#Ringingthealarm: Chronic “Pilotitis” Stunts Digital Health in Nepal

Abstract

Nepal Health Sector Strategy (NHSS) 2015-2020 aspires to leverage digital health to improve health outcomes for Nepalese citizens. At present, there is a paucity in evidence on digital health projects that have been implemented in Nepal. This study aims to map past and extant digital health projects using Arksey and O'Malley's scoping design framework and assess projects using the World Health Organization (WHO) building blocks of a health systems framework. Our findings shed light on the current actors in the digital health space, the spectrum of health services offered, along with opportunities and challenges to move beyond “pilotitis”. In total, 20 digital health solutions were identified through our review that were implemented between 1993 to 2017. The momentum for digital health projects in Nepal is sporadic but continuous. Overall, digital health solutions in Nepal are limited in scope, focus areas, target audiences and sustainability potential. At the national level, implementation of digital health projects is frayed, issue and organization-centric, and primarily driven by donor or non-governmental organizations. Engaging the private sector, especially telecommunications companies, is an underutilized strategy to move beyond “pilotitis”. Existing pioneers in the space must engage in strategic collaborative partnerships with the private sector or incentivize independent commercial health technology ventures.