About this Guidebook

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About Digital Square

Digital Square is a digital health marketplace–or ‘square’–where supply and demand come together to accelerate health equity. We do this by: (1) aligning investors and government bodies around a shared digital health vision based on country needs and priorities; (2) promoting the development, adoption, and reuse of digital public goods for health; and (3) working with regional and country bodies to strengthen national-level digital health governance to support country digital transformation.

Digital Square plays a unique role in the digital health ecosystem, leading as a neutral convenor of donors, government leaders, technical innovators, and entrepreneurs. We advocate for and support global goods, promote open standards and open architecture in health systems design, strengthen regional and national capacity, and support local ownership and decision-making to facilitate the long-term sustainability of digital health solutions.

Since Digital Square launched in 2016, we have partnered with hundreds of stakeholders in local communities across 33 countries to improve how the global community designs, uses, and pays for digital health tools and approaches. Through our Open Application Process, we have approved and supported 36 mature global goods which are accelerating the speed and scale of digital health interventions, growing a dynamic community of technologists who come together to advance digital health solutions.

For more information about Digital Square, visit digitalsquare.org.

What are Global Goods?

Digital Square defines global goods as digital health tools that are adaptable to different countries and contexts to help address key health system challenges. Global goods can take several shapes and forms, often work in conjunction with other global goods, and can fulfill many of the technology needs of a health system. Some of these characteristics are drawn from the Principles for Digital Development.

The advancement of global goods is crucial for saving lives and improving health around the world because these free and open source digital health tools can be used across different countries and health program verticals, cutting down on fragmentation and duplication to accelerate scale and health impact. For example, a global good used for HIV case management can also be used to manage care for malaria or tuberculosis.

Types of Global Goods

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    A software tool that is free, open source, and used to manage, analyze, or transmit health-related data, with proven utility in several settings.

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    A software as a service tool that is used to manage, transmit, or analyze health-related data. This type of tool can be freely accessed and adheres to open data principles.

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    A resource, toolkit, or data standard that is available under an open license and that is used to improve or analyze the capabilities required to manage health data.

Benefits of Global Goods

Since global goods are open source tools, there are multiple benefits to their use:

  • Many developers can contribute to a global good, thereby reducing the risk of vendor lock-in: a situation in which customers are unable to switch providers/developers without a substantial cost.
  • Source code is freely available and modifiable, creating more opportunities for collaboration across organizations and health programs areas.
  • The cost of new feature development and software maintenance is more likely to be shared across users and supporters of global goods, freeing up resources for adaptation and implementation.
  • Software development best practices in requirements gathering and user acceptance testing have already been undertaken, so resources can be focused elsewhere.
  • Interoperability leads to improved data analysis and synthesis, enhanced support for continuity of care as clients engage at multiple points of service across the health care system, and reduced costs for data acquisition and management.
  • Many of the global goods represented in this guidebook already support interoperability standards, in particular the standards identified in the OpenHIE architecture.

How does a digital health tool become a Digital Square global good?

Until now, Digital Square has run specific Notices to identify global goods, the most recent being Notice G0 for software global goods in 2022 and G1 for content global goods in 2023. From February 2024, applicants interested in submitting their digital health tool for consideration as a global good will be able to do so at any time using the Wizehive application portal.

To be considered a global good, applicants must meet certain minimum requirements:

  • Published under an open license such as OSI-Approved licenses or Creative Commons licenses
  • Supported by a strong community with a clear governance structure.
  • Funded by multiple sources.
  • Deployed at significant scale.
  • Used across multiple countries and with demonstrated effectiveness.
  • Software that is designed to be interoperable.

Applicants must fill out the relevant application form and complete a self-assessment using the Digital Square Maturity Model. If you have any questions, you reach out to the Digital Square team at [email protected]. The Peer Review Committee (PRC) reviews all applications and make recommendations. The Global Goods Review Board (GGRB) meets quarterly to consider the PRC’s recommendations and decide whether to accept, reject, or request additional information. All applicants will be notified of the GGRB’s decisions. Successful applicants will be added to the Global Goods Interactive Guidebook and will be publicized through our communication channels.

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Global Goods Product Suites

Digital Square defines product suites as a configuration of open-source technologies and tools that are aligned to meet a functional health domain (such as telemedicine services, primary care,
immunization, antenatal care, neonatal care, etc.) and support standards-based data exchange. A product suite packages digital tools together and exchanges data through appropriate data exchange patterns to achieve a desired set of functionality and outcomes. Product suites may leverage international guidance documents, such as the WHO Digital Adaptation Kits (DAKs), to frame the expected system-wide workflows, features and functional areas. Product suites must:

  • Be comprised of Digital Square approved global goods and/or technologies that meet the definition of a global good. All software components must registered as a Digital Public Good
    or and meet the DPG standard. All software components must be available under an OSI approved open-source license or use this opportunity to become open source.
  • Meet well-defined and documented functional and non-functional requirements to ensure all major functional areas are catered for and core non-functional needs are considered.
  • Support appropriate standards-based data exchange to achieve a fully interoperable solution. Data exchange should be enabled through adherence to globally recognized standards, and
    with the Open Health Information Exchange (OpenHIE) specified workflows where relevant. Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) is the preferred
    open standard and work on product suites should reference and contribute to the development of the WHO L3 work where appropriate. For supply chain systems, the use of the GS1
    standards are preferred.
  • Be aligned with the WHO’s SMART Guidelines (Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable). Ideally, the ultimate vision is that product suites
    should utilize Level Two (L2) (operational) and Level Three (L3) (machine readable) components to produce Level Four (L4) (executable) reference software.our (L4) (executable)
    reference software.
  • Include comprehensive up to date user and technical documentation that is available under an appropriate Creative Commons license.
  • Provide documented evidence of the quality assurance framework used and results of testing.

Linked Registries and Initiatives

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    WHO Digital Health Atlas (DHA)

    The Digital Health Atlas is a WHO global technology registry platform aiming to strengthen the value and impact of digital health investments, improve coordination, and facilitate institutionalization and scale.

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    The Centre for Digital Health Interventions (CDHI) is a joint initiative with an interdisciplinary team of computer and social scientists partners with medical experts to design behavioural, scalable, and self-improving digital health interventions that are effective and cost-efficient.

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    The Digital Public Goods Alliance is a multi-stakeholder initiative to accelerate the attainment of the sustainable development goals in low- and middle-income countries by facilitating the discovery, development, use of, and investment in digital public goods.

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    The DIAL Impact Exchange enables digital change-makers to connect, collaborate, and exchange tools and best practices in the collective pursuit of the Sustainable Development Goals.

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    A Partnerships for Scale Programme designed to find, match, and connect ready-to-scale digital solutions with the urgent needs of UNDP Country Offices and governments in 170 countries.

Global Goods vs DPGs

In short, all global goods are digital public goods, but not all digital public goods are global goods.

  • Digital public goods (DPGs) are open source software, open data, open artificial intelligence (AI) models, open standards, and open content that adhere to privacy and other applicable laws and best practices, do no harm by design, and help attain the 17 Sustainable Development Goals (SDGs) across many sectors including health, agriculture, education, finance, climate, etc.
  • Many developers can contribute to a global good, thereby reducing the risk of vendor lock-in: a situation in which customers are unable to switch providers/developers without a substantial cost.
  • Digital Square global goods have a close relationship to DPGs: they must also meet the nine indicators outlined in the DPG Standard.
  • Digital Square exclusively evaluates solutions relevant to the health sector whereas DPGs are for all SDGs and across multiple sectors.
  • Digital Square facilitates a peer review process that assesses maturity across several criteria that is essential to “awarding” the title of Digital Square global good. In contrast, DPGs have no maturity requirement.
  • While Digital Square closely coordinates with the Digital Public Goods Alliance (DPGA) to align the approval processes for global goods and DPGs, a DPG nominee may not be approved by the DPGA, but could still be approved as a Digital Square global good.

How does the World Health Organization classification of health systems apply to global goods?

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    A digital health intervention represents a discrete area of functionality of a technology to achieve health sector objectives. These interventions are intended for different users, including clients, healthcare providers, health system or resource managers, and those involved in data services.

    Examples of digital health interventions include “Transmit targeted alerts and reminders to client(s)” and “Manage inventory and distribution of health commodities.”

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    System Categories

    Software solutions in digital health are not limited to clinical information systems. Rather, they can be tailored to the needs of different domains, or categories, within a health system—such as health information systems, supply chains, program monitoring and evaluation, disease surveillance, and health insurance.

    Examples of software solutions designed for system categories and taken from Digital Square’s portfolio of global goods include: OpenLMIS, a logistics management information system (LMIS); and Bahmni, an open source electronic medical record (EMR).