Global Perspectives on Digital Health

Overview

We are joined in this episode by Ruchit Nagar, the CEO and Co-Founder of Khushi Baby. For his efforts to deliver scalable public health impact, Ruchit has been recognized as a Forbes 30 under 30 leader in Health Care, a World Innovation Summit in Health Young Innovator, and a Distinguished Young Alumnus by by the Yale School of Public Health

This episode covers into the role of India's Community health workers, or Accredited Social Health Activists (ASHAs). We hear from Ruchit's experience implementing with Khushi baby the challenges of integrating technology to support health workers.

Ruchit also gives us a lowdown on India's digital public health approach and shares his key learnings and insights for people looking to implement tech in rural areas.

We get into the challenges in policy, the data infrastructure layer and the importance of funding for sustainable health initiatives. Ruchit also emphasizes the need for better support and resources for ASHAs, the impact of technology on healthcare delivery, and the necessity of aligning incentives to improve health outcomes.

Chapters

00:00 Intro

03:53 Khushi baby origins

05:10 Challenges in Community Health Delivery

07:18 The Role of ASHAs in Healthcare

12:28 The Need for Integrated Solutions

14:14 India public health digital ecosystem 101

19:51 When "too much digital" gets in the way of good care

22:28 Pitfalls in funding and investment approaches

23:20 The 3 I's that drive implementation success

31:56 Leveraging Data for Health System Strengthening

35:53 Challenges in Health System Integration

41:35 Measuring Impact and Effectiveness

47:44 Aligning Incentives with Ground Realities

53:56 Navigating Quality, Evaluation and Regulatory Challenges

56:48 Future Directions for Khushi Baby

01:02:02 Ruchit's top takeaway for developers

References

Khushi baby website

Book reference: Poor Economics by Abhijit V. Banerjee and Esther Duflo
TB free India 2025

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Implementing a digital mental health solution in Rwanda.
What does real, meaningful co-design look like?
What does it mean to truly engage with a community to develop a solution they actually use and that addresses their problems?
What incentives and mindsets allow us to, instead of 'driving' a certain technology into a context, stop and listen, and go in with no pre-conceived notion of what would be built?
How do we get procurement and policy to really value and elevate equitable solutions?

These are some of the great questions we covered in the latest podcast episode with Dr Jana Alagarajah. His wide experience, and work implementing a digital mental health tool with young people in Rwanda gives us some great talking points. Jana shares what he learned working with people and community leaders, as well as carers, and how they approached co-design and evaluation.

We also talked about his insights from working in partnership with UNICEF, USAID, the King's Fund and Health Foundation.

Dr Jana Alagarajah (MD MPH): Digital mental health specialist, UK-trained public health doctor, and psychiatrist co-designing equitable and impactful digital health innovation in Africa with young people as Technical Lead at YLabs. Partnering with UNICEF, USAID, and Gates Foundation, he leverages digital tools to strengthen health systems.

Linkedin: https://www.linkedin.com/in/janaganalagarajah/

YLabs: https://www.ylabsglobal.org/
Grand Challenges Canada: https://www.grandchallenges.ca/

Key Resources:

• Design:
  • Co-design: YLabs’ Youth-driven approach to digital health focussing on co-designing with youth.
  • Designing for diversity: Importance of co-creating culturally adapted tech to address health inequalities in diverse populations - report from NHS Race and Health Observatory.
  • Regulation: Co-developed Africa’s first evidence-based digital mental health regulation (‘HealthTech Hub Africa Digital Health Policy Blueprint 1.0’) with the Rwandan Ministry of Heath, Africa CDC, Jhpiego, Novartis Foundation covering key design elements such as interoperability, data privacy and UX approaches to meet the needs of diverse populations.
• Implementation:
  • Digital stigma reduction tool: ‘Prepare for a Better Tomorrow’ (Rwanda, 2021): Rwanda’s first youth-driven, holistic digital learning and peer support platform to increase mental health literacy and psychosocial support for Rwandan youth aged 10-19 years old. Funded by Grand Challenges Canada.
  • Digital tools for mental healthcare workers: ‘USAID Kijana Nahodha’ (Tanzania, 2023): digital mental health education and referral tool for community health workers in Tanzania as part of a $5.4M USAID grant, impacting 140,000 youth and 250 community health workers.
• Evaluation:
  • Evidence generation: A systematic literature review evaluating the efficacy of digital mental health technologies for youth in low and middle-income countries: Alagarajah J, Ceccolini D, Butler S. Digital mental health interventions for treating mental disorders in young people based in low-and middle-income countries: A systematic review of the literature. Cambridge Prisms: Global Mental Health. 2024;11:e74. doi:10.1017/gmh.2024.71
  • Innovative approaches to digital evaluation: At YLabs, we have utilized traditional evaluation methodologies such as cluster RCTs to evaluate our digital interventions. However, given the challenges in evaluating digital health solutions, novel methodologies, such as cyclical evaluation, can be used to maximize usability, and support integration into health systems.

Episode 2: Practical Solutions to Health Data Poverty

In this episode, we continue our exploration of health data poverty, showcasing a team that's making a real difference based on the issues discussed in Part 1 with Dr. Xiao Liu.

We're thrilled to have spoken with Prof. Alexandre Filho, a Professor of Machine Learning in Sao Paulo, Brazil. He shared insights on how his team has been maximizing the impact of data-driven technology in Brazil. Prof. Filho's remark, "The world is becoming more like Brazil," sets the stage for a discussion on what the global community can learn from Brazil's approach to data diversity, especially in serving underserved communities.

Key Topics:

• Global Lessons from Local Successes: How Brazil's high-quality, diverse data sets serve as a model for the world.
• Overcoming Data Challenges: Tackling issues with data availability and the performance limitations of algorithms developed in affluent settings when deployed in rural areas.
• Leveraging Local Data: Details on the team's work, including a paper on neonatal mortality prediction using routinely collected data.
• Direct Benefits to Data Providers: Ensuring that those from whom data is collected see benefits from its use.
• Balancing Impact and Scalability: The trade-offs between highly tuned, local solutions and the need for scalable models that perform well across broader contexts.
• Benchmarking for Better Health: Extended efforts in the ITU/WHO focus group on AI for health, evaluating the performance of models across different LMIC settings.
• Advancing Local Impact: The use of transfer learning to enhance model performance and impact locally.
• Prof. Filho’s Recommendations: Key advice for innovators and implementers in the EU, US, and UK.

Guest Bio:
Alexandre Chiavegatto Filho is an Associate Professor of Machine Learning in Healthcare at the Department of Epidemiology, School of Public Health, University of São Paulo. He directs the Laboratory of Big Data and Predictive Analysis in Health (Labdaps), which includes a team of 30 researchers focused on developing AI algorithms to improve healthcare decisions.

Find the team's work on Google Scholar

Welcome to the trailer for the Global Perspectives on Digital Health Podcast.

Join Shubs as he unpacks insights from experts and innovators creating real impact for underserved communities around the world.

Shubs is a physician working in digital health. With experience across product development and deployment, regulation and also with the ITU/WHO focus group AI for healthcare as co-chair of the working group on clinical evaluation Shubs has seen the challenges across the digital and healthcare ecosystem. Join these conversations as he seeks out innovators and experts to unpack what we can do to create real impact for those who need innovation the most around the world. Get a truly global perspective on digital health.

Episode 4: Creating real impact with AI in isolated communities

In this episode, Dino, a pioneer in the digital health landscape, shares his insights on how digital solutions and AI are revolutionizing the healthcare industry. He discusses the critical challenges such as overcrowded healthcare facilities and the urgent need for support for healthcare professionals. Dino’s extensive work at Audere focuses on utilizing digital tools to improve healthcare delivery and outcomes, particularly in underserved communities.

Key Topics:

1. Digital Solutions for Overcrowded Healthcare Facilities: Dino explores how digital health can alleviate pressure on healthcare systems.
2. AI Tools in Healthcare: The role of AI and language models in enhancing diagnostic and conversational capabilities in healthcare settings.
3. Building Trust and Reliability: The importance of trust in technology, especially large language models, and how it's achieved through rigorous data handling and prompt engineering.
4. Partnerships and Local Collaboration: How forming strong local partnerships contributes to the successful implementation of technology solutions in healthcare.
5. Regulatory Support and Technology Verification: The necessity of regulatory backing in ensuring the safety and efficacy of new technologies.

Impactful Insights:

• Improving access to rapid diagnostic testing through digital tools and AI.
• Enhancing patient-provider conversations with advanced language models to make healthcare more accessible and efficient.
• The significance of trust, reliability, and local partnerships in implementing successful digital health solutions.
• Utilization of specific data sets and prompt engineering to enhance the accuracy and relevance of responses from large language models.
• The role of specialization and niche focus in addressing particular healthcare and technology challenges.

Links

• Audere