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On strengthening digital health systems, disease surveillance, emergency preparedness and response, M&E, and what working inside these systems actually teaches you.
Featured Series
Nine essays on what nine years inside WHO Nigeria and Nigeria's health systems actually teach you: on data, coordination, community, and what persists when the funding ends.
Most global health programmes measure what they do. Results-Based Management demands that they measure what changes because of what they do. That distinction between activity tracking and outcome accountability is the difference that determines whether a programme learns, adapts, and improves, or simply reports and repeats.
Moving immunisation data quality from 54% to 81% across all reporting sites in the WHO polio programmes did not come from training health workers to enter data more carefully. It came from redesigning the system so that poor data quality was harder to produce than good data quality. Data quality is a design problem with a design solution.
The 60% reduction in outbreak confirmation time achieved across WHO programmes in Nigeria did not come from better technology. It came from identifying and fixing the structural failures that were slowing detection, investigation, and response mistakes so common they have become invisible.
The question I ask every time I review a DHIS2 instance: who opens this dashboard at 7am on a Monday morning, and what decision do they need to make within the next hour? If the person who built the dashboard cannot answer that, it is not a decision-support tool. It is a data display.
Africa's healthcare challenges are immense, but so is the opportunity to leapfrog legacy systems with digital-first health innovation. Here's why now.
Lesson 7 of 9: The global polio eradication programme is one of the most complex public health endeavours ever attempted. Working inside it taught me that you cannot solve a systems problem by optimising one part of the system.
More articles in progress. Topics include community health systems, eHealth implementation, and lessons from outbreak response.
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