/))%")1%/" ,/!0+!20" 1&3&16
A specialised audit function will be created to oversee and monitor compliance across the Initiative.
29
%"1"+-/&+ &-)"0&!"+1&Ɯ"!&+1%"Ɯ$2/",3")61%",/$+&01&,+)#,2+!1&,+#,/1%"&$&1)
Initiative. The Initiative has been structured into nine workstreams. They will run in parallel and support one
+,1%"/Ǿ01/1&+$4&1%0")" 1-/&,/&16 1&3&1&"0+!"5-+!&+$&+1,,1%"//"0,#4,/(0$&+0/"*!"ǽ
%" ")1%/,$/**"0,/(01/"*4&))#, 20,+1%"&*-)"*"+11&,+,#0-" &Ɯ Ǿ01/1"$& /"$&,+)%")1%
programmes, while the seven Enabling Environment Workstreams will focus on the creation of an enabling
environment for digital health that can be shared across Partner States and that supports health programme
implementations. An overarching workstream for Initiative Management will lead and manage the Initiative. A
02**/6,#1%"!&ƛ"/"+14,/(01/"*0 +"#,2+!"),4ǽ
&$2/"ǚǿ&$&1) +&1&1&3",/(01/"*0
INITIATIVE MANAGEMENT
HEALTH PROGRAMMES
Regional, on-the-ground, health service delivery
programmes driven by digital technology
INFRASTRUCTURE SERVICES AND LEADERSHIP STRATEGY AND Ǿ STANDARDS
APPLICATIONS AND INVESTMENT Ǿ AND INTER-
Create the ADVOCACY COMPLIANCE Build health
technical global Identify and Negotiate with worker
goods that support the Advocate, "51"/+) 1,/0 Develop the professional
support all other development socialise, lay the on behalf of the policies and capacity across Identify and
workstreams of reusable and groundwork, region to realise guidelines the region to develop
and provide interoperable remove political economies needed, and facilitate human common
regional tech 0,ƞ4/" obstacles, and of scale work to gain their resource sharing guidelines,
support services and garner political and greater adoption across and improve standards, and
applications support for "ƛ& &"+ &"0 Partner States care protocols to lay
built for regional implementations the foundation
and national #,/+"ƛ" 1&3"
use regional
digital health
ecosystem
The underpinnings of this Strategic Plan stem from the correlation and relationship between the Digital REACH
Initiative workstreams and the outcome goals. Workstream strategies will focus on having a direct or indirect
&*- 1,+ %&"3&+$1%",21 ,*"$,)0ǽ)"ǖ0%,404%& %,21 ,*"$,)04&))"&*- 1"!64%& %
workstream.
30
&$2/"Ǜǿ21 ,*" ,)0+!00, &1"!&$&1) +&1&1&3",/(01/"*01/&5
4/"+"00
!2 1&,++!
+%+ "2)&
+!+$"*"+1
"0,2/ ")), 1&,+
-1&*&0"
%&+ƛ& &"+ 6
"0-,+0"
2/3"&))+ "+!
Training
!2 1&,++!
,/("/
+&3"/0) "001,
2--,/1
,+!&1&,+0
/"1*"+1,#/&,/&16
1&,+Ǿ&$+,0&0Ǿ+!
-1&*&0"1%"/"3"+-
*-/,3"2--)6
*-/,3"&0"0"
*-/,3" ")1%
2*+
")1% /"
")1%
")1%
+&1&1&3"+$"*"+1
• • •
• • • •
• • •
• • • •
• • • •
• • •
• • • •
• • • •
")1%/,$/**"0
"$&,+)01#/&
&0"0"2/3"&))+ "Ǿ
•
•
•
•
,+1/,)+!"0-,+0"
ț,Ȝ
")"*"!& &+""14,/(0
#,/01#/& +
• "/1&/6țȜ
")1% /""/3& "0
(EAACH)
"$&,+) ")1%
• •
•
•
0"/31,/6ț Ȝ
+,4)"!$"+$"*"+1
•
+!""/"/+&+$
• • • •
• • • • • • •
• • • • •
• • • •
• •
• • • • • • • • •
")1%
++,31&,+0&+ ")1%
+#/01/2 12/"
"/3& "0+!
--)& 1&,+0
"!"/0%&-+!!3, 6
• • • • •
1/1"$6+! +3"01*"+1
• •
"$&0)1&,+Ǿ,)& 6Ǿ+!
•
• • •
•
,*-)&+ "
,/(#,/ "
• •
1+!/!0+!
•
•
•
+1"/,-"/&)&16
31
Approach to Implementation
The section below details the Digital REACH Initiative’s approach to implementation.
The Digital REACH Initiative will utilise an implementation-science approach to running the Initiative. This will
include ongoing and careful M&E as well as the building of an evidence base to demonstrate the impact of
health programmes and workstreams, all the while sharing learnings across workstreams.
Building an evidence base will be a fundamental element of all work done. This approach is especially
&*-,/1+1$&3"+1%" 2//"+1) (,#),+$&12!&+)!1+!"3&!"+ ",#!&$&1)%")1%"ƛ& 61%1&0!"0&/"!6
the global health community.
&$2/"ǜǽ")1&,+0%&-"14""+ ")1%/,$/**"+!+)&+$+3&/,+*"+1,/(01/"*0
HEALTH PROGRAMMES
The Enabling Environment Workstreams provide Health Programmes drive the demand for assets
the assets required for created by Enabling Environment Workstreams using
implementation of health programmes implementation science
INFRASTRUCTURE SERVICES AND LEADERSHIP STRATEGY AND Ǿ STANDARDS
APPLICATIONS AND INVESTMENT Ǿ AND INTER-
ADVOCACY COMPLIANCE
As health programmes are implemented, they will require and utilise assets created by Enabling Environment
Workstreams (e.g., supportive policies, a capable workforce, data standards, the appropriate ICT infrastructure
+!0,)21&,+0Ǿ-,)&1& )26Ȓ&+Ȝǽ&*&)/)6Ǿ0&*-)"*"+11&,+0, 2/Ǿ+"4,01 )"04&))"&!"+1&Ɯ"!Ǿ+!
evidence will be generated, in ways that will drive the demand for new assets to be created by Enabling
Environment Workstreams. In this way, the successful implementation of the Health Programmes Workstream
&0&+"51/& )6)&+("!4&1%1%"02 "00#2)&*-)"*"+11&,+,#1%"+)&+$+3&/,+*"+1,/(01/"*0ǽ,!,0,Ǿ
all workstreams must work closely together to identify synergies and dependencies throughout the duration
of the Initiative.
32
%"&$&1) +&1&1&3"&0!"0&$+"!1, ,*-)"*"+1Ǿ&*-/,3"Ǿ+!01/"+$1%"+ ,2+1/6Ȓ0-" &Ɯ 4,/(&+
digital health, not replace it. A robust, region-wide enabling environment will allow Partner States to deliver
%")1%0"/3& "01%1/"*,/""ƛ" 1&3"1%+ ,2+1/6Ȓ0-" &Ɯ %")1%&+&1&1&3"0ǽ%" +&1&1&3"0""(01,)"3"/$"
00"101%1)/"!6"5&01 /,001%"&+4601%14&)))),4)) ,2+1/&"0&+1%"/"$&,+1,&*-/,3"1%"&/
digital health capacity and service delivery. The activities listed in this document have been requested and
3"11"!6/1+"/11"01%/,2$%*2)1&-)"&+Ȓ-"/0,+*""1&+$0&+ǗǕǖǜ+!ǗǕǖǝ1,"+02/")&$+*"+1+!
synergy with national strategies.
Partner States will be a key part of workstream consultations and implementation. The process below details
%,4/"$&,+)+!+1&,+)$,3"/++ ",#1%"&$&1) +&1&1&3"ȉ0 1&3&1&"0&+1"/0" 1+!%,40-" &Ɯ
00"10 /"1"!61%"/"$&,+/" /"1"!+!&*-)"*"+1"!ǽ,/"!"1&),+1%"/,)",#/1+"/11"01,#2)Ɯ)
0-" &Ɯ /"0,#4,/( +"#,2+!&+" %4,/(01/"*ǽ
Implementation
through Digital
01ƛ
Digital REACH Experts from Present to Present to the Report to the Feedback is
4,/(01/"* Partner States the ,/!,# " 1,/) EAC ,2+ &) received from
participating ,2+ &) ,# Implementation Partner State
01ƛcarry ,**&00&,+"/0
in Workstream ")1% for through National institutions
out Initiative for review and Stakeholders
5-"/1,/(&+$ review and to improve
activities approval under the
/,2-0are approval design and
coordination of implementation
consulted 1&,+) , ) of Initiative
,&+10in each activities
Partner State,
reporting to
the relevant
Workstream Lead
All Activities Depending on the workstream and on activities that
require policy decisions and implementation at the
Partner State level
33
Digital REACH Initiative Priority Activities and Timeline
5.2. Advocate for joint regional position on public health emergency response
4.1. Invest in decision-support tools for dealing with outbreaks and public health emergencies
8.4 Train health care professionals on the use of digital health for health services provision (e.g. in public health emergencies)
Implement and
use READSCoR
9.1. Develop data sharing, security, and management protocols and standards
9.5. Provide regional guidelines for diagnosis, treatment, and standards of care*
Implement and
operate NEAT*
*7.2. and 9.5* are not required for NEAT to be set up but it will support the expansion of the implementation use case over time, allowing data to be shared and treatment
to be provided across borders
8.1. Harmonise and make available eLearning course content for pre- and in-service professionals
8.3. Embed digital health learning methods into health training
+
Implement and
operate EAACH
5.1. Advocate for agreement on data sharing and storage in a regional cloud
9.2. Create a regional data dictionary for interoperable data exchange between Partner State and regional HIS
9.3. Support and promote the exchange of unique IDs and patient health records across EAC Partner States
6.3. Support the development of a business case for regional insurance for favourable premium rates and packages
Knowledge Management and Peer
Learning (initial activities already
started)
Regional Technical Assistance
Innovations in Health
8.2. Harmonise digital health curricula for healthcare and health IT professionals
4.3. Support engagement with OpenHIE and other global communities for best practices
4.5. Provide support with contractual agreements with technology solutions vendors for Partner States
6.2. Conduct business case assessments
and use for negotiations with MNOs for
improved bandwidth
6.4. Aggregate demand based on Partner States’ supply needs and negotiate for
reduced pricing
5.4. Advocate for a reduced common set of priority donor reporting indicators across the EAC
5.5. Advocate for a holistic approach to
use of digital technologies and solutions
the health sector within the EAC region
34
MANAGEMENT AND OVERSIGHT
35
WORKSTREAM 1:
INITIATIVE MANAGEMENT
OVERVIEW
%"&$&1) +&1&1&3"&0!"Ɯ+"!64&!"/+$",# 1&3&1&"01,"&*-)"*"+1"! /,00*2)1&-)"
workstreams. The ten-year time frame and aspirational set of goals associated with the Initiative require
strong leadership. Coordination across the eight activity-based workstreams also presents the need for an
!!&1&,+)Ǿ,3"// %&+$4,/(01/"*1%14&))%,)&01& ))6$2&!"Ǿ ,,/!&+1"Ǿ+!*5&*&0"1%"&*- 1,#1%"
+&1&1&3"ǽ%&0%0""+)"))"!,/(01/"*ǖǽ
,/(01/"*ǖǾ1%" +&1&1&3"+$"*"+14,/(01/"*Ǿ"01)&0%"01%""00"+1&)01/2 12/"0/".2&/"!1,
implement the Digital REACH Initiative. It articulates the organisational and operating mechanisms to
*+$"1%" +&1&1&3"Ǿ&+ )2!&+$1%""5" 21&,+,#1%",1%"/"&$%14,/(01/"*0ǽ +!!&1&,+Ǿ&1-/,3&!"0
strategic organisational direction, orchestrating and knitting together all the other workstreams, so that each
workstream is moving in the same direction towards the Initiative outcome goals. As such, this workstream
runs parallel to, and is integrated with, the other eight workstreams. It is a vehicle for managing change at both
the regional and Partner State levels.
GOALS
• %&"3"*5&*2*&*- 1,#1%",3"/)) +&1&1&3"1%/,2$%,3"/0&$%1+!02--,/1,#))4,/(01/"*
activities.
• Ensure compliance with the legal and regulatory framework and funding requirements across all
workstreams.
• /"1",-"/1&,+)"ƛ& &"+ &"04%"/"-,00&)" /,001%" +&1&1&3"ǽ
• /"1"4/"+"00,#1%" +&1&1&3"1%/,2$%2+&Ɯ"!*"00$&+$+!-2)& /")1&,+0ǽ
• /"1"3)2"#,/1%"Ɯ")!,#!&$&1)!"3"),-*"+1Ǿ-/1& 2)/)6!&$&1)%")1%Ǿ+!#,/,1%"//"$&,+0
looking to improve healthcare services, through thought leadership.
%&04,/(01/"*4&))-/,3&!""5-"/&"+ "!,3"/0&$%16"01)&0%&+$
,1"+1&)"ƛ& &"+ &"0
,/"01ƛ1%1&+ )2!"0), ))"!"/0%&-Ǿ"5-"/&"+ "!*+$"*"+1Ǿ
+!1" %+& )"5-"/1&0"ǽ +!!&1&,+1,1%"1/!&1&,+))6 "+1/)&0"! This workstream could realise
,01"ƛ& &"+ &"06&!"+1&+$
management functions, human resources, communications and public
/"0,2/ "0)&("0%/"!,ƛ& "0- "
/")1&,+0ǾƜ++ "Ǿ Ǿ-/1+"/0%&-*+$"*"+1Ǿ+!)"$)02--,/14&))" +!01ƛ1,/"!2 "0"1Ȓ2-
-/,3&!"!6*&5,#&+1"/+)+! ,+1/ 1"!/"0,2/ "0ǽ and running costs.
+$"*"+101/2 12/"04&))"Ɲ"5&)"+!)"+Ǿ ,+1/ 1&+$,21
resources for period of time when possible. Specialised functions such as M&E and thought leadership will
draw on stakeholder contributions (e.g., universities, research bodies) as internal capacity is developed. This
--/, %4&))*5&*&0"1%" ,))" 1&3"&*- 1,#1%" +&1&1&3"1%/,2$% ,)),/1&,+4&1%3/&,204,/(01/"*0ǽ
%"1"*4&))0,)& &1+! ,,/!&+1"!3&0,/6&+-21#/,*"5-"/10 /,00)),1%"/4,/(01/"*0+!/1+"/
11"01,"+02/"1%10-" &Ɯ "5-"/1&0"ț"ǽ$ǽǾ&+ - &162&)!&+$Ǿ&+#/01/2 12/"!"3"),-*"+1Ǿ01+!/!0
creation) is embraced by the organisation overall, as well as in other individual workstream activities.
36
As the management hub of the Initiative, this workstream will oversee the activities listed below.
ǖǽ/$+&01&,+ • Set up the appropriate entity and structures to lead and manage the Initiative (including
2&)!&+$+! 01ƛ&+$Ǿ)"$) ,+1/ 10Ȝ
+$"*"+1 • Conduct initial and ongoing governance development (set up, maintain, and potentially
/"!"0&$+$,3"/++ "01/2 12/"Ȝ#,/1%" +&1&1&3",++,+$,&+$0&01,"+02/"Ɲ"5&&)&16
• Provide ongoing operational support for the Initiative
• Create workstream strategy and operational plan
Ǘǽ /+1 • Manage administrative aspects of grants and funds as well as communications with grant
+$"*"+1+! and funding partners on behalf of the Initiative
"-,/1&+$ • Develop reports and briefs for updating key stakeholders and partners
ǘǽ/1+"/0%&- • Manage development partner and private-sector engagement for the Initiative
+$"*"+1 • Liaise with grant partners, EAC stakeholders, Partner State government representatives
such as Ministries of Health, digital health teams, and other relevant bodies
ș,,/!&+1"*,+$01"5&01&+$-/1+"/0+!-2/02"+"4-/1+"/0%&-01%/,2$%,211%")&#"0-+
of the Initiative
Ǚǽ"!"/0%&- • Provide leadership across all workstreams and encourage cross-workstream synergies
/,00 4%"/"--/,-/&1"ǽ5*-)"0&+ )2!"',&+1-/,'" 10,/ 1&3&1&"0 /,00!&ƛ"/"+1
,/(01/"*0 4,/(01/"*0+!,--,/12+&1&"0#,/,+"4,/(01/"*1,-/,3&!""5-"/1&0"1,+,1%"/ǽ
• Uphold the values of the Initiative and set the tone across the organisation by upholding
1%"&$&1) +&1&1&3"/$+&01&,+)/&+ &-)"0ț &$2/"ǛȜǽ%&0 +"!,+"60"11&+$
up aligned structures and policies across the Initiative and tracking adherence across
workstreams.
ș3"/0""02--,/11,/1+"/11"0#/,*4,/(01/"*0+!"+02/" ,,/!&+1&,+"14""+
workstreams
ș3"/0""+++2)/"3&"4,#-/&,/&164,/(01/"* 1&3&1&"04&1%02--,/1#/,*1%" 0Ǿ
Workstream Leads, and the EAC
Ǜǽǔ • Create M&E plan for the Initiative, starting with priority activities and health programmes
• Conduct M&E and performance management across all workstreams and coordinate with
independent M&E partner
• Use M&E data to mobilise funding based on tangible results and outputs
37
• A " %+& )!3&0,/6 /,2- will also be set up to gather inputs regarding the implementation of the
&$&1) +&1&1&3"ǽ"*"/0%&-1,1%&0" %+& )!3&0,/6 /,2-*6,3"/)-4&1%1%"/1+"/0ȉ
,/2*21*"*"/04&))"*,/"%"3&)6&+3,)3"!&+1%" ,+1"+1,#1%" +&1&1&3"Ǿ-/,3&!&+$01/1"$&
!3&0,/602--,/11,01ƛ /,001%""+1&/"4,/(01/"*Ǿ!"-"+!&+$,+1%"&//"0,#"5-"/1&0"+!1%"
need.
Workstreams will have their own budget, leadership, team, management structure, and progress indicators,
+!/"-,/11,1%"ǽ/1+"/0%&-01%1&*- 1" %4,/(01/"*4&))"*+$"!11%"4,/(01/"*)"3")Ǿ
&+ )2!&+$ ,,/!&+1&,+4&1%/1+"/11"01("%,)!"/0&+3,)3"!&+0-" &Ɯ /"0,#4,/(Ǿ1%/,2$% 0ǽ
Below is the high-level organisation structure.
{
PARTNERS’ FORUM
(Partner States, EAC Organs and
Board of Directors Institutions, development partners, and
the private sector)
(Partner States, EAC Organs and Institutions,
development partners,
and the private sector) TECHNICAL ADVISORY GROUP
Digital REACH Initiative PMO (Local and international health and
(Executive Director and the Digital REACH Directorate) technology experts)
3"/0&$%1 /,00))1%"/,/(01/"*0
Workstreams will have their own Workstream Lead, teams, management structure, and budget and report to the
ǽ,/(01/"*Ȓ0-" &Ɯ -/1+"/0%&-04&))"*+$"!11%"4,/(01/"*)"3")
HEALTH PROGRAMMES
INFRASTRUCTURE SERVICES AND LEADERSHIP STRATEGY AND Ǿ STANDARDS
APPLICATIONS AND INVESTMENT Ǿ AND INTER-
ADVOCACY COMPLIANCE
The Initiative will be led by the 5" 21&3"&/" 1,/who At the start of the Initiative, the PMO will
will be responsible for creating, planning, implementing, be expected to set up a smaller, leaner
and integrating the strategic direction and vision of the management structure while other
Digital REACH Initiative. The &$&1) &/" 1,/1" will workstreams are also set up. This will allow
more resource allocation to the technical
/"-,/11,1%"5" 21&3"&/" 1,/+! ,+0&01,#&/" 1,/,#
workstreams. As resource become available,
/,$/**"0 4&1%"5-"/1&0"&+-2)& +! )&+& )%")1%+! 01ƛ&+$ +" ,*"*,/"0-" &)&0"!Ǿ
digital health and technology, and a &/" 1,/,#-"/1&,+0. allowing management structures to grow.
The &/" 1,/,#/,$/**"0 will provide oversight and This will allow the Initiative to get started on
02--,/11,))1" %+& )"5-"/10+!4,/(01/"*0ǽ % priority activities and demonstrate quick-
4,/(01/"*4&))%3",/(01/"*"!ț+!02--,/1&+$01ƛȜ wins that will attract further resources while
putting the organisation in place.
who will report to the Director of Programmes. M&E will also 2ƛ& &"+11&*"0%,2)!)0,")), 1"!1,
fall under this function. The &/" 1,/,#-"/1&,+0oversee %&/&+$1%"/&$%101ƛǽ )"5&)"01/2 12/"4&))"
internal activities and includes legal, human resources, internal important to ensure that work on priorities
,-"/1&,+0ǾƜ++ "Ǿ ,**2+& 1&,+0Ǿ-2)& /")1&,+0Ǿ+! can begin, at least in part, while larger hiring
thought leadership. These functions will also provide support "ƛ,/10/",+$,&+$ǽ
and oversight to each workstream.
38
%"#,)),4&+$Ɯ$2/"&))201/1"01%"-/,-,0"!,/$+&01&,+)01/2 12/"#,/"+1&/"&$&1) +&1&1&3"ǽ
&$2/"Ǟǽ/$+&01&,+)%/1#,/&$&1) +&1&1&3"
DIGITAL REACH INITIATIVE MASTER ORGANISATIONAL CHART
+$&+$&/" 1,/
*00!,/0
1+!/!0+!&+1"/,-"/&)&16"!
-"/1&,+0+! ,,/!&+1,/0
,1) !*&+&01/1&,+
01&*1"! 2'" 1Ȓ11"/
5-"/10
"! ,2+11 )"
ǚǚȒǛǕ
All Workstreams will be supported by Expert Working Groups made up of
Partner State and EAC experts. Coordinators will be responsible for managing
and running these working groups.
39
As the Digital REACH Initiative is set up, its leadership will need to take a strategic approach to identifying and
hiring the minimum capable team to launch and implement priority activities that will secure more long-
1"/*#2+!&+$ǽ%",/$+&01&,+4&))+""!01ƛ4&1%)"!"/0%&-+!*+$"*"+10(&))0Ǿ04"))01%,0"4&1%
1%"1" %+& )&)&1&"0ț"ǽ$ǽǾ-/,$/**+$"/0Ǿ*"!& )!, 1,/0Ǿ"+$&+""/0Ǿ1" %+& )"5-"/10Ǿ ,,/!&+1,/0Ȝ
required for actual implementation. The table below, taken directly from the Digital REACH Costing tool,
0%,401%"+1& &-1"!%"! ,2+1+!%&/&+$/*-2-Ǿ#,/01ƛ+! ,+02)1+10-"/4,/(01/"*,3"/1%"Ɯ/01
Ɯ3"6"/0,#1%"&+&1&1&3"ǽ 1&00"!,+1%"002*-1&,+1%11%"*',/&16,#/"0,2/ "0 +"*,&)&0"!#,/1%"
Ɯ/016"/,#1%"&+&1&1&3"1,02--,/1))-/&,/&166"/ǖ 1&3&1&"0ǽ
3 3 ǜ ǜ ǝ
Ǘǿ ")1%/,$/**"0
Ǖ ǚ ǖǕ ǖǕ ǖǕ
ǘǿ +#/01/2 12/"
Ǚǿ"/3& "0+! 4 ǝ ǜ ǜ ǜ
--)& 1&,+0
ǚǿ"!"/0%&-+! 4 Ǜ Ǜ ǚ ǚ
!3, 6
4 ǜ ǜ ǜ ǜ
Ǜǿ1/1"$6+! +3"01*"+1
ǜǿ"$&0)1&,+Ǿ,)& 6Ǿ+!,*- 4 ǝ ǝ ǝ ǝ
-)&+ "
4 ǚ ǖǖ ǖǕ ǖǕ
ǝǿ,/(#,/ "
Ǟǿ1+!/!0+! 3 ǜ ǜ ǝ ǝ
+1"/,-"/&)&16
40
DIGITAL REACH INITIATIVE
HEALTH PROGRAMME
IMPLEMENTATIONS
41
WORKSTREAM 2:
HEALTH PROGRAMMES
OVERVIEW
%" ")1%/,$/**"0,/(01/"*,3"/0""0+!*+$"01%"&*-)"*"+11&,+,#0-" &Ɯ %")1%
programmes that seek to improve health-service delivery and outcomes while building the human, technical,
and functional infrastructure to deliver the Digital REACH Initiative’s outcome goals. This workstream will focus
on implementations that are regional and cross-border in nature and that improve the quality and access
to healthcare services across the EAC, while also supporting the needs and mandates for the other seven
activity-based workstreams.
GOALS
%"4,/(01/"*4&))#, 20,+&*-)"*"+1&+$%")1%-/,$/**"01%102--,/1 ,01Ȓ"ƛ" 1&3"&*-/,3"*"+101,
the quality of healthcare services in the EAC region while utilising the assets developed by other workstreams
+!2&)!&+$/"$&,+)"5-"/1&0"1,02--,/11%"&$&1) +&1&1&3",21 ,*"$,)0ǽ&+"-/&,/&16%")1%
-/,$/**"01%102--,/11%" +&1&1&3"ȉ0,21 ,*"$,)0%3"""+&!"+1&Ɯ"!61%"#,/&*-)"*"+11&,+
2+!"/1%"&$&1) +&1&1&3"ǽ%"0"%3"""+-/&,/&1&0"!00%,4+&+1%"Ɯ$2/""),4ǽ
&$2/"ǖǕǿ&$&1) +&1&1&3"/&,/&16 ")1%/,$/**"0
Level of Priority: &$% ,4
TELEMEDICINE REGIONAL EAST AFRICAN ACADEMY EAC REGIONAL THE EAST AFRICAN
EAST AFRICA DISEASE FOR COMMUNITY HEALTH CLOUD (EAHC)
AFRICAN TERTIARY Ǿ HEALTH (EAACH) (RHO)
(NEAT) HEALTHCARE CONTROL AND Set up the EAHC to
SERVICES RESPONSE Establish a community Create a Regional support other health
(READSC,R) training and learning ")1%0"/31,/6 programmes, inform
Implement platform to improve to facilitate access health research, and to
telemedicine to link Design a health alert health education and to data, information, better understand health
East African Centres and early warning awareness, and train analyses, and trends and outcomes in
,#5 "))"+ "+! system for disease frontline workforce in the empirical evidence the region.
specialised health care outbreaks and community leveraging for monitoring and
facilities across the epidemics in the digital technology. evaluating regional
region. region. health.
Key
REGIONAL HEALTH REGIONAL TECHNICAL INNOVATIONS IN
SERVICES MANAGEMENT AND ASSISTANCE FOR HEALTH OPTIMISE THE PREVENTION,
DIAGNOSIS, AND TREATMENT OF
PEER LEARNING DIGITAL HEALTH PRIORITY HEALTH CONDITIONS
by sharing data in priority reusable assets in States in areas &*-/,3"!"ƛ& &"+ &"0+! OPTIMISE HUMAN RESOURCE
cross-border communities the region through that support the "ƛ" 1&3"+"00&+-2)& ALLOCATION AND MANAGEMENT
and supporting portability the implementation implementation health. IMPROVE DISEASE SURVEILLANCE
AND RESPONSE
of health insurance. of knowledge of Digital REACH IMPROVE SUPPLY CHAIN
management Initiative. EFFICIENCY
+ + +
42
STRATEGIES AND GUIDELINES FOR IMPLEMENTATION
At its core, the Digital REACH Initiative is an evidence-based, implementation science-led Initiative designed
1,20"0-" &Ɯ %")1%-/,'" 101,!"*,+01/1" ,01"ƛ& &"+ 6Ǿ%")1%"+"Ɯ10Ǿ+!"3&!"+ ",#&*- 1+!1,
apply that evidence in a way that drives subsequent implementations.
Health programmes will place East African ownership at the forefront, with technical assistance provided
in the background. Work on some of the health programmes has already begun (indicated in each health
programme below), implementation on others will be staggered. Priority health programmes have been
&!"+1&Ɯ"!20&+$1%" /&1"/&,+-$"ǘ3ǽ
The Health Programmes Workstream team will be responsible for prioritising implementation opportunities
+! ,,/!&+1&+$/"0,2/ "0*,+$01&1Ǿ4/&1&+$1%",3"/))4,/(01/"*-)+04"))00-" &Ɯ -)+0#,/
" %&*-)"*"+11&,+ǽ ")1%-/,$/**"04&))" ,*-)&0%"!6,1%1%" ,/"01ƛ+!,210,2/ "!
implementation partners (e.g., private sector, development partners). The workstream team will be heavily
involved in oversight, M&E, and alignment with regional and national health goals and funding. It will also be
/"0-,+0&)"#,//2++&+$1%" ,*-"1&1&3" 01,&!"+1&*-)"*"+11&,+-/1+"/0ǽ
Successfully architecting, implementing, and scaling the nine health programmes requires an overall process
#,/&+1"$/1&,++!-/&,/&1&01&,+ǽ%"!&$&1)%")1%)+!0 -"%0*2)1&-)""5*-)"0,##&)"!-/,'" 101%1
either never worked or were never able to scale. The key principle for this workstream will be to rely heavily
on an agile methodology that allows for rapid iterations and staged implementations built upon a solid
/ %&1" 12/"Ǿ&!"+1&Ɯ"!1%/,2$% ,+02)11&,+04&1%/1+"/11"0ǽ"20",#1,,)0+!"01-/ 1& "04&))
-/,3&!" ,01"ƛ& &"+ &"0Ǿ21*12/&16*,!")4%"/"&+&1&)&*-)"*"+11&,+0/"3)&!1"!+!1%"+"3,)3"
0"!,+"5-"/&"+ "Ǿ&0"00"+1&)1,02 "00ǽ
The following are strategic guidelines for the operationalisation of this approach:
• All health programme implementations will involve an early scan of what work is already being done in
related areas by Partner States and development partners
• Place emphasis on East African ownership and local capacity development, with international technical
assistance provided where needed
• Ensure alignment with EAC health-sector priorities and secure political support for regional health-service
implementations
• Coordinate with other workstreams to utilise supportive assets being developed (e.g., standards and
policies) in ways that support health programme implementations
• Work closely with all other workstreams to request the creation of assets (e.g., policies, standards,
0,ƞ4/"0"/3& "0Ȝ0"!,+$-0+! %))"+$"0"5-"/&"+ "!!2/&+$&*-)"*"+11&,+,#%")1%
programmes
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the &$&1) +&1&1&3",/(01/"*,*-"+!&2*.
43
Health Programme 1: The East Africa Health Cloud (EAHC)
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
The East Africa Health Cloud (EAHC) is a technology-driven,
• Data on the regional health
interoperable health information system (HIS) that will enable
situation used to drive the
real-time storing, capturing, analysing, and retrieving of health
regional health agenda
data across the region, including data related to access to care
• Local health researchers are
and care delivery, health worker mobilisation and training, supply
capacitated to analyse and use
chain, public health statistics, and surveillance and response
data
information.
• Underlying cloud infrastructure
Placed in a common EAC cloud and not in a single Partner supports all other outcome
State, the EAHC will allow users to securely access, analyse, goals through various health
and use health data across the region, following formal data programmes
0%/&+$$/""*"+104&1%/1+"/11"0ǽ 2&!"!6"1%& )!1
Supporting Workstreams:
-/ 1&0"0&+ )2!&+$!10" 2/&16Ǿ-/&3 6Ǿ+! ,+Ɯ!"+1&)&16Ǿ1%"
EAHC will facilitate greater regional cooperation. It will initially +#/01/2 12/": Provides underlying
provide insights and evidence into health system governance infrastructure for programme to operate
from the perspective of regional changes in demographics, 1/1"$6+! +3"01*"+1: Helps to
socioeconomics, disease trends, and mobility. It will then provide identify sustainable operating models
the basis for case reporting and disease management to support for the cloud infrastructure through
regional health security and regional healthcare delivery. private sector engagement
The EAHC will be used to: "$&0)1&,+Ǿ,)& 6Ǿ+!,*-)&+ ":
• 1/"+$1%"+ - &161,#,/*2)1""ƛ" 1&3"%")1%-,)& &"0Ȁ Designs the legislation and policies for
remote data hosting
• Provide health workers with relevant data and knowledge to
improve health practice and decision making; "!"/0%&-+!!3, 6: Advocates
for sharing of data across borders
• Strengthen the potential of data to serve as early warning
#,/1&*")6+!"ƛ" 1&3"/"0-,+0"ț"ǽ$ǽǾ"/)6!&$+,0&0,#
!"3&1&,+0#/,*"5-" 1"!!&0"0""%3&,2/Ǿ+!ȡ,/+"4+!
2+"5-" 1"!%")1%1%/"10ȜȀ
• Establish mechanisms for data utilisation, using clear
/&1"/&,#"1%& )-/ 1& "Ǿ1,*("!1Ɯ+!)"Ǿ "00&)"Ǿ %"1/"%,20"
interoperable, and reusable, driving policy decisions, the The EAHC is complementary to current
regional health agenda, and health research; "ƛ,/101,%,01%")1%&+!& 1,/!1
• Contribute to improved universal health coverage (UHC) and collected through DHIS2 in the EAC
accessibility to quality healthcare services in remote areas Data Warehouse. In addition to health
and for low-income members of society, by using data to indicator data, the EAHC will also act
drive the regional health agenda. as a central repository for other types
The EAHC will help to strengthen the ongoing analyses of health- of data. Data inside the EAC Data
science data, regionally and for Partner States, by creating the Warehouse will be made available
,**,+&+#/01/2 12/"Ǿ0"/3& "0Ǿ+!0(&))0+""!"!1,"51/ 1 through the EAHC.
valuable insights from data.
44
IMPLEMENTATION VALUE
6"01)&0%&+$/")Ȓ1&*"Ǿ/"$&,+) #,/ -12/&+$Ǿ01,/&+$Ǿ/"1/&"3&+$Ǿ+)60&+$Ǿ+!*+$&+$!"&!"+1&Ɯ"!
+1&,+)+!/"$&,+)%")1%!1Ǿ1%" 4&)),ƛ"/1%",--,/12+&161,!/*1& ))6&+ /"0"1%""3&!"+ "
base with which health policy and services can be designed across the EAC. Priority data sets will be fed into
the EAHC and analysed to create high-value common goods (e.g., algorithms to trigger outbreak alerts, routine
+)60"0,+ ,*-/1&3""ƛ" 1&3"+"00,#%")1%-/,$/**"0Ǿ01+!/!&0"!1,,)0#,/!1 ,))" 1&,+Ȝǽ1
will also be made available through secured electronic channels, such as a secure web portal or virtual private
+"14,/(țȜǾ1,01("%,)!"/002 %0$,3"/+*"+1-"/0,++")Ǿ.2)&Ɯ"!/"0"/ %"/0Ǿ+! !"*& &+0
whose access will drive further insights and evidence for health in general.
The establishment of the EAHC will support the Digital REACH Initiative by providing the underlying
infrastructure to store and analyse data necessary to:
• 5*&+"1%"0, &)!6+*& 0,# "001,+!21&)&01&,+,#%")1%0"/3& "0Ǿ&+ )2!&+$%")1%0601"*0
$,3"/++ "+!%")1%Ɯ++ &+$ț"ǽ$ǽǾ/"*&11+ "0Ȝ#/,*1%"-"/0-" 1&3",#$),) %+$"0&+
demographics, mobility, migration, and technology
• Strengthen the continuous, ongoing analyses , and sharing of health-science data to achieve lasting
0601"*01/+0#,/*1&,+1%/,2$%&++,31&,+Ǿ$,3"/++ "Ǿ+!0201&+)"Ɯ++ &+$
• /,*,1"+!# &)&11" "00&&)&16Ǿ0201&+&)&16Ǿ-/"!& 1&)&16Ǿ"ƛ" 1&3"+"00Ǿ+!.2)&16,#%")1% /"
0"/3& "0&+),4Ȓ&+ ,*"Ǿ/2/) ,**2+&1&"0Ǿ-,01Ȓ ,+Ɲ& 1/"0Ǿ!&0-) "! ,**2+&1&"0Ǿ /,00Ȓ,/!"/
communities, and amongst vulnerable groups (e.g., the elderly and children)
• Share and access health training and learning materials including health worker training
• Identify relevant regional events or trends to inform dissemination of tailored and timely public health
messages to health workers and EAC citizenry through digital tools (e.g., alerts on outbreaks, alerts on
disease trends and associated factors)
IMPLEMENTATION APPROACH
The EAHC architecture will be designed
This health programme will work very closely with the
to receive and provide access to real-time
Infrastructure workstream to build and implement the
data on diagnostics, treatment adherence,
EAHC. The implementation approach will prioritise regional
causes of ill-conditions, hotspots, and
health security while rolling out incremental functionality
resources. The system will interconnect data
to build a robust platform supporting all the use cases
on services from facilities and communities
above. Design and development of the EAHC will begin
within selected areas in each Partner State
by identifying an achievable use case. This will allow for
and across the EAC, including:
building out the right security and privacy protocols to suit
the use case, and embedding principles of patient-level ǖǽ,21&+"%")1%0601"*&+!& 1,/0ț"ǽ$ǽǾ
protection, privacy, and data portability from the very start. Partner State HMIS, EAC Data Warehouse)
2. M&E survey data (e.g., Demographic and
+ "1%" &0&+-) "Ǿ), )/"0"/ %"/0ț&+ )2!&+$
Health Surveys (DHS), Multiple Indicator
PhD students and post-doctoral fellows) will then be able
Cluster Survey (MICS), Household Budget
to utilise the database for research and analysis of health
Survey (HBS) with MEASURE and the
trends. This will also enhance the regional and global body
World Bank)
of knowledge on health in the EAC region and build the
capacity of local researchers and health professionals. 3. Country statistics (e.g., census)
4. Common data registries (e.g., master
facility lists, diagnosis codes, client
registry and shared health records for
management of cross-border case-
based surveillance)
45
This health programme will actively work with
%")1%-/,$/**"0Ǘ1,Ǟ!"0 /&"!"),41,
20"!1#/,*%")1%-/,$/**" 1&3&1&"0ǽ ,/
"5*-)"Ǿ!13&))"#/,*1%"01#/& +
Cross-Border Health Services implementation
in Health Programme 2 (Regional Health
Services) can be used to inform the design and
&*-)"*"+11&,+,#01+!/!&0"!!&$&1) ȡ
4,/(Ɲ,40Ǿ)$,/&1%*0Ǿ+!-/,1, ,)0&+
selected sites to allow for comparative analyses
,#$$/"$1"!1,+ ȡ3/&)"0ǽ%"
%")1%-/,$/**"1"*4&)))0,"5-),/"460,#
optimising for regional use the architecture and
!"0&$+0,#4,/(Ɲ,40Ǿ)$,/&1%*0Ǿ+!-/,1, ,)0
developed and used by the EAC Partner States.
Real-time, data-driven, pilot studies will
be designed and conducted by this health
programme when the EAHC infrastructure and
services have been optimised, and EAC Partner
States skills to use EAHC tools and its data-driven
&+0&$%10%3"""+!"3"),-"!ǽ5*-)"0,#
potential pilot studies include:
• Real-time treatment compliance monitoring
for TB patients, capturing data through ICT
20&+$*,&)"-%,+"0+!")" 1/,+& -&)),5"0Ǿ
also known as electronic directly observed
1%"/-6ț"Ȝǽ!!&1&,+)--)& 1&,+0
include capture and analyses of diagnostics,
cohort, MTB subtypes, MDR TB data, and
%,10-,10,#ǾǾȡ ,&+#" 1&,+ǽ
• +)60"0,# -1&"+1!1ț"ǽ$ǽǾ!&$+,01& 0Ǿ &/ 2)1&+$ 0216-"0Ǿ1/"+!0,#3&/)),!ǾǙ ,2+10Ǿ
)&+& )-/*"1"/0Ǿ%,10-,10Ǿ+! ,+1 10Ȝ1,&!"+1"01-/ 1& "0+!&*-/,3" ,01"ƛ" 1&3"+"00,#
treatment.
• /&,20&*-)"*"+11&,+0,#!&$&1)%")1%#,/!&0"0"-/"-/"!+"00Ǿ!"1" 1&,+Ǿ+!/"0-,+0"1,!&0"0"
,21/"(0ț"ǽ$ǽǾ"-&!"*& 0Ǿ-+!"*& 0Ǿ+" ")1%Ǿ ,+1&+2,20!1+)61& 0Ǿ/&"#0Ȝ
• %"&*- 1,#/"*&11+ "0+!!,*"01& Ɯ++ &+$,+ "001,%")1%0"/3& "0&+ /,00Ȓ,/!"/
communities.
4&))"/,201+!"ƛ" 1&3"1,,)1,-/,3&!"!11%14&)) ,*-)"*"+1+!$2&!"1%"!")&3"/6,#%")1%
0"/3& "06&01/& 1 ")1%ƛ& "/0+!1%", 0&+/1+"/11"0ǽ%"4&))4,/(4&1%,1%"/-/1+"/0&+
1%&00- "ț"ǽ$ǽǾ +!&+01&121&,+0Ȝǽ
46
Health Programme 2: Regional Health Services
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
To address the key and unique challenges associated with
• Supports continuity of care
providing quality health services for mobile populations and
across the region
communities residing along the EAC border areas, Health
• Supports portability of health
Programme 2 will develop or support health programmes
insurance
that demonstrate the value of coordinating digital health and
• Supports sharing of
increasing public health security in the region.
information across borders
which can support surveillance
IMPLEMENTATION VALUE Supporting Workstreams:
/""!,*,#*,3"*"+1/"02)10&++&+ /"0&+$+""!#,/ /,00Ȓ
+#/01/2 12/"ǿBuilds client registry
border access to healthcare. As mobility increases, people
and shared health records to support
become further removed from their traditional medical support
cross-border health care
systems in their home countries, making them more vulnerable
to health risks. Recent studiesǛ#,2+!1%11%"/"&00&$+&Ɯ +1 "/3& "0+!--)& 1&,+0ǿInvests
undocumented travel across porous borders in the EAC region, in unique ID systems and solutions to
and that this includes travel for the purpose of accessing health process insurance claims regionally
services. In fact, people living in border communities have even 1+!/!0+! +1"/,-"/&)&16ǿ
indicated a preference for using cross-border facilities because 2--,/10!"3"),-*"+1,#!1"5 %+$"
,#01&$*+!!&0 /&*&+1&,+Ǿ-/1& 2)/)6#,/!&0"0"0)&(" standards
and TB, as well as perceived quality and distance. This creates a
,)& 6Ǿ"$&0)1&,+Ǿ+!,*-)&+ "ǿ
number of challenges for providers and patients including stock-
Supports sharing of data across borders
outs, lack of data to support continuity of care across borders
and health resource allocation, and lack of insurance to pay for "!"/0%&-+!!3, 6ǿAdvocates
services received in another country. for sharing of data across borders
IMPLEMENTATION APPROACH
4,&*-)"*"+11&,+0%3")/"!6""+&!"+1&Ɯ"!#,/02--,/12+!"/1%&0%")1%-/,$/**"ǿ
• +01#/& /,00Ȓ,/!"/ ")1%"/3& "ǿTo support the continuity of care for priority diseases along
strategic border areas of East Africa
• , &) ")1%/,1" 1&,+ǿ,/1)"%")1%&+02/+ "&+ )2!&+$0& "+"Ɯ10- ($"
Both implementations have been conceptualised by the EAHRC. Work is currently underway to secure the
political support and buy-in from key Partner State decision makers.
52$'63URMHFW$,+'6WXG\($&+HDOWKDQG+,96LWXDWLRQ$QDO\VLV5HSRUW&%+,33%DVHOLQHDQG)RUPDWLYH
$VVHVVPHQWV0($685((YDOXDWLRQ81&¶V(DVW$IULFD&URVV%RUGHU,QWHJUDWHG+HDOWK6WXG\
47
ǖǿ
C
Ȓ
HEALTH SERVICE
The East Africa Cross-Border Health
Service (EACBHS) will strengthen
cross-border healthcare and allow for
,+1&+2,20+!/")Ȓ1&*"!1"5 %+$"
on priority health issues associated with
mobile populations and communities
HC HC HC HC HC HC
residing along strategic border areas of
HC HC HC HC HC HC
East Africa, supporting the continuity
of care for priority diseases in those localities with a focus on serving the patient. The EACBHS will target
ǖǚ-/&,/&16,/!"/0&1"0ǜǾ01/1&+$4&1%ǚ&+1%"Ɯ/016"/+!/,))&+$,211%"!!&1&,+)ǖǕƞ"/1%1ǽ 12&)!0
on the Cross-Border Health Integrated Partnership Program (CB-HIPP), a regional project funded by USAID/
+!&*-)"*"+1"!6 ǘǛǕ+!-/1+"/0ǽ 14&))1-&+1,)"/+&+$0#/,* /,00Ȓ,/!"/-&),1-/,$/**"0
being implemented elsewhere on the continent e.g., programme under the Regional Action through Data
țȜ,+0,/1&2*1%1&0"&+$&*-)"*"+1"!&+1%" ,2+1/&"01%1#,/*1%" +1"/Ȓ ,3"/+*"+1)21%,/&16,+
"3"),-*"+1ț ȜǾ+!1%" ,+,*& ,**2+&16,#"01#/& +11"0țȜǽ-,+--/,3)6
and its Partner States, implementation of the EACBHS will focus on the following areas:
• Real-time data sharing for decision making amongst cross-border health facilities
• Cross-border data collection and real-time data analysis, interpretation, reporting, and utilisation
• ,+1&+2,20!&0"0"02/3"&))+ "#,/-/&,/&16!&0"0"0+!&!"+1&Ɯ 1&,+,#!&0"0"&+ 21&,+%,10-,10+!
# 1,/01%1&+Ɲ2"+ "!&0"0"0&+ /,00Ȓ,/!"/ ,**2+&1&"0
• *-/,3"*"+10&+ /,00Ȓ,/!"/),001,#,)),4Ȓ2-Ǿ ,+1 11/ &+$Ǿ+!1/"1*"+1 ,*-)&+ ",# +!
patients
Under this Health Programme, other regional health services programmes will also be established to address
important regional health conditions such as non-communicable diseases (NCDs) (e.g., cancer, heart,
)2+$Ǿ+!(&!+"6!&0"0"0Ȝ04"))0/,!1/ƛ& &!"+10ǽ%" 4&))4,/( ),0")64&1%1%" ")1%
/,$/**"ǖ1"*1,21&)&0"!101,/"!&+1%" ǽ%" 4&))"+)"1%"&+1"$/1&,+,#-"/0,+)%")1%
records to allow for dashboards, cloud analytics, and reporting.
Land Border Sites%XVLD .HQ\D8JDQGD 1DPDQJD .HQ\D7DQ]DQLD 5XVXPR 5ZDQGD7DQ]DQLD%XUXQGL
*DWXQD.DWXQD 5ZDQGD8JDQGD 5XKZD 5ZDQGD%XUXQGL ,VHEDQLD6LUDUL .HQ\D7DQ]DQLD (DVWHUQ
(TXDWRULD.DUDPRMD5HJLRQ 8JDQGD6RXWK6XGDQ.HQ\D
Wet Border Sites0XKXUX%D\.LURQJZH .HQ\D7DQ]DQLD 3RUW9LFWRULD6LR3RUW0DMDQML .HQ\D8JDQGD
.DERQJD/XVROR %XUXQGL7DQ]DQLD .DVHQVHUR.DJHUD5HJLRQ 8JDQGD7DQ]DQLD 0ELWD5XVLQJD,VODQG
.HQ\D8JDQGD
48
Health Programme 3: Regional East Africa Disease Surveillance,
Control and Response (READSCoR)
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
The READSCoR health programme aims to establish a digital
• Supports timely surveillance
mechanism for regional surveillance of disease outbreaks
of disease outbreaks and
for early preparedness, including prediction, detection, and
emergencies
response. READSCoR will set up health alerts and an early
warning system for disease outbreaks and epidemics. It will Supporting Workstreams:
support regional health security by helping authorities prevent, "/3& "0+!--)& 1&,+0: Invests in
track, and respond to health threats such as infectious diseases decision support tools for dealing with
and epidemics that can rapidly spread across the region. outbreaks
,)& 6Ǿ"$&0)1&,+Ǿ+!,*-)&+ ":
IMPLEMENTATION VALUE Establishes policy for regional
,/,20,/!"/0+!1%"Ɲ2&!*,3"*"+1,#-",-)"Ǿ+&*)0Ǿ+! surveillance and response
agricultural produce across the EAC Partner States underscore "!"/0%&-+!!3, 6: Advocates
the need for a regional approach to tracking and responding to for joint position on health emergencies
health needs and emergencies. A regionally integrated digital
,1"+1&)ƛ& &"+ &"0+!
surveillance, alert, and early warning system will ensure the
/1+"/0%&-0: Partner with EAIDSNet
0-""!+!"ƛ& &"+ 6,#!1 ,))" 1&,+Ǿ+)60&0Ǿ-/"3"+1&,+Ǿ+!
and SACIDS on disease surveillance in
public health response to outbreaks.
the region.
Leverage work being done in
IMPLEMENTATION APPROACH participating countries to support
READSCoR will create the algorithms for continuous, real-time +!+" ")1%Ǿ04"))0
data generation, transmission, storage, and analyses, using the surveillance tools, protocols, and
EAHC to identify potential outbreaks and generate alerts and early best practices from the widespread
!"1" 1&,+,#+!"ƛ" 1&3"/"0-,+0"1,,21/"(0ǽ%"0601"* implementation of the IDSR framework
will provide regular updates on the general status of health in the to create more predictive algorithms
region and priority health conditions including public health risks and alerts to prevent future outbreaks.
and threats. Look to lessons from the Regional
%"0601"*4&))!/4,+"5&01&+$02/3"&))+ "0601"*002 %0 Disease Surveillance Systems
the East African Integrated Surveillance Network (EAIDSNet), Enhancement Program (REDISSE)
Southern African Consortium for Infectious Disease Surveillance supported by the Bill and Melinda
(SACIDS) and other data collection systems used in Partner 1"0 ,2+!1&,+ǽǾ,/)!+(Ǿ
States, the EAC, and other data stored in the EAHC to generate +!1%" #,/01/"+$1%"+&+$/"$&,+)
information that will enable READSCoR to reliably predict, rapidly health systems and collaboration of
/" 1Ǿ+!"ƛ" 1&3")6/"0-,+!1,+! ,+1&+!&0"0",21/"(0Ǿ disease surveillance and epidemic
epidemics, and other health security threats. preparedness in West Africa.
READSCoR will utilise the EAHC as a central data warehouse for
aggregate and case-based data, as applicable, and create and
/"Ɯ+"01+!/!"-&!"*&,),$& ))$,/&1%*01,!"1" 1-,1"+1&)
threats by analysing clinical and epidemiological characteristics ))201/1&3"!11%1 ,2)!"20"!
,#,21/"(0ǽ%"-/,$/**"4&))"+%+ ""5&01&+$02/3"&))+ " #,/,ǿ
tools in the region or deploy novel tools as needed to standardise • Case incidents
data collection for analysis, for which the EAHC will also provide • Supplies and stock-outs
technical assistance. • Weather patterns
,4&))-/1+"/4&1%("601("%,)!"/011%" +! • Behaviour patterns
Africa CDC to assist with the development of algorithms and the • Agricultural and livestock abnormalities
creation of alert and response activities.
49
Health Programme 4: Telemedicine Networks for East African
Tertiary (NEAT) Healthcare Services
OVERVIEW
This health programme will implement telemedicine to link East *- 1"!21 ,*" ,)0ǿ
#/& +"+1/"0,#5 "))"+ "ț,Ȝ+!0-" &)&0"!%")1% /" • Supports access and continuity
facilities with other health and academic facilities across the of care across the region
region. The networks will provide advanced and specialised • Allows resources to be shared
healthcare services and provide continuous medical education to across the region remotely
health workers in the region. • Supports training of health
workers remotely
IMPLEMENTATION VALUE Supporting Workstreams:
CoE have been set up across the region to provide specialised 1/1"$6+! +3"01*"+1: Helps to
care to patients based on their relative areas of strength. However, identify sustainable operating models
CoEs are currently working in relative isolation. The Telemedicine for the telemedicine network through
NEAT Healthcare Services programme aims to link CoEs and their private sector engagement
specialists to address the need for timely, high-quality specialty
medical care in countries where such specialists may be lacking. 1+!/!0+! +1"/,-"/&)&16:
Services will include patient care, education, research, and public Establishes standards for care and data
health consultation and training. sharing
,)& 6Ǿ"$&0)1&,+Ǿ+!,*-)&+ ":
IMPLEMENTATION APPROACH Supports data sharing for patients seek-
This health programme will start by connecting CoEs with one ing care
another across the region, enabling medical practitioners to ,1"+1&)ƛ& &"+ &"0+!
,+02)1+!0%/""5-"/1&0"ǽ+ " ,++" 1&,+0/""01)&0%"!Ǿ /1+"/0%&-0ǿ1&)&0&+$"5&01&+$,Ǿ
operational and in use, the implementation can move into a and relevant grants to support their
second phase in which specialised healthcare facilities across build, across the region
the region will be linked with selected healthcare facilities within
" %/1+"/11"ǽ +1%"1%&/!-%0"Ǿ1%&0)&+("51"+!01,,1%"/%")1% /"# &)&1&"0 /,001%"/"$&,+ǽ%&04&))
enable CoEs to provide tertiary health services to facilities that lack the capacity to deal with emerging health
conditions such as NCDs and (re)emerging diseases. While establishing these networks, emphasis will also
be put on transforming the CoEs into digital-driven training and research centres to provide state-of-the-art
1/&+&+$1,+"51Ȓ$"+"/1&,+%")1%-/,#"00&,+)0+!1, ,+!2 1/"0"/ %ǽ
The health programme will closely work with the East African CoEs, the Partner States, and EAC Institu-tions
to develop the programme. It will also work with Partner States to identify other activities being conducted in
1%&00- "1,"&1%"/)"/+,/)"3"/$"#/,*1%"&/"5-"/&"+ "ǽ
,++" 1&+$,0
/,001%""$&,++!4&1%&+
/1+"/11"0 ,#,/+ ,),$6Ǿ ,#,//,),$6
"-2)& ,#$+! +!"-%/,),$6Ǿ
"-2)& ,#"+6
,#,/21/&1&,+)
&"+ "0 +01&121"Ǿ
"-2)& ,#2/2+!&
,&+&,*"!& )+$&+""/&+$Ǿ
" ")1%+! ")1%
"%&)&11&,+ &"+ "0
,#,/ &+"0Ǿ ,#,//!&,30 2)/
**2+&71&,++! ")1% &"+ "0Ǿ
2--)6%&++$"*"+1Ǿ +&1"!"-2)&
"-2)& ,#4+! ,#+7+&
50
Programme 5: East African Academy for Community Health (EAACH)
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
This health programme will establish the East African Academy
• Builds capacity of community
for Community Health (EAACH), a community platform for
health workers
improving health awareness and education to increase
• Support public education and
EAC citizen’s ownership of the health agenda and their own
awareness among communities
wellbeing and provide training for community health workers
• Capacitates health workers to
(CHWs).
+ better identify public health
emergies and outbreaks
IMPLEMENTATION VALUE Supporting Workstreams:
The EAACH aims to make EAC citizens responsible for their
,/(#,/ "ǿ Supports the integration
own health, and for the health of their communities. The
of digital learning tools into health
connection between care and timely continuing education is a
worker training and the harmonisa-
key element of an integrated healthcare system. It is important
tion of digital health training curricu-
for communities to be well equipped to manage their own
lum
health. The EAACH will be designed with the recognition that
citizen participation is central to the promotion of sustainable ,1"+1&)ƛ& &"+ &"0+!
community health and healthcare. The academy will bring /1+"/0%&-0ǿ Leverage lessons from
awareness, ownership, and skilled CHWs to the community. Last Mile Health’s Community Health
Academy in West Africa
Implemented as a technological-driven learning platform, the
EAACH will equip communities with the ability to prevent and Learn from ongoing eLearning pro-
manage diseases and provide education on disease prevention grammes in Partner States (e.g., the
1%/,2$%1%"1" %&+$,## 1,/01%1&+Ɲ2"+ "&))%")1%+! CHWs eLearning pilot implementation
health conditions. It will serve as a community platform for in Rwanda
better understanding and learning about health matters in the
region.
IMPLEMENTATION APPROACH
This health programme will oversee the establishment of a digital technology platform to support strong
+!"ƛ& &"+1-/&*/6+! ,**2+&16%")1%0"/Ȓ3& "000&0#,/ 2/1"%")1%!1$"+"/1&,++!
1/+0*&00&,+Ǿ"ƛ& &"+1!&0"0"002/3"&))+ "ț"ǽ$ǽǾ&+#" 1&,20!&0"0"0ǾǾ/"Ȓ+!Ȓ"*"/$&+$!&0"0Ȓ"0Ȝ+!
"ƛ" 1&3"%")1%-/,*,1&,+ǽ%" !"*64&))#, 20,+"!2 1&,++!4/"+"00,#"+1&/" ,**2+&1&"0
and train CHWs, as the frontline health work-force, to be responsible for promoting, addressing, managing
community health conditions, and reporting on health matters to the appropriate channels. EAACH will work
together with other organisations conducting similar initiatives (e.g., Last Mile Health).
51
Programme 6: EAC Regional Health Observatory (RHO)
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
This health programme will set up the EAC Regional Health
• Track regional health priority
0"/31,/6ț ȜǾ4%& %%0""+&!"+1&Ɯ"!0-/&,/&16
indicators to drive the health
#,/1%"ț0""-$"Ǘ7Ȝǽ 14&))-/,3&!" ,+0,)&!1"!3&"4
agenda
of regional health and highlight trends using core indicators,
database views, publications, information products, and other Supporting Workstreams:
evidence-driven knowledge management platforms. It will +#/01/2 12/"ǿ Provides underlying in-
serve as an EAC regional resource for monitoring and evaluating frastructure for programme to operate
regional health.
1/1"$6+! +3"01*"+1ǿHelps to
identify sustainable operating models
IMPLEMENTATION VALUE for the cloud infrastructure through
0&+$!1 ,))" 1"!Ǿ1%" 4&))*,+&1,//"$&,+)%")1% private sector engagement
-/&,/&1&"0ǽ 14&)) ,+1/&21"1,1%"&!"+1&Ɯ 1&,+,#$-0+! ,1"+1&)ƛ& &"+ &"0+!
opportunities for health research and development priorities. /1+"/0%&-0ǿCoordinate with
It will support coordinated actions on health research and /1+"/11"0+!1%" 1,)"/+
development in ways that are aligned with regional public health #/,*"5-"/&"+ ",#0"11&+$2-+-
!"*+!0+!+""!0ǽ,!,1%&002 "00#2))6Ǿ1%" 4&))ǿ tional (e.g., Kenya) and global health
• 1%"/Ǿ+)60"Ǿ06+1%"0&0"Ǿ0%/"Ǿ+!21&)&0".2)&16 observatories.
information on health and health services.
• Take social relationships and sociological factors into
account including cultural, economic, geophysical, and geographical factors.
• ,+&1,/%&$%Ȓ)"3")%")1%"3"+10+!1/"+!020&+$,'" 1&3"0+!3"/&Ɯ)"*"1%,!0+!00"00-/,$/"00
towards agreed-upon health-related targets and provide empirical evidence for monitoring and evaluating
the population health situation of the region.
IMPLEMENTATION APPROACH
%" 4&))20"1%" +!4,/(4&1%/1+"/11"01,,1&+ "001,/")"3+1 ,2+1/6!10,2/ "0Ǿ
(e.g., routine HMIS) and data in the EAC Data Ware-house, master facility lists, and statistical databases that
include aggregate demographic data. The EAHC will facilitate analysis of cross-country data sources through
01+!/!&01&,+,#!1+! /"1&,+,#!10"3&"401,# &)&11".2"/&"061%" ǽ 2/1%"/1" %+& )
assistance will be provided to improve each Partner State’s data systems to capture standardised data that
allows for more comprehensive analyses of regional health indicators.
%" 4&))",/$+&0"!6-/&,/&16%")1%1%"*1& /"0ǽ21-2104&))&+ )2!"/,21&+"/"-,/10+!,1%"/
information products such as objective recommendations to harmonise quality and access to care across
EAC Partner States. Technical briefs and recommendations will be generated to support decision making and
information products will be published and disseminated via the EAHC knowledge repository, further driving
2-1(",#1%" 0 "+1/)-)1#,/*#,/!1+!(+,4)"!$"ǽ+ *!"2-,#&+1"/+1&,+)+!
/1+"/11""5-"/104&))!3&0",+-/&,/&1&"0#,/+"4%")1%&+3"01*"+100"!,+&+#,/*1&,+-/,3&!"!6
1%" ǽ%"4&)))0, ,+1/&21"1,$),)(+,4)"!$"6 ,)),/1&+$4&1%,1%"//"$&,+),/&+1"/+1&,+)
,!&"0+!,/$+&01&,+02+!"/Ȓ1(&+$0&*&)/&+&1&1&3"0ț"ǽ$ǽǾ ),) ")1%0"/31,/6Ǿ#/& Ȝǽ
52
Programme 7: Knowledge Management and Peer Learning
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
%&0%")1%-/,$/**"4&))02--,/1,+$,&+$"ƛ,/10 //&"!
• Learnings shared through the
out by the EAHRC in areas of peer learning and knowledge
platforms can cover any area of the
management in the region.
outcome goals
IMPLEMENTATION VALUE
By creating a platform for the sharing of knowledge across the
region, this health programme will provide Partner States with +
the ability to learn about and apply lessons and tools already
developed by others in the region, avoiding duplication of Supporting Workstreams:
"ƛ,/10ǽ 14&))0"/3"0%2#,/-/,*,1&+$4,/("&+$!,+"&+ +#/01/2 12/"ǿ Provides underlying in-
the region, sharing evidence generated by the Digital REACH frastructure for programme to operate
Initiative and other health research, supporting capacity building
)),1%"/4,/(01/"*0ǿ "+"/1"!1
of future health professionals and researchers, and using
and knowledge that can be shared
digital technology to disseminate and manage health related
through these platforms and networks
information in the region.
,1"+1&)ƛ& &"+ &"0+!
/1+"/0%&-0ǿ"3"/$""5&01&+$ 1&3&-
IMPLEMENTATION APPROACH ties being carried out by the EAHRC.
Work will be divided into two categories: peer learning and
knowledge management.
""/"/+&+$+!"14,/()1#,/*0
This area of work will connect researchers, government leaders, and health professionals across the region to
provide a forum for decision making and learning.
PLATFORM DESCRIPTION
01#/& + This forum brings together East African government leaders and parliamentarians from the
,3"/+*"+1"!"/0Ǿ EAC Secretariat and Partner States, members of the East African Legislative Assembly (EALA),
"$&0)1,/0Ǿ+! and Partner State judiciary systems, with the aim of sharing information on pertinent health
"$)5" 21&3"0ȉ issues, gaining consensus, and making collective decisions on the best path forward.
")1%ț Ȝ
,/2*
01#/& + ")1% The biennial EAHSC, coordinated by the EAHRC, strengthens regional cooperation in health
+! &"+1&Ɯ in line with the articles of the Treaty for the establishment of EAC and relevant provisions of
,+#"/"+ " (EAHSC) the EAC Common Market Protocol. It brings together stakeholders of the health sector from
țǾ01#/& +"$&0)1&3"00"*)6Ǿ01#/& +,2/1,# 201& "Ǿ*"*"/0
of the EAC council of ministers, members of the summit, and EAC institutions); EAC Partner
11"0&+ )2!&+$*&+&01"/0,#%")1%ǾƜ++ "Ǿ%&$%"/"!2 1&,+Ǿ0 &"+ "+!1" %+,),$6Ȁ
*"*"/0,#-/)&*"+1#/,*+1&,+)00"*)&"0Ȁ$,3"/+*"+1,ƛ& &)0Ȁ/"0"/ %"/0Ȁ
scientists; practitioners; civil society; media; development partners; and the general public.
53
+,4)"!$"+$"*"+1)1#,/*0
This area of work will implement regional knowledge management platforms that allow capturing,
!&01/&21&+$Ǿ+!"ƛ" 1&3")620&+$(+,4)"!$",21%")1%-,)& 6Ǿ$,3"/++ "Ǿ+!0"/3& "0&+1%"/"$&,+ǽ%"
platforms listed below can also be used as a vehicle for disseminating and socialising evidence generated
through the Digital REACH Initiative.
PLATFORM DESCRIPTION
EAHRC JOURNALS
01#/& &"+ " EASci aims to contribute to the economic and social development of the EAC through research
(EASci): Search, innovation and development in health by representing East African innovations in the health
Discover, Develop sector. The EASci will serve as a forum for sharing innovations and knowledge in heath through
research, discovery, and development of solutions to priority EAC issues.
It will focus on showcasing research and technology innovations in health, health research and
development in the region. By doing this, the EASci will serve as a catalyst for innovation and use
of science and technology including digital health technologies and solutions and guiding the
development of products and services in health that harness the advancement of science and
technology.
54
Programme 8: Regional Technical Assistance for Digital Health
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
EAC Partner States have requested aid to provide additional
• Technical assistance provided can
and complementary support to country-level digital health
cover any area of the outcome goals
&*-)"*"+11&,+0ǽ ")1%/,$/**"ǝ0"102-#2+!4%"/"6
Partner States can apply to receive technical assistance directly
from the Digital REACH Initiative.
%&)"&1&0!&ƛ& 2)11,-/,'" 14%1(&+!,#02--,/1&0+""!"!Ǿ +
the purpose of this health programme is to create a fund and
*" %+&0*1,-/,3&!"0-" &Ɯ !&$&1)%")1%Ȓ/")1"!02--,/11, Supporting Workstreams:
each Partner State.
))4,/(01/"*0ǿ Support to Partner
States supports implementation of
IMPLEMENTATION VALUE assets created by all workstreams
%"-2/-,0",# ")1%/,$/**"ǝ&01,-/,3&!"!&$&1)%")1% ,1"+1&)ƛ& &"+ &"0+!
support to EAC Partner States in areas where there is clear /1+"/0%&-0ǿ Learnings for how to
"+"Ɯ1#/,*/"$&,+)&+3,)3"*"+1ǽ%&0%")1%-/,$/**" set-up and run this fund will be taken
,ƛ"/0/1+"/11"01%",--,/12+&161,1-&+1,!&$&1) from other similar programmes (e.g.,
%")1%"5-"/1&0"+! /"1"+1&,+)00"101%102--,/11%" the West Africa Health Informatics
implementation of the Digital REACH Initiative. This will help Team (WAHIT) programme team from
to improve the enabling environment for digital health in 1%""01#/& + ")1%/$+&01&,+
East Africa and support the achievement of Digital REACH’s ț Ȝǽ
outcome goals.
IMPLEMENTATION APPROACH
Partner States will apply for support in areas where regional involvement brings the highest value, and not on
/"01%1 ,2+1/&"0 +&*-)"*"+1,+1%"&/,4+ǽ%/""16-"0,#02--,/1%3"""+&!"+1&Ɯ"!ǿ01/1"$6+!
advocacy, implementation and management, and optimisation and institutionalisation.
,"+02/"#&/+"00*,+$01/1+"/11"0Ǿ" % ,2+1/64&))")), 1"!*5&*2**,2+1,#02--,/1ǽ
/1+"/11"04&))0,)& &12-1,1%1*,2+11,#2+!&$&1) +&1&1&3"01ƛ+!+6,210,2/ "!02--,/1
1%1&0+""!"!ǽ3"/1%" ,2/0",#Ɯ3"6"/0Ǿ" % ,2+1/6 +/" "&3"1,1),#ʏǘ*&))&,+Ǿ4%& % +"
spent in any of the three support types. Partner States will submit a request for support in collaboration with
1%" ")1%/,$/**"ǝ ,,/!&+1,/0ǽ
Learnings for how to set-up and run this fund will be taken from the West Africa Health Informatics Team
ț Ȝ-/,$/**"1"*#/,*1%""01#/& + ")1%/$+&01&,+ț Ȝǽ
5*-)"0,#1%"16-",#02--,/1+!1%""01&*1"! ,01000, &1"!4&1%" %16-"/"0%,4+&+1%"1)"
"),4ǽ%""5*-)"0-/,3&!"!/"+,1"5%201&3"Ǿ+!&1&0"5-" 1"!1%1,3"/1%" ,2/0",#1%"Ɯ3"6"/0+"4
/"04&))"&!"+1&Ɯ"!11%"/".2"01,#/1+"/11"0ǽ
55
)"ǜǿ ")1%/,$/**"ǝȕ2--,/16-"0Ǿ5*-)"0Ǿ+!01&*1"!,01
1/1"$6+!!3, 6 • Development of standards and policies for digital health that ʏǗǚǕǾǕǕǕ
align with regional objectives
• Development of a strategy for electronic patient record
implementation
• Academic curriculum development and aligning accreditation
• Update of country digital health plan
• Technical assistance for the development of strategies for private
sector engagement
• Support with change management and business process
engineering for digital health implementations
*-)"*"+11&,++! • Technical assistance for country implementations that use shared ʏǜǚǕǾǕǕǕ
+$"*"+1 regional assets or provide a model that can be replicated by other
Partner States
• Implementation support for national ID that aligns with a regional
unique ID
• Implementation support for telemedicine infrastructure across
Partner States for remote medical consultations
• Local capacity building for areas that align with Digital REACH
Initiative workstream activities
-1&*&01&,++! • Capacity building for a new workforce in digital health, including ʏǚǕǕǾǕǕǕ
+01&121&,+)&01&,+ education and training at the university level and through peer-
learning and sharing
• Support for interoperability and standards creation in ways that
support regional interoperability
56
Programme 9: Innovations in Health
OVERVIEW
*- 1"!21 ,*" ,)0ǿ
%&)"*,01%")1%-/,$/**"04&))"*-%0&0""ƛ" 1&3"20"
• Innovations implemented can impact
,#1"01"!1" %+,),$&"0Ǿ ")1%/,$/**"Ǟ4&))0"12-
any of the outcome goals
group dedicated to understanding and piloting new potential
applications of technology for health. Where appropriate, this
group will also support the integration of those technologies
&+1,0-" &Ɯ 1&3&1&"0+!-/,$/**"0 /,001%" +&1&1&3"+!
advise on the degree to which they should be used.
+
Supporting Workstreams:
IMPLEMENTATION VALUE )) ")1%/,$/**"0ǿ "+"/1"0
&3"+1%"1"+Ȓ6"/1&*"#/*",#1%&0 +&1&1&3"+!1%"/-&!)6 evidence of innovative technologies
changing technology landscape, it is critical that Digital REACH that can support the implementation
keep up to date on the latest technological innovations and the of all health programmes
&*- 1&1 +%3",+/")&0&+$"ƛ& &"+ &"0&+1%"%")1%0" 1,/ǽ
,1"+1&)ƛ& &"+ &"0+!
Designed to function like an incubator, this health programme /1+"/0%&-0ǿ 2+ 1&,+)&("01/1Ȓ
will actively integrate technologies into selected test up with a small, lean team overseeing
implementations. It will support the design of and provide select pilot implementations
funding for innovative implementations, testing potential
Identify opportunities for coworking
"ƛ& &"+ &"0#,/1%"%")1%0" 1,/+!,1%"/%")1%-/,$/**"0ǽ
spaces within EAC institutions or in the
region
IMPLEMENTATION APPROACH Coordinate on incubating digital health
Suggestions for new technology implementations will be with EAC Institutions, the East Afri-
/" "&3"!+!/"3&"4"!61%" ")1%/,$/**"Ǟ4,/(01/"* can CoE for eHealth in Rwanda, and
governance group through a joint submission by a Partner Science and Technology institutions in
State Ministry of Health or ICT and other Digital REACH Initiative EAC Partner States
workstreams. Up to two new concepts per year will be selected.
%" ")1%/,$/**"Ǟ1"*4&))1%"+!"0&$++!1"011%" ,+ "-1,3"/14,Ȓ6"/-"/&,!ǽ"-"+!&+$
on the concept, implementation can be done in collaboration with Partner States or at the regional level in
collaboration with other implementations being carried out by Workstream 2. The following approaches will
be part of this programme’s work:
• ,201+! ,+1&+2,20ǔǿ Implementations will be subject to robust M&E to test and measure
their success. If, following a successful implementation, a technology is deemed scalable, applicable,
and successful, it will be integrated into other Initiative-backed health programmes and workstreams.
Partner States will have the opportunity to provide feedback on the innovative implementations to build
the evidence base. A mechanism for standardising the collection and dissemination of evidence from
&*-)"*"+11&,+04&))"!"3"),-"!1,)),4#,/ ,*-/)"&+0&$%10 /,00Ɯ+!&+$0ǽ &+!&+$04&))"
published in in peer-reviewed journals (e.g., the EASci).
• &0(Ȓ1(&+$ 2)12/"ǿ ")1%/,$/**"Ǟ4&))"+ ,2/$"/&0(Ȓ1(&+$+!&++,31&3" 2)12/"4&1%&+&10
team. Success will not be measured by the number of successful implementations but by the evidence
collected and the lessons learned.
• /,3"+1" %+,),$&"0ǿ,*5&*&0"1%"-,1"+1&)#,/&*- 1Ǿ1%"$/,2-4&))-/&,/&1&0"1" %+,),$&"01%1
%3"-/,3"+&)&161,0 )"&+,1%"/ ,+1"510ǽ
• "/&,!& 00"00*"+10ǿ: The group will develop a plan for running nine health programmes which will
include an initial assessment of the technology landscape, followed by annual refresher assessments.
57
POTENTIAL APPLICATIONS OF TRANSFORMATIONAL TECHNOLOGIES FOR HEALTH
,*""5*-)"0,#&++,31&3"--)& 1&,+0,#1" %+,),$6&+%")1%/")&01"!&+1%"1)""),4ǽ%&0)&01,ƛ"/0
potential targets for early implementation, starting with technologies that have been proven elsewhere,
&+ )2!&+$$),)$,,!0"&+$!"3"),-"!2+!"/&$&1).2/"1,/"!2 "1%"/&0(,#Ȋ-&),1&1&0ȋȕ1%"&+&)&161,
break out of pilot stage — and stretching resources too thin.
&$1+)61& 0 • Automating data mining and modelling for early disease outbreak ʏȒʏʏ
alerts
ș,+&1,/&+$#,/!&0"0"02/3"&))+ "/"!Ɲ$0
• Tracking travel pattern trends and linking to disease outbreaks
• Tracking of online health information-seeking behaviour among
citizens
+1"/+"1,#%&+$0 - Tracking smaller physical assets moving through delivery systems ʏȒʏʏ
ț ,Ȝ - Monitoring the state of target goods and structures through sensors,
over time
58
CREATING AN ENABLING
ENVIRONMENT THROUGH THE
DIGITAL REACH INITIATIVE
WORKSTREAM 3: INFRASTRUCTURE
WORKSTREAM 4: SERVICES AND APPLICATIONS
WORKSTREAM 5: LEADERSHIP AND ADVOCACY
WORKSTREAM 6: STRATEGY AND INVESTMENT
WORKSTREAM 7: LEGISLATION, POLICY, AND COMPLIANCE
WORKSTREAM 8: WORKFORCE
WORKSTREAM 9: STANDARDS AND INTEROPERABILITY
59
ESTABLISHING
FOUNDATIONAL TECHNOLOGY
COMPONENTS
WORKSTREAM 3: INFRATRUCTURE
60
WORKSTREAM 3:
INFRASTRUCTURE
OVERVIEW
The Infrastructure workstream will develop the foundational ,1"+1&)ƛ& &"+ &"0+!
technical components and global goods needed to support all other /1+"/0%&-0ǿ
workstreams in the Digital REACH Initiative. The workstream creates Identify sustainable operating
the foundation for a regional approach to digital health through the models for the cloud infrastructure
building and facilitation of improved connectivity and digital health through private sector engagement
infrastructure, allowing for timely data access and sharing and ,,(1,-"+ *-)"*"+11&,+
enabling services and applications to function. It also includes the 2&!"01,02--,/12&)!+!/,))Ȓ
technical support required to maintain systems over time. out of assets
GOALS
The overall goal of this workstream is to identify, build, host, and implement common technological
components and systems that will allow other workstreams and health programmes to achieve the Digital
REACH Initiative’s outcome goals.
61
IMPROVING HEALTHCARE THROUGH INFRASTRUCTURE
to enable real-time storing, capturing, regional services cloud OPTIMISE HUMAN RESOURCE
ALLOCATION AND MANAGEMENT
analysing, and retrieving of health data • Revisit national ICT strategies and IMPROVE DISEASE SURVEILLANCE
on priority diseases and outbreaks, and guidelines and provide an enabling
AND RESPONSE
&+#,/*1&,+"5 %+$"ț"ǽ$ǽǾ"14""+
EAHC and other regional and • Set aside resources for maintenance
Partner State HIS) including a client of platforms in national budgets
registry, terminology services, and • Contribute to the development,
interoperability layer adoption, and use of platforms
through the contribution of
resources and content and the
integration of national systems
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ &3"+1%"-/&,/&16,#1%" #2/1%"/
!"1&),+0-" &Ɯ &*-)"*"+11&,+ 1&3&1&"0,+ "1%"&$&1) +&1&1&3"&0)2+ %"! +"#,2+!&+
--"+!&5 ǽ
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the &$&1) +&1&1&3",/(01/"*,*-"+!&2*.
62
SUPPORTING THE ACCESS,
EXCHANGE, AND MANAGEMENT
OF DATA AND CONTENT
63
WORKSTREAM 4:
SERVICES AND APPLICATIONS
OVERVIEW
"Ɯ+&1&,+0ǿ
The Services and Applications workstream will support the
development of common, reusable, and interoperable digital "/3& "0can be provided by the
solutions and global goods for regional and national use. It government or the private sector (e.g.,
supports the products and services that provide tangible means 0,ƞ4/"00"/3& "Ǿ!1+)60&0Ȝǽ
#,/"+)&+$!&$&1)%")1%0"/3& "0+!0601"*01,"5 %+$"+! --)& 1&,+0 include point-of-care
manage information and content. 0601"*020"!6%")1%01ƛ1,!")&3"/
care.
0"/0include the general public,
GOALS
patients, and health and insurance
The overall goal of this workstream is to design, make available, providers.
foster, and invest in the use of shared services and applications
that are built for regional and national use in ways that support
the achievement of Digital REACH Initiative’s outcome goals and associated health programmes.
64
• -"/1&,+0+!02--,/1,#1" %+,),$60%,2)!+,1",2+!1,0-" &Ɯ 3"+!,/0)),4&+$-/,#"00&,+)
services to be obtained from multiple partners to prevent vendor lock-in.
• Work with the Standards and Interoperability workstream to choose standards regionally, publish them,
and support their adoption (e.g., national health indicators, diagnosis codes, patient record formats, civil
registration IDs, disease surveillance alerts, process for referrals).
• Work in support of the health programme workstream by providing technical assistance and by
prioritising the development of services and applications based on health programme needs.
• Work with the Legislation, Policy, and Compliance workstream to ensure data protection and
,+Ɯ!"+1&)&16+!1%1&+1"))" 12)-/,-"/16/&$%10/"02--,/1"!ǽ
&+1,+"4,/"5&01&+$0601"*01,02--,/1 being used and help to document key IMPROVE HEALTH WORKER
EDUCATION AND TRAINING
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ 2/1%"/!"1&),+1%"*+$"*"+1
and operations of this workstream, including organisation structures, responsibility areas, key performance
&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+ 1&3&1&"0 +"#,2+!&+1%" Digital
+&1&1&3",/(01/"*,*-"+!&2*.
65
ADVOCATING FOR
DIGITAL REACH
66
WORKSTREAM 5:
LEADERSHIP AND ADVOCACY
OVERVIEW
,1"+1&)ƛ& &"+ &"0+!
The activities of the Leadership and Advocacy workstream will
/1+"/0%&-0ǿ
be outward facing, and the workstream will interact with senior
The workstream lead for Leadership
")" 1"!,ƛ& &)0+!$,3"/+*"+1!" &0&,+*("/0,+"%)#
and Advocacy will also function as
of the Digital REACH Initiative. In so doing, it will collect high-
1%""!!3, 1"!2/&+$1%"Ɯ/01#"4
level feedback and rally support from key government decision
years of the Initiative
*("/0+!")" 1"!,ƛ& &)0#,/1%" +&1&1&3"ȉ0-/,'" 10ǽ2 %
support will greatly facilitate the participation of government
The workstream team will also use the
,ƛ& &)0+!,1%"/0&+1%" %+$"0"&+$&+1/,!2 "!1%/,2$%1%"
,/2*1, ,+!2 1!3, 6
Initiative.
on behalf of the Initiative
GOALS
%",3"/))$,),#1%&04,/(01/"*&01,!3, 1"#,/1%"&$&1) +&1&1&3"+!0, &)&0"&10"ƛ,/10 /,00
/1+"/11"0ǾǾ" 1,/),2+ &),+ ")1%Ǿ+!1%",2+ &),#&+&01"/01,)61%"$/,2+!4,/(Ǿ
remove obstacles, and garner political support for the Initiative at the Partner State and regional level.
67
IMPROVING HEALTHCARE THROUGH LEADERSHIP AND ADVOCACY
Key
LEADERSHIP AND ADVOCACY PARTNER STATE ROLE OPTIMISE THE PREVENTION,
țǗǕǖǞȔǗǕǗǘȜ DIAGNOSIS, AND TREATMENT OF
PRIORITY HEALTH CONDITIONS
5. 2 Advocate for regional agreement on • Advocate with regulatory authorities ENHANCE PUBLIC HEALTH
+
to provide frameworks and platforms EDUCATION AND AWARENESS
health insurance portability for all
to allow cross-border sharing of MONITOR POPULATION HEALTH
EAC citizens STATUS
information and implement by regional ALL OUTCOME GOALS
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the &$&1) +&1&1&3",/(01/"*,*-"+!&2*.
7RDYRLGWKHULVNRIUHVWULFWLQJRSSRUWXQLWLHVIRUIXQGLQJWKLVDFWLYLW\ZLOOEHFDUULHGRXWLQSDUWQHUVKLSZLWKGHYHORS-
ment partners. Once progress is made over time and buy-in for a reduced set of indicators is achieved this activity can
EHPRYHGWRWKH6WUDWHJ\DQG,QYHVWPHQW:RUNVWUHDPWRGULYHLWIRUZDUG
68
NEGOTIATING ECONOMIES
OF SCALE
69
WORKSTREAM 6:
STRATEGY AND INVESTMENT
70
IMPROVING HEALTHCARE THROUGH STRATEGY AND INVESTMENT
business case, and identify opportunity negotiations on per-issue basis IMPROVE HEALTH WORKER
EDUCATION AND TRAINING
for PPPs for the build and maintenance • Commit to using negotiated goods OPTIMISE HUMAN RESOURCE
ALLOCATION AND MANAGEMENT
of the EAHC and NEAT and services IMPROVE DISEASE SURVEILLANCE
AND RESPONSE
6.2 Conduct business case and use
• Assess needs that will inform IMPROVE SUPPLY CHAIN
assessments for negotiating 01/1"$61,"5-+! ,**2+& 1&,+ EFFICIENCY
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the&$&1) +&1&1&3",/(01/"*,*-"+!&2*.
71
ESTABLISHING COMMON
GUIDELINES, POLICIES, AND
PROTOCOLS
72
WORKSTREAM 7:
LEGISLATION, POLICY, AND COMPLIANCE
OVERVIEW
The Legislation, Policy, and Compliance (LPC) workstream
will develop the policies needed to support the Digital REACH ,1"+1&)ƛ& &"+ &"0ǿ
Initiative and to gain policy adoption across Partner States. It
"3"/$""5&01&+$-,)& &"0+!)"0-
will also work with Partner States to ensure that country policies
sons learned from Partner States
and legislation are amended to facilitate the implementation of
and use as a starting point for policy
Digital REACH Initiative interventions and technologies.
and legislation development where
appropriate.
GOALS "#"/"+ ""5&01&+$&+1"/+1&,+)$2&!"-
The overall goal of this workstream is to create a policy lines, best practices, and frameworks
environment across the EAC that facilitates the implementation to guide the development of policies
of digital health and creates a supportive regional enabling and legislation.
environment for better health infrastructure and policies. It will
also support Partner States in their adoption of new policies and
promote compliance across the region.
73
Ǿ Ǿ
regulatory frameworks around and country policies and legislation OPTIMISE HUMAN RESOURCE
ALLOCATION AND MANAGEMENT
remote data hosting (including data • Implement common policies, IMPROVE DISEASE SURVEILLANCE
regulatory frameworks to support guidelines using the regional testing and MONITOR POPULATION HEALTH
STATUS
data sharing in cases of disease "/1&Ɯ 1&,+1,,)0 ALL OUTCOME GOALS
outbreaks and telemedicine to allow
-1&"+101,"+"Ɯ1#/,* ,+1&+2&16
of care and improved health security
and surveillance across the region
7.3 Establish a policy and the associated
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the&$&1) +&1&1&3",/(01/"*,*-"+!&2*.
74
BUILDING HEALTH WORKER
CAPACITY
WORKSTREAM 8: WORKFORCE
75
WORKSTREAM 8:
WORKFORCE
OVERVIEW
,1"+1&)ƛ& &"+ &"0+!
This workstream focuses on establishing a workforce capable of
/1+"/0%&-0ǿ
acquiring, maintaining, designing, creating and implementing,
customising, and evaluating research and development (R&D) Partner with academic and training
and digital health programmes which are needed by the EAC institutions in the region and leverage
region to enhance healthcare. Technology can play a key role curriculum and guidelines already
in building this capacity and in delivering harmonised training. developed (e.g., eLearning at MUHAS
Building capacity and harmonising training regionally is an and the East African CoE in Supply
investment for the medium and long term, and the EAC can Chain Management, the East African
be a leader in Africa in the use of technology for a transformed 2)&Ɯ 1&,+0 /*"4,/(#,/ &$%"/
+!Ɲ"5&)"%")1%4,/(#,/ "&+4601%1)0,02--,/11%" Education developed by the IUCEA)
sustainability of digital health investments in the long term. ,,/!&+1"4&1%1%" +!
"ƛ,/11, /"1"$),)$,,!0
GOALS curriculum and eLearning.
76
• Coordinate with the IUCEA to ensure that all curriculum developed is aligned with the East African
2)&Ɯ 1&,+0 /*"4,/(#,/ &$%"/!2 1&,+ǽ
• +1"$/1"4&1%"5&01&+$*"!& )+!%")1%4,/("/1/&+&+$-/,$/**"0ț"ǽ$ǽǾ%")1%Ȓ/")1"!
undergraduate programmes (medicine, nursing, pharmacy, laboratory, other allied health programmes),
post-graduate programmes (MSc, MMed, MPhil), introduce post-graduate programmes in digital health
and promote PhD-based research programmes on digital health.
• Work with the relevant regulatory bodies to conduct a needs assessment and develop eLearning demand-
driven CPD courses for in-service health professionals.
• "12-+!*+$",/(#,/ "/1+"/0ȉ ,/2*1%1&+3,)3"0*"!& )2+&3"/0&1&"0+!/")"3+1
professional bodies (e.g., doctor and nurse associations) to facilitate cohesive inclusion of digital health in
medical training, strategise optimal delivery of eLearning content, and advise on content.
• Work with the EAACH Health Programme to support workforce for community health, adapt their skills,
and share best practices.
• Work in support of the Health Programme Workstream by providing technical assistance and by
prioritising the development of content based on health programme implementation needs.
institutions to harmonise and and develop, review, and update IMPROVE HEALTH WORKER
EDUCATION AND TRAINING
make available eLearning course national training curricula to align with OPTIMISE HUMAN RESOURCE
ALLOCATION AND MANAGEMENT
,+1"+1+!00&3"-"++)&+" harmonised regional digital health
IMPROVE DISEASE SURVEILLANCE
,2/0"0ț0Ȝ#,/&+Ȓ0"/3& "+! curricula AND RESPONSE
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ 2/1%"/!"1&),+1%"*+$"*"+1
and operations of this workstream, including organisation structures, responsibility areas, key performance
&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+ 1&3&1&"0 +"#,2+!&+1%"Digital
+&1&1&3",/(01/"*,*-"+!&2*.
77
SETTING COMMON AND
SHARED STANDARDS FOR
DIGITAL HEALTH
78
WORKSTREAM 9:
STANDARDS AND INTEROPERABILITY
OVERVIEW
%1/"1+!/!0Ȅ
This workstream will identify and develop common guidelines,
01+!/!0Ǿ-/,1, ,)0Ǿ ,**,+*+2)0Ǿ0Ǿ+!1"*-)1"0 Standards are common rules that
1,)61%"#,2+!1&,+#,/+"ƛ" 1&3"+!&+1"/,-"/)"/"$&,+) information abides by in order to make
digital health ecosystem. The workstream researches and sets it easier to interact with and share. This
common and shared standards that enable the realisation of workstream will work to harmonise
1%"&$&1) +&1&1&3",21 ,*"$,)0ǽ%&0"ƛ,/1&+ )2!"0 1%/""!&ƛ"/"+116-",#01+!/!0ǽ
developing and promoting regional principles that promote access " %+& )01+!/!0 describe
to healthcare services and interoperability across the EAC region. -/"!"Ɯ+"! %/ 1"/&01& 0,21
how information is represented
within a technology to enable
GOALS "51"/+)2+!"/01+!&+$Ǿ"5 %+$"Ǿ,/
The overall goal of this workstream is to develop and implement interaction with that information (e.g.,
regional interoperability standards, while adhering to the diagnosis codes, disease surveillance
/&+ &-)"0#,/&$&1)"3"),-*"+1+!4,/(&+$1%/,2$%"5&01&+$ alerts).
$),)+!/"$&,+)"ƛ,/10Ǿ1,02--,/1-/&,/&1&0"!&$&1) ,+1"+101+!/!0 describe
+&1&1&3"!1"5 %+$"20" 0"0ǽ 14&)))0,4,/(1,"+02/"1%1 0-" &Ɯ ,+1"+1ț"ǽ$ǽǾ 2//& 2)2*Ǿ
best practices for interoperability, data sharing, and integration 0"!"Ɯ+&1&,+Ǿ-/,1, ,)Ȝ1%1%")1%
are in place and used regionally in a way that support the workers should be taught and have
realisation of the Digital REACH Initiative’s outcome goals. access to in order to support their
work.
STRATEGIES AND GUIDELINES FOR 101+!/!0describe rules for
IMPLEMENTATION how data is described and recorded
1,"+)""51"/+)2+!"/01+!&+$Ǿ
This workstream will be responsible for developing and setting
"5 %+$"Ǿ ,*-/&0,+Ǿ+!&+1"/ 1&,+
standards that support the Initiative. Primarily composed
with that data (e.g., standardised
,#02'" 1Ȓ*11"/"5-"/10Ǿ1%"1"*4&))4,/( ),0")64&1%
indicators, data dictionaries). This can
/")"3+1-/1+"/,/$+&01&,+0Ǿ/1+"/11",ƛ& &)0Ǿ+!,1%"/
also include protocols for ensuring
workstreams, providing and soliciting input as needed. The team
data is safe and secure when it is
4&))4,/(4&1%1%"1, ,,/!&+1"!3&0,/6&+-21#/,*"5-"/10
stored and shared (e.g., data security
/,00)),1%"/4,/(01/"*01,"+02/"1%10-" &Ɯ "5-"/1&0",+
standards, data integrity, responsible
standards is provided.
data practices).
The workstream will form and be guided by a Standards
+! +1"/,-"/&)&16 1%1&0*!"2-,#4,/(01/"*
02'" 1Ȓ*11"/"5-"/10+!/1+"/11",ƛ& &)0 1&+$
together to scope and review standards developed by the ,1"+1&)ƛ& &"+ &"0ǿ
4,/(01/"*ǽ2--,/1"!6&+1"/+)2!&1,/0Ǿ1%" 4&)) "3"/$""5&01&+$&+1"/,-"/&)&16
also play a compliance role, in that it will review progress with assessments carried out in the
implementation of agreed-upon standards across Partner State region and within Partner States
and Digital REACH Initiative workstreams. (e.g., Uganda’s work on harmonising
The following are strategic recommendations for the standards to support interoperability
operationalisation of this approach: domestically).
• "1-,)&1& )26Ȓ&+#,/+"401+!/!0+!-/,1, ,)06
$1%"/&+$&+-210#/,*/1+"/11"0+!# &)&11&+$ ,**,+$/""*"+11%/,2$% 0ǽ
• Develop standards and protocols based on stakeholder inputs.
• Socialise protocols and standards to ensure use and gather inputs to inform iteration over time.
• Advise other workstreams on appropriate world-class digital standards and protocols (e.g., data security,
design).
• Conduct internal auditing to monitor compliance across workstreams to ensure that all workstreams
79
promote interoperability in all their activities. Use internal auditing as an opportunity to receive feedback
periodically and to provide support.
• Learn from other regions that have implemented shared standards and protocols.
• Work closely with the Legislation, Policy, and Compliance workstream on relevant regulation that impacts
the development and compliance of interoperability standards.
• Work in support of the Health Programme Workstream by providing technical assistance and by
prioritising the development of standards based on health programme implementation needs.
• Work with the Infrastructure and Services and Applications workstreams to identify areas where standards
can help to support interoperability in the region.
9.2 Create a regional data dictionary, standards that are developed OPTIMISE HUMAN RESOURCE
ALLOCATION AND MANAGEMENT
mapped to international standards, • Agree on regional reference IMPROVE DISEASE SURVEILLANCE
AND RESPONSE
and supporting governance process interoperability architecture and adopt IMPROVE SUPPLY CHAIN
to support interoperable data best practices sharing common global EFFICIENCY
)&*0Ǿ1,"5 %+$"-1&"+1/" ,/!0 regulations and passing legislation ALL OUTCOME GOALS
%"-/&,/&1&"0)&01"!%"/"4&))"/"3&"4"!++2))66,/(01/"*ǖ+!&10-/1+"/0ǽ!!&1&,+) 1&3&1&"0
#,/1%&04,/(01/"*1%1 +"1/$"1"!1)1"/01$"0 +"#,2+!&+--"+!&5ǽ%"0-" &Ɯ 0(&))0+!
-&)&1&"0/".2&/"!#,/1%&04,/(01/"* +"#,2+!&+--"+!&5 ǽ
2/1%"/!"1&),+1%"*+$"*"+1+!,-"/1&,+0,#1%&04,/(01/"*Ǿ&+ )2!&+$,/$+&01&,+01/2 12/"0Ǿ
/"0-,+0&&)&16/"0Ǿ("6-"/#,/*+ "&+!& 1,/0Ǿ/&0(0+!*&1&$1&,+01/1"$&"0Ǿ+!0-" &Ɯ &*-)"*"+11&,+
activities can be found in the &$&1) +&1&1&3",/(01/"*,*-"+!&2*.
80
The Path Forward
RESOURCE REQUIREMENTS
An important goal of this strategic planning process is to build support for resource mobilisation among potential
funding partners. The resources required for the Digital REACH Initiative will come from a variety of sources and
4&))&+ )2!",1%Ɯ++ &)+!+,+ȒƜ++ &)#,/*0,#02--,/1Ǿ002**/&0"!&+1%"1)""),4ǽ 2/1%"/!"1&),+
each of these can be found in this section.
)"ǚǽ"0,2/ ",2/ "0+!1"$,/&"0""!"!#,/2 "00
RESOURCE CATEGORIES RESOURCE SOURCES
ș &++ &) ,+1/&21&,+0ț"ǽ$ǽǾ$/+10+!),+0Ȝ • Development Partners
ș" %+& )"5-"/1&0" ș ,/Ȓ-/,Ɯ1/&31"" 1,/
• Political and public support and commitment ș"$&,+)+!/1+"/11" ,3"/+*"+10
• Civil society buy-in and engagement ș, ) ")1%/,3&!"/0+!&3&), &"16 /,2-0
ș +Ȓ(&+!+!!&/" 1Ɯ++ &) ,+1/&21&,+0 • Research Bodies and Universities
It is important to note that while this while this Strategic Plan lays out what is needed to achieve the Digital
REACH Initiative, an important part of resource mobilisation and implementation will be to identify opportunities
#,/"ƛ& &"+ &"01%1/"!2 "1%" ,01,#&*-)"*"+11&,+,3"/1&*"ǽ5*-)"0,#02 %"ƛ& &"+ &"0&+ )2!"1%"20"
,#/"!6*!"00"104%"/"1%"6"5&01Ǿ&!"+1&Ɯ 1&,+,#01/1"$& -/1+"/0%&-04&1%,3"/)-&+ 1&3&1&"0Ǿ+!
)"3"/$&+$,--,/12+&1&"0#,/,-"/1&,+) ,0103&+$0ț02 %00%/&+$,ƛ& "0- "4&1%,1%"/2+&10Ȝǽ%"0"
opportunities have been highlighted across the plan in various workstreams.
%"Ɯ++ &)/"0,2/ "/".2&/"*"+10#,/1%"Ɯ/01Ɯ3"6"/0,#/2++&+$1%"&$&1) +&1&1&3"Ǿ64,/(01/"*Ǿ
/"!"1&)"!"),4ǽ 2/1%"/!"1&)&03&))"&+1%"&$&1) +&1&1&3",01&+$1,,)ǽ
)"Ǜǿ2**/6,#"0,2/ "0".2&/"!
# YEAR 1 YEAR 2 ǘ Ǚ ǚ TOTAL
ǖ Initiative Management $2,388,169 $2,993,217 $2,997,509 $3,038,247 $2,950,551 $14,367,693
2.2 Regional Health Services $1,500,000 $2,832,500 $3,182,700 $3,824,545 $2,251,018 $13,590,762
2.4 Telehealth NEAT Healthcare Services $1,500,000 $5,407,500 $3,182,700 $3,746,493 $2,894,166 $16,730,858
ǜ Policy, Legislation, and Compliance $ 820,138 $1,985,290 $2,333,351 $2,579,995 $2,535,727 $10,254,501
81
Engagement with a range of stakeholders is critical for the success of the Digital REACH Initiative. A multi-
01("%,)!"/"+$$"*"+1--/, %4&))"+02/"1%1 /&1& )&+1"/+1&,+)"5-"/1&0"&021&)&0"!+!1%11%" +&1&1&3"
is structured in a way that ensures sustainability from the start. Priority will be given to partners who recognise
1%"&*-,/1+ ",#-211&+$), )"5-"/1&0"11%"#,/"#/,+1+!!!/"00&+$$-0&+1%"/"$&,+1%/,2$%(+,4)"!$"
transfer and capacity building, rather than providing long-term continuous support. The development community
is already involved in multiple activities related to the Initiative, and private-sector companies may be interested in
!&ƛ"/"+1/"0,#02--,/1!"-"+!&+$,+1%"&//")1&3"20&+"00*,!")0ǽ
development part- tional corporations • Partner State tion service provid- health, education and
ners with aligned (e.g., insurers, governments ers (e.g., hospitals, research institutions
agendas health manage- ș1%"//"$&,+) clinics, medical
*"+1Ɯ/*0Ȝ bodies (e.g., provider groups,
• Pharmaceutical African Union, faith-based provid-
companies European Union) "/0Ǿ 0Ȝ
• Medical device • Professional health
companies worker associa-
ș /!4/"Ǿ0,ƞ- tions
ware, and profes- • Advocacy groups
sional services
Ɯ/*0
ș0Ǿ), )"+1/"-
preneurs/SMEs,
and private sector
forums
82
DEVELOPMENT FOR-PROFIT REGIONAL AND LOCAL SERVICE
PARTNERS PRIVATE SECTOR NATIONAL PROVIDERS AND UNIVERSITIES
GOVERNMENT CIVIL SOCIETY
GROUPS
• Support of activi- • "+"Ɯ1#/,*"+- • Progress towards • Support of activities • +,4)"!$""5 %+$"+!
VALUE FOR THE SECTOR
ties that align with abling environment national health that align with "5-"/1&0"2&)!&+$
organisational and market entry agendas and organisational goals • + /"0"!"5-,02/"#,/
goals and agendas • Market development targets and agendas published research
• Direct funding or • Potential for in- • Potential for • Increased pool of academic
loss guarantees /"0"!&+Ɲ2"+ " &+ /"0"!&+Ɲ2"+ " talent
from development (e.g., replication of (e.g., opportunity to
partner community EU regional coop- lobby governments
• Capacity building of eration models) or development
01ƛ&+1%"/",# • Capacity building partners)
digital health ,#01ƛ&+1%"/" • Capacity building of
of digital health 01ƛ&+1%"/",#
digital health
• Direct funding or • Direct funding or • Direct funding or • In-kind support and • In-kind support and con-
investment (e.g., investment (e.g., investment contributions tributions (e.g., research
grants, loans, grants or equity • Political support • Provision of techni- support, training support)
private-sector loss investments) and technical cal assistance • Participation in advisory
guarantees) • Participation in "5-"/1&0"+! • Participation in bodies
POTENTIAL TYPES OF SUPPORT
• In-kind support and PPPs and advisory assistance advisory bodies • !3, 6"ƛ,/10
contributions (e.g., bodies • In-kind support • !3, 6"ƛ,/10
technical assis- • In-kind support and and contributions
tance) contributions (e.g., (e.g., seconded
• Participation in provision of airtime 01ƛȜ
advisory bodies 60Ǿ/"!2 "! • Participation in
• !3, 6"ƛ,/10 or highly subsidised advisory bodies
(e.g., lobbying) -/& &+$Ǿ0,ƞ4/" • !3, 6"ƛ,/10
licences)
• !3, 6"ƛ,/10Ǿ
speaker bureaus,
thought leadership
"5-,02/"Ǿ+!
access to networks
+!&+Ɲ2"+ "
83
)"Ǟǿ,)",#1%"/&31"" 1,/&+&$&1) /,00+)&+$+3&/,+*"+1,/(01/"*0
HOW THE PRIVATE SECTOR CAN SUPPORT THIS
INVESTMENT
ș)2)""5-"/1&0"Ǿ1" %+& )00&01+ "Ǿ+! ș ,2+!1&,+)&+#/01/2 12/" /"1"0+,--,/-
02--,/11%/,2$%0" ,+!*"+1,#01ƛǾ-/"#"/"+1&) tunity for additional value-added services and
-/& &+$#,//".2&/"!0,ƞ4/")& "+ "0+!%/!- applications to be created.
ware, and design and R&D assistance. ș 2/1%"/!"3"),-01" %+& )"5-"/1&0"&+1%"
• Direct investment for technical or commercial region.
pilots. ș 5*-)"/"$&,+)1" %+& )&*-)"*"+11&,+0
ș210,2/ &+$,# 1&3&1&"0&+ )2!&+$1%"2&)!&+$ signals clear, unambiguous opportunities to
INFRASTRUCTURE
and maintenance of platforms and the technical create other regional and national services and
call centre or tiered technical support for the applications.
region. • Better connectivity infrastructure makes it eas-
ș 5-+0&,+,# ,++" 1&3&16&+#/01/2 12/"&+1%" ier for the private sector to invest and function
region through strategic PPPs. and creates opportunities for new products to
enter the market.
84
ș 5-"/1&0"+!1" %+& )00&01+ "ț"ǽ$ǽǾ1%/,2$% • Companies will have a clearer and more har-
0" ,+!*"+1,#01ƛȜ#,/1%"!"3"),-*"+1,# monised standards environment in which to do
harmonised standards and best practices on business.
STANDARDS AND interoperability. • Better data that can be compared regionally to
INTEROPERA-
support better health products and services.
• Interoperability increases the opportunity for
new value-added products and services to
enter the market.
85
%"Ɯ$2/""),4)60,211%"&**"!&1"+"5101"-01,0" 2/&+$02--,/1+!#2+!&+$#,/1%"&$&1) +&1&1&3"ǽ
&$2/"ǖǖǿ **"!&1""511"-0#,/"0,2/ "0,&)&01&,++! +&1&1&3"2+ %
FORMAL LAUNCH AND SET-UP
• 5" 21"$&+011 1& )-)+
• Set up entity
• /$"10-" &Ɯ ,/$+&01&,+0Ǿ • Hire all Workstream Leads
events, and activities LAY THE FOUNDATIONS • Schedule and hold launch
• Host a development partner • Launch the website
• /"1"ǘǕȒǛǕȒǞǕȒ!6 • 01)&0%+,ƛ& "
roundtable as a co-design
1 1& )-)+#,/ǖǗǕǖǞ • /"1"Ɯ++ &) ,2+1&+$
opportunity to identify
• Establish the governing mechanisms and foundations for
strategic linkages between EAC APPROVAL bodies ,/(01/"*ǖ
development partners’
• EAC approval • Begin recruiting process and • Identify independent M&E and
current and future priorities
processes for %&/"-/&*/6,/(01/"*ǖ research partners
and the Digital REACH
strategic plan 01ƛ • Identify health programmes for
Initiative
and further • Create a blueprint for the immediate implementation
• Secure domestic and
socialisation infrastructure, services, and • Coordinate and hold subject-matter
international commitments
with key regional applications that will be built "5-"/1 ,+3"+&+$01,$1%"/&+-210
in time for launch
stakeholders Ɯ/01ț"ǽ$ǽǾ Ȝ for workstreams
• Tailor resource mobilisation
strategy to priority areas,
demonstrating synergies,
where possible 5" 21&,+
--/,3) /"-/"1,2+ % +!2+ %
Q4 2018 Q4 2018 - Jan 2019 Q1 2019
"0,2/ ",&)&01&,+
(ongoing)
&+1&+Ɲ"5&)"-/&,/&1&"00"!,+ Coordinate across workstream to ensure Conduct ongoing partnership building and
resources available at launch; set up priorities remain aligned regardless of awareness raising to continuously mobilise
governance structures accordingly funding available resources and socialise Initiative goals and
outcomes
86
APPENDICIES
87
Appendix A: Full Acknowledgements
The Strategic Plan was developed in a highly consultative and collaborative way and involved inputs from key
decision makers in East Africa. The following are members of the EAHRC who oversaw and lead the creation of
this document.
NAME DESIGNATION INSTITUTION
/,#ǽ &0,+&&(& 5" 21&3"" /"1/6 EAHRC
/ǽ "+!"&"2$&/"$ "-2165" 21&3"" /"1/6 EAHRC
Dr Novat Tun-gubumwe /&+ &-) ")1%ƛ& "/ EAHRC
/ǽ &+0%2/& /&+ &-) ")1%ƛ& "/ EAHRC
The EAHRC would like to thank the multiple stakeholders who have been engaged throughout the process
,#!"3"),-&+$1%" ,01"!&$&1) 1/1"$& )+ǽ-" &)1%+(0/""51"+!"!1,1%" ,+1/&21,/0)&01"!
below.
ǾǙ Ȓǝ ǗǕǖǝǾ Ǿ
PARTNER STATE/
NAME DESIGNATION INSTITUTION
COUNTRY
/,#ǽ &0,+&&(& 5" 21&3"" /"1/6 EAHRC EAHRC - EAC
/ǽ "+!"&"2 "-2165" 21&3"" /"1/6 EAHRC EAHRC - EAC
Ngirabega
Dr Novat Tun- /&+ &-) ")1%ƛ& "/ EAHRC EAHRC - EAC
gubumwe
/ǽ &+0%2/& /&+ &-) ")1%ƛ& "/ EAHRC EAHRC - EAC
Betty Nankya Senior Personal Secretary EAHRC EAHRC - EAC
Dr Isaac Kadowa /&+ &-) ")1%ƛ& "/ Ministry of Health Republic of Uganda
Dr. Elias M Kwesi EAC Coordinator Ministry of Health United Republic of
Tanzania
David Edward Lenga Statistician Ministry of Health United Republic of
Tanzania
Dr. Mary B Charles Public Health Specialist Ministry of Health and United Republic of
Muhimbili National Hospital Tanzania
)&*/)& Public Health Epidemiologist Ministry of Health - Zanzibar United Republic of
Tanzania
/ǽ 00+2! 2* ƛ& "/ Ministry of Health - Zanzibar United Republic of
Tanzania
Brendan Smith ,#/,#"00&,+)"/3& "0 &1)3"Ǿ + ǽ USA
+! &)&11,/
Katherine de Tolly "!+)601+! &)&11,/ &1)3"Ǿ + ǽ USA
88
Ǿ ǗǕǖǝ
Dr. Anthony Were Deputy Director EAKI East African Kidney Institute
89
Ǿ ǗǕǖǝțȆȜ
90
Ǿ ǗǕǖǝțȆȜ
NAME DESIGNATION INSTITUTION
"+!ȉ*,2/ $20"+$ Coordinator East Africa CoE for Health Supply
Chain Management, University of
Rwanda
$"+7& ,0"-%2+" Academic Associate East Africa CoE for Biomedical
Engineering and eHealth, University
of Rwanda
Alpha Marara Director of ICT Kigali Teaching Hospital
Dr. Henry Mwebesa $ǽ&/" 1,/ "+"/) ")1%"/3& "0 Ministry of Health
91
*""14&1%0"+&,/,ƛ& &)0#/,*1%"*&+&01/&"0/"0-,+0&)"#,/ƛ&/0Ǿ+!*&+&01/&"0/"0-,+0&)"
for health for inputs into the mid-term review of the EAHRC strategic plan and inputs into the EAHRC strategic
programmes and initiatives.
92
%+(0/")0,"51"+!"!1,1%"*"*"/0,#1%"&$&1) 1""/&+$,**&11""Ǿ4%& %40#,/*"!61%"
EAHRC to support the process and provide inputs. who provided key inputs into the Strategic Plan.
93
The roadmap that preceded this Strategic Plan and determined the areas of work for the Digital REACH
Initiative was also developed through inputs from key decision makers through conferences and smaller
4,/(0%,-0ǽ-" &)1%+(0/""51"+!"!1,1%" ,+1/&21,/01,1%&0/,!*-)&01"!"),4ǽ
Ǜ Ǘǝ ȔǘǕ ǗǕǖǜǾ
Ǿ
PARTNER STATE/
NAME DESIGNATION INSTITUTION
COUNTRY
/ǽ *)!* EAHRC Commissioner Zanzibar Medical Research United Republic of
Taib &/" 1,/ "+"/)+!%&/ Council Tanzania
/ǽ ,0"-%6+!4& EAHRC Commissioner University of Burundi, Republic of Burundi
Lecturer & Researcher 2)16,#"!& &+"
Dr. Pierre Claver EAHRC Commissioner National Institute of Public Republic of Burundi
Kazihise &/" 1,/ "+"/) Health
Dr. Isaac Minani EAHRC Commissioner Ministry of Public Health Republic of Burundi
&/" 1,/ "+"/) +! &$%1$&+01
/ǽ "/)!(,'& EAHRC Commissioner Kenya Medical Research Republic of Kenya
&/" 1,/ "+"/) Institute (KEMRI)
/ǽ (0,+&,(, EAHRC Commissioner Ministry of Health Republic of Kenya
Director of Medical
Services
/,#ǽ &+0*& EAHRC Commissioner Moi University College of Republic of Kenya
Professor of Child Health Health Sciences
and Pediatrics
/ǽ*(4/" EAHRC Commissioner Uganda National Health Republic of Uganda
&/" 1,/ "+"/) "0"/ %/$+&71&,+
ț Ȝ
Prof. Pauline EAHRC Commissioner Makerere University College Republic of Uganda
Byakika-Kibwika Associate Professor of Health Sciences
/,#ǽ2+20$6 EAHRC Commissioner The National Institute for United Republic of
&/" 1,/ "+"/) Medical Research (NIMR) Tanzania
/,#ǽ)&$&20 /+ &0 EAHRC Commissioner Muhimbili University of United Republic of
Lyamuya "-216& "%+ ")),/ Health & Allied Sciences Tanzania
Academics, Research & (MUHAS)
Consultancy
Prof. Dr. Mohamed EAHRC Commissioner Ministry of Health United Republic of
Bakari Kambi %&"#"!& )ƛ& "/ Tanzania
/ǽ,%**"! ǽ EAHRC Commissioner Zanzibar Medical Research United Republic of
Dahoma Director of Hospitals and Council Tanzania
Member of the Zanzibar
Research Council
94
ǾǛ Ȓǝ
ǗǕǖǜǾǾ
PARTNER STATE/
NAME INSTITUTION DESIGNATION
COUNTRY
HONORARY GUEST
,+ǽ-"+!& %&"+$ Ministry of Health Chair EAC Sectoral Council of Republic of Uganda
Sarah Health
Minister of State for Health
ț "+"/)21&"0Ȝ
EAHRC PMO
EAHRC COMMISSIONERS
95
ǾǛ Ȓǝ
ǗǕǖǜǾǾ țȉȜ
PARTNER STATE/
NAME INSTITUTION DESIGNATION
COUNTRY
96
ǾǛȒǝǗǕǖǜǾ
Ǿ țȉȜ
PARTNER STATE/
NAME INSTITUTION DESIGNATION
COUNTRY
,!,2 6" Muhimbili National Hospital Director of ICT United Republic of
Tanzania
Dr. Nabudeere Harriet Uganda National Health "-216&/" 1,/ "+"/) Republic of Uganda
"0"/ %/$+&01&,+
Patrick Kibaya Uganda Chartered HealthNet Head Republic of Uganda
Dr. Peter Cherutich Ministry of Health Head Division of Strategic Republic of Kenya
Health Information
Dr. Pilly Chillo Muhimbili University of Health & Lecturer United Republic of
Allied Sciences (MUHAS) Tanzania
Richard Tumwesigye Uganda Cancer Institute Coordinator Republic of Uganda
Dr. Zacharia Mtema Digital Health Ifakara Health In-charge of Health United Republic of
Institute Informatics Tanzania
97
ǾǛȒǝǗǕǖǜǾ
Ǿ țȉȜ
PARTNER STATE/
NAME INSTITUTION DESIGNATION
COUNTRY
98
ǾǛȒǝǗǕǖǜǾ
Ǿ țȉȜ
PARTNER STATE/
NAME INSTITUTION DESIGNATION
COUNTRY
&/&*2 (2, USAID, Kenya and East Africa Regional Deputy Chief Republic of Kenya
"+.&+$&+ Leiden Unversity Center for Data Digital Health PhD The Netherlands
Science candidate
Dr. Samuel Mwenda Christian Health Association of "+"/)" /"1/6 Republic of Kenya
Kenya (CHAK)
Dr. Tonny Tumwesigye Uganda Protestant Medical 5" 21&3"&/" 1,/ Republic of Uganda
Bureau (UPMB)
FACILITATORS
99
ǾǗǜ ȒǗǝ ǗǕǖǜǾ
Ǿ
PARTNER STATE/
NAME DESIGNATION INSTITUTION
COUNTRY
Daniel Murenzi /&+ &-) ƛ& "/ EAC EAC
100
ǾǘǗǕǖǜǾ
Ǿ
PARTNER STATE/
NAME DESIGNATION INSTITUTION
COUNTRY
Daniel Murenzi /&+ &-) ƛ& "/ EAC EAC
101
Appendix B: Partner State Situation Analysis
%"Ɯ$2/""),4-/,3&!"0+,3"/3&"4,#1%" 2//"+1011",#!&$&1)%")1%-/,$/*0+!0601"*0&+" %
EAC Partner State. It describes the strategies in place, as well as services and applications that support
1%,0"01/1"$&"0ǽ 1)0,-/"0"+101%" %))"+$"01%1" % ,2+1/6&0# &+$#,/"5-+!&+$!&$&1)%")1%
&*-)"*"+11&,+0ǽ%))"+$"04"/"&!"+1&Ɯ"!6&+&01/6,# ")1%+!&+&01/6,# 01ƛ&+" % ,2+1/6ǽ
%&0&0+,+Ȓ"5%201&3")+!0 -",3"/3&"4ǽ!"1&)"!)+!0 -"00"00*"+14&))" ,+!2 1"!6" %
4,/(01/"*,+ "1%" +&1&1&3"&00"12-1,&!"+1@%100"10)/"!6"5&01&+" %,#1%"/1+"/11"01%1
can be utilised for the Digital REACH Initiative.
102
Current Status of Digital Strategy and Illustrative ")#Ȓ !"+1&Ɯ"!
Health Services and Applications Challenges
%""-2)& 1DVFHQWVWUDWHJ\ Strategy in Place • Political instability
,#,21% ,PSOHPHQWDWLRQSODQVWLOO ș1&,+) ")1%,)& 6ǗǕǖǛȒ • Poor infrastructure
2!+ under formulation ǗǕǗǚ • No clear eHealth strategy
• Nascent strategy and DHIS2 Illustrative Services & in place
implementation Applications
ș ,3"/++ "01/2 12/"2+ )"/ • DHIS2 partial implementation
103
Appendix C: EAC Digital REACH Initiative Supporting Documentation
ǖǚ
104
105
106
107
The 35th Extra-Ordinary Meeting of the Council of Ministers
108
109
Appendix D: EAC Strategic Priorities and Digital REACH Outcome Goals
# Digital REACH Initiative Outcome Goal Associated EAC Regional Health Sector Investment
Health-Focused Outcomes Priorities
ǖǽ-1&*&0"1%"/"3"+1&,+Ǿ&$+,0&0Ǿ+!/"1*"+1,# ș 5-+0&,+,# "001,0-" &)&0"!%")1% /"and cross
/&,/&16 ")1%,+!&1&,+0 border health services
• Improve quality of care across countries (e.g., by improving • Upgrading of %")1%&+#/01/2 12/"and equipment in priority
communication of diagnosis/treatment best practices, national and sub national health facilities/hospitals
providing clear and monitorable harmonised guidelines, • Establishment of strong -/&*/6+! ,**2+&16%")1%
and allowing for collaboration and sharing of information.) 0"/3& "0 as a basis for health promotion and diseases
ș *-/,3""ƛ& &"+ 6,# /" /,00 ,2+1/&"0ț"ǽ$ǽǾ6 prevention and control
improving management of care while carefully tracking of ș 5-+0&,+,#%")1%&+02/+ " coverage and social health
results/outcomes, harmonised drug treatment protocols) protection
• Improve continuity of care across countries (e.g., by
ensuring the patients and their histories remain at the
centre of care regardless of location of that care)
• Improve access to healthcare services
Ǘǽ2--,/1+&3"/0) "001, ")1% /" ș 5-+0&,+,# "001,0-" &)&0"!%")1% /" and cross
• Provide universal health insurance to anyone in the region border health services
ș 5-+0&,+,#%")1%&+02/+ " coverage and social health
• Identify everyone with a right to quality healthcare (full
protection
registration)
110
Appendix E: Additional Workstream Activities
The table below lays out additional activities by workstream that can be targeted for implementation once
progress has been made on the priority activities.
ADDITIONAL ACTIVITIES
ǘǿ +#/01/2 12/" ș,/(4&1%1%"1/1"$6+! +3"01*"+11"*1,&!"+1-/&,/&16/"0#,/"5-+!"!
network connectivity in the region based on priority use cases
• Development of further digital foundational technologies (e.g., regional facility registry,
shared health record)
Ǚǿ"/3& "0+!--)& 1&,+0 • Work with the Workforce team to support linking regional knowledge management
platforms to content in national knowledge repositories and eLearning systems that
support the regional mission
• Develop tools to support decision planning, tracking, and decision support for supply
%&+Ǿ2!$"1Ǿ+!Ɯ++ &)+)60&0
• Improve and integrate human resource information systems to improve human
resource allocation
• Implement a communications system to reach subgroups of the patient population
with targeted public health messaging
ǚǿ"!"/0%&-+!!3, 6 • Advocate to support better governance structures
• Advocate to facilitate inclusion and recognition of digital health in curricula to ensure
all health workers are trained and knowledgeable on digital health
• Advocate for messaging services to public and private facilities to improve public
education and awareness
• Advocate across countries for bulk purchasing of medical supplies to reduce cost of
healthcare to providers and patients
Ǜǿ1/1"$6+! +3"01*"+1 ș"3"),-20&+"00 0"0#,/+"$,1&1&,+4&1%0#,/ƛ,/!)"+!4&!1%+!
improved network connectivity to support other implementations
• Manage and negotiate bulk purchasing of supplies across states to reduce cost of
provision of health
ǜǿ"$&0)1&,+Ǿ,)& 6Ǿ+! • Create manpower policies to improve health worker productivity
,*-)&+ " • Achieve accreditation and recognition of eLearning courses provided by the Initiative
(e.g., by nursing and doctors associations and Partner States) to allow health workers
to travel in the region and to ensure patient receive the same standard of care
ǝǿ,/(#,/ " • Promote eLearning as means of reaching a broader group of healthcare professionals
that in the long run reduces training cost and time away from duty stations
• Share best practices on digital methods including use of social media platforms for
public health education and awareness
• Build capacity of health professionals for areas of Digital REACH Initiative activities
(e.g., data sharing, supply chain management tools, public health messaging tools,
monitoring of population health trends). Prioritise according to needs.
Ǟǿ1+!/!0+! • Create standards for compensation across region to ensure fair premiums and
+1"/,-"/&)&16 repayment
• Harmonise regional data standards for health insurance to support the insurance
market
• Create a common standardised template to collect Partner States’ supply needs to
support demand aggregation
• Create nonbinding guidelines on the recognition of prescriptions across borders to
allow EAC citizens to access necessary medication
• Create minimum data set for diagnostic algorithms and clinical referral guidelines to
support continuity of care
ș"Ɯ+"-/,1, ,)0#,/-2)& %")1%*"00$&+$ț1,&+ )2!"1&*&+$+! ,+1"+1Ȝ1,"+02/"
2+&Ɯ"!0&+$)"*"00$"&0/" "&3"!6 &1&7"+01,3,&! ,+#20&,++! /"1"
#/*"4,/(0+!1"*-)1"01,&+ /"0"0-""!+!"ƛ& &"+ 6,# ,**2+& 1&,+0
• Develop guidelines for cross-border health research with regional universities and
research bodies to encourage and support regional research
• Set service delivery standards and harmonise service delivery guidelines
111
Appendix F: Skills and Capabilities Across Workstreams
ADDITIONAL ACTIVITIES
ǖǿ +&1&1&3" • Leadership • Communications and public relations
+$"*"+1 • Management • Knowledge management
• Project coordination ș 5-"/1&0"&+$),)%")1%Ǿ!&$&1)%")1%Ǿ
• Stakeholder and partnership management and regional policy
• Change management • M&E
ș-"/1&,+0țƜ++ "Ǿ Ǿ)"$)Ǿ Ȝ
Ǘǿ ")1% • Management and oversight ș2)& %")1%"5-"/1&0"
/,$/**"0 ș-"/1&,+)02--,/1 ș" %+,),$6"5-"/1&0"
• M&E
ǘǿ +#/01/2 12/" • Management and oversight • Database administration
ș-"/1&,+)02--,/1 • Server administration
• Product ownership ș,ƞ4/"!"3"),-*"+1
• Enterprise IT management • Human-centred design
• Partnership management • IT security
• IT system architecture
• M&E
Ǚǿ"/3& "0+! • Management and oversight • Public health
--)& 1&,+0 ș-"/1&,+)02--,/1 • Medical informatics
• Product ownership • Requirements gathering
• Partnership management ș0"/&+1"/# "ȡ20"/"5-"/&"+ "ț ȡȜ
design
ș,ƞ4/"!"3"),-*"+1
• Human-centred design
• M&E
ǚǿ!3, 6 • Management and oversight ș,+02)11&,++!+"$,1&1&,+"5-"/1&0"
ș-"/1&,+)02--,/1 ș 5-"/1&0"4,/(&+$3& %++")0+!
• Stakeholder management structures
• M&E
Ǜǿ1/1"$6+! • Management and oversight ș"5-"/1&0"
+3"01*"+1 ș-"/1&,+)02--,/1 • Business analysis
• Negotiation
• M&E
ǜǿ"$&0)1&,+Ǿ • Management and oversight of workstream by health ș,)& 6+!)"$&0)1&,++)60&0+!!/ƞ&+$
,)& 6Ǿ+! professionals with both managerial and technical "5-"/1&0"
,*-)&+ " skills • Digital health, particularly at the policy
ș-"/1&,+)02--,/1 level
• Stakeholder management • M&E
ǝǿ,/(#,/ " • Management and oversight ș ")1%-/,#"00&,+)"!2 1&,+"5-"/1&0"
ș-"/1&,+)02--,/1 ș2)& %")1%"5-"/1&0"
• Coordination across all workstreams ș&$&1)%")1%"5-"/1&0"
• Partnership management • Capacity building, training, CPE and
,+1"+1 /"1&,+"5-"/1&0"
• M&E
Ǟǿ1+!/!0+! • Management and oversight • Public and clinical health
+1"/,-"/&)&16 ș-"/1&,+)02--,/1 ș "5-"/1&0"
• Stakeholder management • Standards deͰelopment
• Implementation • Solution development
• Research and analysis
• M&E
112
Appendix G: EAHC Implementation Activities
%&0--"+!&5-/,3&!"0#2/1%"/!"1&),+1%"&*-)"*"+11&,+ 1&3&1&"01," //&"!,2161%" +#/01/2 12/"
workstream and the EAHC Health Programme. To realise the EAHC, three sub-workstreams will be employed.
%"0"1%/""02Ȓ4,/(01/"*04&))#2+ 1&,+&+-/))")ǽ%"1)""),4-/,3&!"0*,/"!"1&),+1%"0-" &Ɯ
activities in each sub-workstream.
Ȓ ACTIVITIES
+0&$%10+!,+1"+1 • Advocate for buy-in from all the EAC Partner States for the EAHC
• Create shared vision for EAHC
ș1&+#""! (#/,*/1+"/11"0,+4%11%"6+""!1,,-1&*&0"1%"&/3)2"
from the EAHC (e.g., what data to include, what database views to make available, how
1,"+02/""06 "00#,/--/,3"!/"0"/ %"/0Ǿ !"*& 0Ǿ+!$,3"/+*"+1,ƛ& &)0Ȝ
• Analyse EAHC data to create common goods (e.g., algorithms to trigger outbreak alerts,
/,21&+"+)60"0,+ ,*-/1&3""ƛ" 1&3"+"00,#%")1%-/,$/**"0Ǿ01+!/!&0"!
tools for data collection and use)
ș&&0""14""+1%"/1+"/11"0+!1%" +&1&1&3"ȉ0/"$/!&+$1%,2$%1
leadership and implementation learnings
" %+,),$6 • Implement and manage the EAHC, its data, and the database views that are accessible
6/")"3+120"/0ț"ǽ$ǽǾ/"0"/ %"/0Ǿ !"*& &+0Ǿ+!$,3"/+*"+1,ƛ& &)0Ȝ
ș01)&0%+!*&+1&+0" 2/"+!/")&)"Ɲ,40,#!1#/,* ,+1/&21&+$/1+"/
• State systems into EAHC and then out to users in the proper format
ș01)&0%0+!!1ȡ)"/1&+$4,/(Ɲ,40#/,*1%" 1,/1+"/11"0
• Support the design and deployment by EAC Partner States and other health
programmes of standardised tools and standards for data collection and use, directly
linked to the EAHC architecture
ș--)6&+!201/601+!/!0#,/!10" 2/&16Ǿ&+1"/,-"/&)&16Ǿ+!"ƛ& &"+ 6
-"/1&,+0 • Agree on location of EAHC
• Identify opportunity for PPPs for the build and maintenance of the EAHC
• Establish and enforce security protocols for accessing system data
• Establish a user support system for accepting, tracking, and resolving requests for
support, system issue reports, and new feature requests
• Monitor system usage and data access
• Inform users of any new system features or data sets, changes to access protocols, or
disruptions to service
• Maintain a public roadmap of current and planned feature development
The Infrastructure team will be responsible for ensuring that all health programmes that are dependent on
EAHC to operate will feed into the functional requirements so that they are able to store the data they need in
the cloud.
%""!"/0%&-+!!3, 64,/(01/"*1"*Ǿ4,/(&+$4&1%1%" +#/01/2 12/"1"*+!1%"0
needed, will familiarise the EAC Partner States on EAHC for better understanding among countries of the
+""!+!3)2",#&10"01)&0%*"+1ǽ 2/1%"/*,/"Ǿ1,$&+26Ȓ&+#/,*/1+"/11"0+!01("%,)!"/0Ǿ
"*-%0&04&))"-21,+-/, "00"0+! ,+1/,)0/")1"!1,!10" 2/&16Ǿ-/&3 6Ǿ ,+Ɯ!"+1&)&16Ǿ+!
management of the information. This programme’s implementation approach will be as much about
advocacy and buy-in as it is about generating knowledge, research insights, and building the technology.
Success will also require working closely with the Legislation, Policy, and Compliance workstream to ensure
the right policies are in place for sharing data securely and safely.
,2+1/6Ȓ6Ȓ ,2+1/6--/, %Ǿ20&+$ 0+! ,+02)11&3"*""1&+$0Ǿ4&))"1("+1,")& &1 ,+ "/+0Ǿ&+-21Ǿ
and approval for the programme. Early adoption from select countries will aid the EAHC’s full adoption across
the EAC by providing a subgroup of intensively reviewed and evaluated implementations to inform further
"5-+0&,+ǽ%" 4&))+""!1,"!"0&$+"!1," ,*-1&)"4&1% ,2+1/60601"*0ǽ
113