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Figure 6: Overview of key residual challenges at endline
Malawi,22 investigations conducted for Special Study 1 indicated that over 60% of users continue to experience connectivity challenges, and 70% use their own money to procure internet bundles. ● Ongoing issues of system fragmentation: Successive independent reviews and evaluations continue to highlight issues of fragmentation of the digital health information system, especially at facility and district levels.23 Endline evaluation findings consistently pointed to the need for better donor coordination to limit the data reporting demands of new initiatives, and to ensure compliance with established standards and harmonisation and alignment principles. ● Keeping pace with the multiple challenges of good digital health governance: As discussed in Section 1.3 and Special Study 2, there are key areas of digital health governance that need ongoing attention and investment – with the challenge of optimising the balance between human rights, data protection and public health priorities being a central and cross-cutting concern.
Figure 6: Overview of key residual challenges at endline
22 See: World Bank. (2021). Malawi Economic Monitor: Investing in Digital Transformation. June 2021. 23 See, for example, Vital Wave. (2019). Assessment of EMR Systems in Malawi: Initial Landscape Assessment. Prepared for MoH, Malawi.
